{
	"reporting_entity_name": "Hometown Health",
	"reporting_entity_type": "Group Health Plan",
	"issuer_name": "HTH Nevada Department of Corrections",
	"plan_name": "HOMETOWN NEVADA DEPARTMENT OF CORRECTIONS: TPA NEVADA DEPARTMENT OF CORRECTIONS",
	"plan_id_type": "HIOS",
	"plan_id": "80000116",
	"plan_market_type": "group",
	"last_updated_on": "2026-04-08",
	"version": "2.0.1",
	"out_of_network":[{
		"name": "PR SUBSEQUENT HOSPITAL CARE,LEVL II",
		"billing_code_type": "CPT",
		"billing_code_type_version": "2026",
		"billing_code": "99232",
		"description": "Subsequent Hospital Care,Levl II",
		"allowed_amounts":[{
			"tin": {
				"type": "ein",
				"value": "815094291"
			},
			"service_code": ["21"],
			"billing_class": "professional",
			"payments":[{
				"allowed_amount": 0.00,
				"providers":[{
					"billed_charge": 278.00,
					"npi": [1396468344,1699188839,1811420672,1962152454]
				}]
			}]
		}]
	}]
}