{"reporting_entity_name":"Blue Shield of California","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-02-13","version":"2.0.0","provider_references":[{"provider_group_id":1088,"network_name":["H1"],"provider_groups":[{"npi":[1982880118],"tin":{"type":"ein","value":"26-1766141","business_name":"SUPERIOR CHOICE MEDICAL GROUP"}}]},{"provider_group_id":1089,"network_name":["H1"],"provider_groups":[{"npi":[1124172358],"tin":{"type":"ein","value":"95-4365761","business_name":"ASSOCIATED HISPANIC PHYS IPA"}}]},{"provider_group_id":1090,"network_name":["H1"],"provider_groups":[{"npi":[1275655250],"tin":{"type":"ein","value":"95-3846788","business_name":"PREMIER PHYSICIANS NETWORK"}}]},{"provider_group_id":1091,"network_name":["H1"],"provider_groups":[{"npi":[1619049798],"tin":{"type":"ein","value":"33-0664380","business_name":"FAMILY CHOICE MEDICAL GROUP"}}]},{"provider_group_id":1092,"network_name":["H1"],"provider_groups":[{"npi":[1619187978],"tin":{"type":"ein","value":"95-4535099","business_name":"ANGELES IPA"}}]},{"provider_group_id":1093,"network_name":["H1"],"provider_groups":[{"npi":[1790730786],"tin":{"type":"ein","value":"33-0204654","business_name":"CHINO MEDICAL GROUP INC"}}]},{"provider_group_id":1094,"network_name":["H1"],"provider_groups":[{"npi":[1629291810],"tin":{"type":"ein","value":"95-4469504","business_name":"SEOUL MEDICAL GROUP INC"}}]},{"provider_group_id":1095,"network_name":["H1"],"provider_groups":[{"npi":[1801848452],"tin":{"type":"ein","value":"33-0674406","business_name":"DESERT VALLEY MEDICAL GROUP"}}]},{"provider_group_id":1096,"network_name":["H1"],"provider_groups":[{"npi":[1518114677],"tin":{"type":"ein","value":"33-0573709","business_name":"PROMISECARE MEDICAL GRP INC - HEMET COMMUNITY MEDICAL G"}}]},{"provider_group_id":1097,"network_name":["H1"],"provider_groups":[{"npi":[1093844656],"tin":{"type":"ein","value":"95-4457453","business_name":"BELLA VISTA MEDICAL GROUP IPA"}}]},{"provider_group_id":1098,"network_name":["H1"],"provider_groups":[{"npi":[1164552378],"tin":{"type":"ein","value":"95-4730100","business_name":"CENTINELA VALLEY IPA"}}]},{"provider_group_id":1099,"network_name":["H1"],"provider_groups":[{"npi":[1043433220],"tin":{"type":"ein","value":"33-0548927","business_name":"AMVI MEDICAL GROUP"}}]},{"provider_group_id":1100,"network_name":["H1"],"provider_groups":[{"npi":[1225172984],"tin":{"type":"ein","value":"95-4729595","business_name":"ST VINCENT IPA MED CORP"}}]},{"provider_group_id":1101,"network_name":["H1"],"provider_groups":[{"npi":[1477677961],"tin":{"type":"ein","value":"95-4582615","business_name":"FAMILY CARE SPECIALISTS IPA"}}]},{"provider_group_id":1102,"network_name":["H1"],"provider_groups":[{"npi":[1376583344],"tin":{"type":"ein","value":"33-0184827","business_name":"PREMIER HEALTH PLAN SERVICES INC"}}]},{"provider_group_id":1103,"network_name":["H1"],"provider_groups":[{"npi":[1457548604],"tin":{"type":"ein","value":"95-4449869","business_name":"OMNICARE MEDICAL GROUP"}}]},{"provider_group_id":1104,"network_name":["H1"],"provider_groups":[{"npi":[1275655250],"tin":{"type":"ein","value":"95-3846788","business_name":"PREMIER PHYSICIANS NETWORK"}}]},{"provider_group_id":1105,"network_name":["H1"],"provider_groups":[{"npi":[1225080864],"tin":{"type":"ein","value":"95-4337143","business_name":"HISPANIC PHYSICIANS IPA"}}]},{"provider_group_id":1106,"network_name":["H1"],"provider_groups":[{"npi":[1821018433],"tin":{"type":"ein","value":"33-0455953","business_name":"CORWIN MEDICAL GROUP IPA INC"}},{"npi":[1801929757],"tin":{"type":"ein","value":"95-4298276","business_name":"HEALTHCARE L A INC"}}]},{"provider_group_id":1107,"network_name":["H1"],"provider_groups":[{"npi":[1619190881],"tin":{"type":"ein","value":"33-0608012","business_name":"FAMILY HEALTH ALLIANCE"}}]},{"provider_group_id":1108,"network_name":["H1"],"provider_groups":[{"npi":[1770655847],"tin":{"type":"ein","value":"33-0556584","business_name":"ALPHA CARE MEDICAL GROUP"}}]},{"provider_group_id":1109,"network_name":["H1"],"provider_groups":[{"npi":[1821018433],"tin":{"type":"ein","value":"33-0455953","business_name":"CORWIN MEDICAL GROUP IPA INC"}}]},{"provider_group_id":1110,"network_name":["H1"],"provider_groups":[{"npi":[1326171265],"tin":{"type":"ein","value":"95-4439760","business_name":"GLOBAL CARE MEDICAL GRP INC"}}]},{"provider_group_id":1111,"network_name":["H1"],"provider_groups":[{"npi":[1770537466],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":1112,"network_name":["H1"],"provider_groups":[{"npi":[1881805349],"tin":{"type":"ein","value":"95-4827390","business_name":"NOBLE AMA IPA"}}]},{"provider_group_id":1113,"network_name":["H1"],"provider_groups":[{"npi":[1811421670],"tin":{"type":"ein","value":"46-5371819","business_name":"EMANATE HEALTH IPA"}}]},{"provider_group_id":1114,"network_name":["H1"],"provider_groups":[{"npi":[1508502782],"tin":{"type":"ein","value":"87-2160320","business_name":"ADVENTIST HEALTH CARE NETWORK INC"}}]},{"provider_group_id":1115,"network_name":["H1"],"provider_groups":[{"npi":[1457548091,1790561405],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":1116,"network_name":["H1"],"provider_groups":[{"npi":[1124027529],"tin":{"type":"ein","value":"95-4634826","business_name":"GREATER