{
	"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": "80000110",
	"plan_market_type": "group",
	"last_updated_on": "2026-05-08",
	"version": "2.0.1",
	"out_of_network":[{
		"name": "PR CHEST XRAY 2 VIEWS",
		"billing_code_type": "CPT",
		"billing_code_type_version": "2026",
		"billing_code": "71046",
		"description": "Chest Xray 2 Views",
		"allowed_amounts":[{
			"tin": {
				"type": "ein",
				"value": "364779215"
			},
			"service_code": ["09"],
			"billing_class": "professional",
			"payments":[{
				"allowed_amount": 37.94,
				"billing_code_modifier": ["26"],
				"providers":[{
					"billed_charge": 44.64,
					"npi": [1285622175]
				}]
			}]
		}]
	}]
}