{
  "reporting_entity_name": "UMR, Inc.",
  "reporting_entity_type": "TPA",
  "last_updated_on": "2022-08-01",
  "version": "1.0.0",
  "out_of_network": [
    {
      "name": "SBSQ HOSPITAL CARE/DAY 25 MINUTES",
      "billing_code_type": "CPT",
      "billing_code_type_version": "2022",
      "billing_code": "99232",
      "description": "Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.",
      "allowed_amounts": [
        {
          "tin": {
            "type": "ein",
            "value": "843933901"
          },
          "service_code": [
            "21"
          ],
          "billing_class": "professional",
          "payments": [
            {
              "allowed_amount": 221.00,
              "providers": [
                {
                  "billed_charge": 221.00,
                  "npi": [
                    1194363135
                  ]
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "name": "SBSQ HOSPITAL CARE/DAY 35 MINUTES",
      "billing_code_type": "CPT",
      "billing_code_type_version": "2022",
      "billing_code": "99233",
      "description": "Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.",
      "allowed_amounts": [
        {
          "tin": {
            "type": "ein",
            "value": "843933901"
          },
          "service_code": [
            "21"
          ],
          "billing_class": "professional",
          "payments": [
            {
              "allowed_amount": 319.00,
              "providers": [
                {
                  "billed_charge": 319.00,
                  "npi": [
                    1194363135
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}