COVINA MEDICAL GROUP INC"}}]},{"provider_group_id":1117,"network_name":["H1"],"provider_groups":[{"npi":[1427093236],"tin":{"type":"ein","value":"95-4786125","business_name":"SERRA COMMUNITY MEDICAL CLINIC INC"}}]},{"provider_group_id":1118,"network_name":["H1"],"provider_groups":[{"npi":[1114212685],"tin":{"type":"ein","value":"95-4367156","business_name":"CITRUS VALLEY PHYS GRP"}}]},{"provider_group_id":1119,"network_name":["H1"],"provider_groups":[{"npi":[1730794124],"tin":{"type":"ein","value":"85-2937808","business_name":"ELITE PHYSICIANS GROUP"}}]},{"provider_group_id":1120,"network_name":["H1"],"provider_groups":[{"npi":[1942398482],"tin":{"type":"ein","value":"33-0698548","business_name":"LASALLE MEDICAL ASSOCIATES"}}]},{"provider_group_id":1121,"network_name":["H1"],"provider_groups":[{"npi":[1477760940],"tin":{"type":"ein","value":"95-4385217","business_name":"ALLIED PACIFIC OF CALIF IPA"}}]},{"provider_group_id":1122,"network_name":["H1"],"provider_groups":[{"npi":[1003095464],"tin":{"type":"ein","value":"95-2810095","business_name":"ALTAMED HEALTH SERVICES"}}]},{"provider_group_id":1123,"network_name":["H1"],"provider_groups":[{"npi":[1528279080],"tin":{"type":"ein","value":"33-0845270","business_name":"GREATER TRI CITIES IPA"}}]},{"provider_group_id":1124,"network_name":["H1"],"provider_groups":[{"npi":[1235502360],"tin":{"type":"ein","value":"46-3096217","business_name":"PROSPECT HEALTH PLAN"}}]},{"provider_group_id":1125,"network_name":["H1"],"provider_groups":[{"npi":[1124149612],"tin":{"type":"ein","value":"33-0219957","business_name":"PROSPECT MED GRP ORANGE"}}]},{"provider_group_id":1126,"network_name":["H1"],"provider_groups":[{"npi":[1235502360],"tin":{"type":"ein","value":"46-3096217","business_name":"PROSPECT HEALTH PLAN"}}]},{"provider_group_id":1127,"network_name":["H1"],"provider_groups":[{"npi":[1457548091],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":1128,"network_name":["H1"],"provider_groups":[{"npi":[1922127422],"tin":{"type":"ein","value":"33-0457134","business_name":"SAN DIEGO PHYS MED GRP"}}]},{"provider_group_id":1129,"network_name":["H1"],"provider_groups":[{"npi":[1790122083],"tin":{"type":"ein","value":"45-2805224","business_name":"SAINT AGNES MEDICAL GROUP INC"}}]},{"provider_group_id":1130,"network_name":["H1"],"provider_groups":[{"npi":[1689797342],"tin":{"type":"ein","value":"33-0724304","business_name":"PHYSICIAN CHOICE MED GRP OF SAN LUIS OBISPO"}}]},{"provider_group_id":1131,"network_name":["H1"],"provider_groups":[{"npi":[1841290228],"tin":{"type":"ein","value":"33-0587660","business_name":"MONARCH HEALTHCARE A MEDICAL GROUP INC"}}]},{"provider_group_id":1132,"network_name":["H1"],"provider_groups":[{"npi":[1407293814],"tin":{"type":"ein","value":"46-1870181","business_name":"MEMORIALCARE SELECT HEALTH PLAN"}}]},{"provider_group_id":1133,"network_name":["H1"],"provider_groups":[{"npi":[1851092035],"tin":{"type":"ein","value":"33-0219957","business_name":"PROSPECT MED GRP ORANGE"}}]},{"provider_group_id":1134,"network_name":["H1"],"provider_groups":[{"npi":[1942293279],"tin":{"type":"ein","value":"95-4714494","business_name":"AXMINSTER MEDICAL GROUP INC"}}]},{"provider_group_id":1135,"network_name":["H1"],"provider_groups":[{"npi":[1609925957,1871607762],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":1136,"network_name":["H1"],"provider_groups":[{"npi":[1750454260],"tin":{"type":"ein","value":"33-0607478","business_name":"PRIMECARE MEDICAL NETWORK INC"}}]},{"provider_group_id":1137,"network_name":["H1"],"provider_groups":[{"npi":[1902697832],"tin":{"type":"ein","value":"33-4465522","business_name":"RINCON HEALTH NETWORK"}}]},{"provider_group_id":1138,"network_name":["H1"],"provider_groups":[{"npi":[1942799523],"tin":{"type":"ein","value":"33-0676831","business_name":"HOAG CLINIC"}}]},{"provider_group_id":1139,"network_name":["H1"],"provider_groups":[{"npi":[1346252533],"tin":{"type":"ein","value":"33-0073515","business_name":"TORRANCE HEALTH ASSOCIATES"}}]},{"provider_group_id":1140,"network_name":["H1"],"provider_groups":[{"npi":[1316984388],"tin":{"type":"ein","value":"95-4457756","business_name":"CEDARS SINAI HLTH ASSOCS"}}]},{"provider_group_id":1141,"network_name":["H1"],"provider_groups":[{"npi":[1013035716],"tin":{"type":"ein","value":"33-0541971","business_name":"REGENTS OF THE UNIVERSITY OF CALIFORNIA"}},{"npi":[1619431244],"tin":{"type":"ein","value":"38-4101192","business_name":"REGENTS OF THE UNIVERSITY OF CALIFORNIA"}},{"npi":[1578672184],"tin":{"type":"ein","value":"61-1745574","business_name":"REGENTS OF THE UNIVERSITY OF CALIFORNIA"}},{"npi":[1871377333],"tin":{"type":"ein","value":"82-1648830","business_name":"UC SAN DIEGO HEALTH ACCOUNTABLE CARE NETWORK INC"}},{"npi":[1871062927],"tin":{"type":"ein","value":"83-2310783","business_name":"UC SAN DIEGO HEALTH MONICA PERLMAN CLINIC"}}]},{"provider_group_id":1142,"network_name":["H1"],"provider_groups":[{"npi":[1336438902],"tin":{"type":"ein","value":"81-4542216","business_name":"PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION"}}]},{"provider_group_id":1143,"network_name":["H1"],"provider_groups":[{"npi":[1316023013],"tin":{"type":"ein","value":"77-0243333","business_name":"ALLCARE IPA"}}]},{"provider_group_id":1144,"network_name":["H1"],"provider_groups":[{"npi":[1386721934],"tin":{"type":"ein","value":"33-0865659","business_name":"SEAVIEW IPA PROFESSIONAL CORPORATION"}}]},{"provider_group_id":1145,"network_name":["H1"],"provider_groups":[{"npi":[1891175444],"tin":{"type":"ein","value":"94-2722082","business_name":"PHYSICIANS MEDICAL GROUP SAN JOSE"}}]},{"provider_group_id":1146,"network_name":["H1"],"provider_groups":[{"npi":[1659312593,1851599369],"tin":{"type":"ein","value":"46-2385459","business_name":"DAVITA HEALTHCARE PARTNERS PLAN INC"}}]},{"provider_group_id":1147,"network_name":["H1"],"provider_groups":[{"npi":[1275657827],"tin":{"type":"ein","value":"47-3366764","business_name":"GEMCARE MEDICAL GROUP INC"}}]},{"provider_group_id":1148,"network_name":["H1"],"provider_groups":[{"npi":[1184782724],"tin":{"type":"ein","value":"33-0527335","business_name":"PRIMARY CARE ASSOCIATES MEDICAL GROUP IN"}}]},{"provider_group_id":1149,"network_name":["H1"],"provider_groups":[{"npi":[1902903388],"tin":{"type":"ein","value":"95-4142044","business_name":"POMONA VALLEY MED GRP INC DBA PRO MED HLTH NWK"}}]},{"provider_group_id":1150,"network_name":["H1"],"provider_groups":[{"npi":[1518951300,1962442012,1992724959],"tin":{"type":"ein","value":"27-1504911","business_name":"MEMORIALCARE MEDICAL FOUNDATION"}}]},{"provider_group_id":1151,"network_name":["H1"],"provider_groups":[{"npi":[1336280940],"tin":{"type":"ein","value":"33-0372617","business_name":"SHARP COMMUNITY MEDICAL GRP SAN DIEGO"}}]},{"provider_group_id":1152,"network_name":["H1"],"provider_groups":[{"npi":[1710031588],"tin":{"type":"ein","value":"95-4322584","business_name":"PROVIDENCE FACEY MEDICAL FOUNDATION"}}]},{"provider_group_id":1153,"network_name":["H1"],"provider_groups":[{"npi":[1013912641,1275735011,1487768891,1588748073,1609089705,1720196702,1780832972,1831426642],"tin":{"type":"ein","value":"95-4582920","business_name":"HERITAGE PROVIDER NETWORK INC"}}]},{"provider_group_id":1154,"network_name":["H1"],"provider_groups":[{"npi":[1720446255],"tin":{"type":"ein","value":"47-5605950","business_name":"ALL AMERICAN MEDICAL GROUP"}}]},{"provider_group_id":1155,"network_name":["H1"],"provider_groups":[{"npi":[1316023013],"tin":{"type":"ein","value":"77-0243333","business_name":"ALLCARE IPA"}}]},{"provider_group_id":1156,"network_name":["H1"],"provider_groups":[{"npi":[1770614281],"tin":{"type":"ein","value":"77-0440790","business_name":"SANTA BARBARA SELECT IPA MED GRP INC"}}]},{"provider_group_id":1157,"network_name":["H1"],"provider_groups":[{"npi":[1134252802,1881636108],"tin":{"type":"ein","value":"33-0782099","business_name":"SCRIPPS CLINIC MEDICAL GRP"}}]},{"provider_group_id":1158,"network_name":["H1"],"provider_groups":[{"npi":[1487075578,1649503319],"tin":{"type":"ein","value":"27-2767291","business_name":"CHAFFEY MEDICAL GROUP"}},{"npi":[1316219868],"tin":{"type":"ein","value":"45-0518247","business_name":"REDLANDS-YUCAIPA MEDICAL GROUP"}}]},{"provider_group_id":1159,"network_name":["H1"],"provider_groups":[{"npi":[1588829006],"tin":{"type":"ein","value":"95-3942828","business_name":"PIH HEALTH PHYSICIANS"}}]},{"provider_group_id":1160,"network_name":["H1"],"provider_groups":[{"npi":[1730180415],"tin":{"type":"ein","value":"33-0587303","business_name":"RIVERSIDE MEDICAL CLINIC"}}]},{"provider_group_id":1161,"network_name":["H1"],"provider_groups":[{"npi":[1871607762],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":1162,"network_name":["H1"],"provider_groups":[{"npi":[1154440527],"tin":{"type":"ein","value":"33-0616028","business_name":"IMPERIAL COUNTY PHYSICIANS MEDICAL GROUP"}}]},{"provider_group_id":1163,"network_name":["H1"],"provider_groups":[{"npi":[1902930381],"tin":{"type":"ein","value":"94-3008941","business_name":"SANTA CLARA CNTY IPA"}}]},{"provider_group_id":1164,"network_name":["H1"],"provider_groups":[{"npi":[1306049226],"tin":{"type":"ein","value":"94-3168453","business_name":"BROWN AND TOLAND PHYSICIANS"}}]},{"provider_group_id":1165,"network_name":["H1"],"provider_groups":[{"npi":[1205167350],"tin":{"type":"ein","value":"27-1504911","business_name":"MEMORIALCARE MEDICAL FOUNDATION"}}]},{"provider_group_id":1166,"network_name":["H1"],"provider_groups":[{"npi":[1336280940],"tin":{"type":"ein","value":"33-0372617","business_name":"SHARP COMMUNITY MEDICAL GRP SAN DIEGO"}}]},{"provider_group_id":1167,"network_name":["H1"],"provider_groups":[{"npi":[1043427248],"tin":{"type":"ein","value":"95-4377219","business_name":"UCLA MEDICAL GROUP"}}]},{"provider_group_id":1168,"network_name":["H1"],"provider_groups":[{"npi":[1780746610],"tin":{"type":"ein","value":"77-0339753","business_name":"KEY MEDICAL GROUP"}}]},{"provider_group_id":1169,"network_name":["H1"],"provider_groups":[{"npi":[1689708042],"tin":{"type":"ein","value":"94-3192446","business_name":"AFFINITY MED GRP"}}]},{"provider_group_id":1170,"network_name":["H1"],"provider_groups":[{"npi":[1407058787],"tin":{"type":"ein","value":"33-0678022","business_name":"UCI UNIVERSITY PHYSICIANS AND SURGEONS"}}]},{"provider_group_id":1171,"network_name":["H1"],"provider_groups":[{"npi":[1265719033],"tin":{"type":"ein","value":"94-3168453","business_name":"BROWN AND TOLAND PHYSICIANS"}}]},{"provider_group_id":1172,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1173,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1174,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1175,"network_name":["H1"],"provider_groups":[{"npi":[1841277704],"tin":{"type":"ein","value":"95-1684089","business_name":"SCRIPPS HEALTH"}}]},{"provider_group_id":1176,"network_name":["H1"],"provider_groups":[{"npi":[1912982216],"tin":{"type":"ein","value":"95-1643359","business_name":"ST JOSEPH HOSPITAL"}}]},{"provider_group_id":1177,"network_name":["H1"],"provider_groups":[{"npi":[1013950807],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1178,"network_name":["H1"],"provider_groups":[{"npi":[1841407665],"tin":{"type":"ein","value":"68-0360801","business_name":"JOHN MUIR PHYSICIAN NETWORK"}}]},{"provider_group_id":1179,"network_name":["H1"],"provider_groups":[{"npi":[1477074474],"tin":{"type":"ein","value":"35-2567959","business_name":"DIGNITY HEALTH MEDICAL NETWORK - SANTA CRUZ"}}]},{"provider_group_id":1180,"network_name":["H1"],"provider_groups":[{"npi":[1285616177],"tin":{"type":"ein","value":"33-0106028","business_name":"JUSTIN D'AVANZO"}}]},{"provider_group_id":1181,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1182,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1183,"network_name":["H1"],"provider_groups":[{"npi":[1003267196],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1184,"network_name":["H1"],"provider_groups":[{"npi":[1558396986],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1185,"network_name":["H1"],"provider_groups":[{"npi":[1013950807],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1186,"network_name":["H1"],"provider_groups":[{"npi":[1366898538],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1187,"network_name":["H1"],"provider_groups":[{"npi":[1669617197],"tin":{"type":"ein","value":"95-1691313","business_name":"CHILDRENS HOSPITAL SAN DIEGO"}}]},{"provider_group_id":1188,"network_name":["H1"],"provider_groups":[{"npi":[1013950807,1417003195],"tin":{"type":"ein","value":"94-1156581","business_name":"SUTTER BAY MEDICAL FOUNDATION"}}]},{"provider_group_id":1189,"network_name":["H1"],"provider_groups":[{"npi":[1932121514],"tin":{"type":"ein","value":"95-6419205","business_name":"SANSUM CLINIC"}}]},{"provider_group_id":1190,"network_name":["H1"],"provider_groups":[{"npi":[1700803418],"tin":{"type":"ein","value":"34-1996544","business_name":"MERCY MEDICAL GROUP"}}]},{"provider_group_id":1191,"network_name":["H1"],"provider_groups":[{"npi":[1144497678],"tin":{"type":"ein","value":"57-1205856","business_name":"DIGNITY HEALTH MEDICAL FOUNDATION"}}]}],"in_network":[{"negotiation_arrangement":"capitation","name":"PMPM","description":"Per Member Per Month","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","severity_of_illness":"","negotiated_rates":[{"provider_references":[1088],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":60.45,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1089],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1090],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":78.69,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1091],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":81.31,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1092],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":82.39,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1093],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":82.94,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1094],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":83.29,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1095],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":84.38,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1096],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":85.28,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1097],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":86.7,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1098],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1099],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":87.54,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1100],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":87.94,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1101],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.56,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1102],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.63,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1103],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.87,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1104],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1105],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":92.16,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1106],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.01,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1107],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.08,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1108],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.46,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1109],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.99,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1110],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":95.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1111],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":96.42,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1112],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1113],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":100.66,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1114],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":102.12,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1115],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":105.92,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1116],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":106.83,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1117],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":109.78,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1118],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":110.01,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1119],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":111.56,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1120],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":111.74,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1121],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":114.15,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1122],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":119.07,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1123],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":122.84,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1124],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":124.73,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1125],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":125.86,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1126],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":126.54,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1127],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":129.91,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1128],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":134.97,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1129],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":135.07,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1130],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":137.52,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1131],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":139.99,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1132],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":140.87,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1133],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":142.73,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1134],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":142.74,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1135],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":142.75,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1136],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":143.5,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1137],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":143.73,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1138],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":145.51,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1139],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":146.4,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1140],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":150.04,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1141],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":154.51,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1142],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":154.99,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1143],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":155.49,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1144],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":156.73,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1145],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1146],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":159.77,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1147],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":160.07,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1148],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":160.2,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1149],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.45,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1150],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.74,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1151],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.89,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1152],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.96,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1153],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":162.94,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1154],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":163.04,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1155],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":163.67,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1156],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":164.53,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1157],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":165,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1158],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":166.55,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1159],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":167.09,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1160],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":168.85,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1161],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":171.31,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1162],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":172.19,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1163],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":174.19,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1164],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":174.9,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1165],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":180.05,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1166],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":182.64,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1167],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":187.48,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1168],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":187.55,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1169],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":193.84,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1170],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":197.17,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1171],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":197.77,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1172],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":203.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1173],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":209.58,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1174],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":209.69,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1175],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":211.23,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"institutional"}]},{"provider_references":[1176],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":212.26,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"institutional"}]},{"provider_references":[1177],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":215.03,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1178],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":216.26,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1179],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":218.05,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1180],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":218.51,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1181],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":218.77,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1182],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":221.67,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1183],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":224.55,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1184],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":228.4,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1185],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":231.11,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1186],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":232.26,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1187],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":233.2,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1188],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":246.5,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1189],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":247.13,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1190],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":250.3,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1191],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":263.39,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]}],"covered_services":[{"billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","description":"Per Member Per Month"}]}]}