{"reporting_entity_name":"Blue Shield of California","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-05-15","version":"2.0.0","provider_references":[{"provider_group_id":3191,"network_name":["H1"],"provider_groups":[{"npi":[1629291810],"tin":{"type":"ein","value":"95-4469504","business_name":"SEOUL MEDICAL GROUP INC"}}]},{"provider_group_id":3192,"network_name":["H1"],"provider_groups":[{"npi":[1811421670],"tin":{"type":"ein","value":"46-5371819","business_name":"EMANATE HEALTH IPA"}}]},{"provider_group_id":3193,"network_name":["H1"],"provider_groups":[{"npi":[1477677961],"tin":{"type":"ein","value":"95-4582615","business_name":"FAMILY CARE SPECIALISTS IPA"}}]},{"provider_group_id":3194,"network_name":["H1"],"provider_groups":[{"npi":[1770655847],"tin":{"type":"ein","value":"33-0556584","business_name":"ALPHA CARE MEDICAL GROUP REGION 5 TEMECULA VALLEY"}}]},{"provider_group_id":3195,"network_name":["H1"],"provider_groups":[{"npi":[1770537466],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":3196,"network_name":["H1"],"provider_groups":[{"npi":[1508502782],"tin":{"type":"ein","value":"87-2160320","business_name":"ADVENTIST HEALTH CARE NETWORK INC"}}]},{"provider_group_id":3197,"network_name":["H1"],"provider_groups":[{"npi":[1003095464],"tin":{"type":"ein","value":"95-2810095","business_name":"ALTAMED HEALTH SERVICES"}}]},{"provider_group_id":3198,"network_name":["H1"],"provider_groups":[{"npi":[1457548091],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":3199,"network_name":["H1"],"provider_groups":[{"npi":[1659312593,1851599369],"tin":{"type":"ein","value":"46-2385459","business_name":"DAVITA HEALTHCARE PARTNERS PLAN INC"}}]},{"provider_group_id":3200,"network_name":["H1"],"provider_groups":[{"npi":[1477760940],"tin":{"type":"ein","value":"95-4385217","business_name":"ALLIED PACIFIC OF CALIF IPA"}}]},{"provider_group_id":3201,"network_name":["H1"],"provider_groups":[{"npi":[1134252802,1881636108],"tin":{"type":"ein","value":"33-0782099","business_name":"SCRIPPS CLINIC MEDICAL GRP"}}]},{"provider_group_id":3202,"network_name":["H1"],"provider_groups":[{"npi":[1609925957,1871607762],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":3203,"network_name":["H1"],"provider_groups":[{"npi":[1922127422],"tin":{"type":"ein","value":"33-0457134","business_name":"SAN DIEGO PHYS MED GRP"}}]},{"provider_group_id":3204,"network_name":["H1"],"provider_groups":[{"npi":[1942799523],"tin":{"type":"ein","value":"33-0676831","business_name":"HOAG CLINIC"}}]},{"provider_group_id":3205,"network_name":["H1"],"provider_groups":[{"npi":[1457548091],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":3206,"network_name":["H1"],"provider_groups":[{"npi":[1851092035],"tin":{"type":"ein","value":"33-0219957","business_name":"PROSPECT MED GRP ORANGE"}}]},{"provider_group_id":3207,"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":3208,"network_name":["H1"],"provider_groups":[{"npi":[1588829006],"tin":{"type":"ein","value":"95-3942828","business_name":"PIH HEALTH PHYSICIANS"}}]},{"provider_group_id":3209,"network_name":["H1"],"provider_groups":[{"npi":[1346252533],"tin":{"type":"ein","value":"33-0073515","business_name":"TORRANCE HEALTH ASSOCIATES"}}]},{"provider_group_id":3210,"network_name":["H1"],"provider_groups":[{"npi":[1902697832],"tin":{"type":"ein","value":"33-4465522","business_name":"RINCON HEALTH NETWORK"}}]},{"provider_group_id":3211,"network_name":["H1"],"provider_groups":[{"npi":[1275657827],"tin":{"type":"ein","value":"47-3366764","business_name":"GEMCARE MEDICAL GROUP INC"}}]},{"provider_group_id":3212,"network_name":["H1"],"provider_groups":[{"npi":[1962442012,1992724959],"tin":{"type":"ein","value":"27-1504911","business_name":"MEMORIALCARE MEDICAL FOUNDATION"}}]},{"provider_group_id":3213,"network_name":["H1"],"provider_groups":[{"npi":[1942293279],"tin":{"type":"ein","value":"95-4714494","business_name":"AXMINSTER MEDICAL GROUP INC"}}]},{"provider_group_id":3214,"network_name":["H1"],"provider_groups":[{"npi":[1750454260],"tin":{"type":"ein","value":"33-0607478","business_name":"PRIMECARE MEDICAL NETWORK INC"}}]},{"provider_group_id":3215,"network_name":["H1"],"provider_groups":[{"npi":[1336438902],"tin":{"type":"ein","value":"81-4542216","business_name":"PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION"}}]},{"provider_group_id":3216,"network_name":["H1"],"provider_groups":[{"npi":[1700803418],"tin":{"type":"ein","value":"34-1996544","business_name":"MERCY MEDICAL GROUP"}}]},{"provider_group_id":3217,"network_name":["H1"],"provider_groups":[{"npi":[1265719033],"tin":{"type":"ein","value":"94-3168453","business_name":"BROWN AND TOLAND PHYSICIANS"}}]},{"provider_group_id":3218,"network_name":["H1"],"provider_groups":[{"npi":[1316219868],"tin":{"type":"ein","value":"45-0518247","business_name":"REDLANDS-YUCAIPA MEDICAL GROUP"}}]},{"provider_group_id":3219,"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":3220,"network_name":["H1"],"provider_groups":[{"npi":[1386721934],"tin":{"type":"ein","value":"33-0865659","business_name":"SEAVIEW IPA PROFESSIONAL CORPORATION"}}]},{"provider_group_id":3221,"network_name":["H1"],"provider_groups":[{"npi":[1710031588],"tin":{"type":"ein","value":"95-4322584","business_name":"PROVIDENCE FACEY MEDICAL FOUNDATION"}}]},{"provider_group_id":3222,"network_name":["H1"],"provider_groups":[{"npi":[1316023013],"tin":{"type":"ein","value":"77-0243333","business_name":"ALLCARE IPA"}}]},{"provider_group_id":3223,"network_name":["H1"],"provider_groups":[{"npi":[1306049226],"tin":{"type":"ein","value":"94-3168453","business_name":"BROWN AND TOLAND PHYSICIANS"}}]},{"provider_group_id":3224,"network_name":["H1"],"provider_groups":[{"npi":[1205167350],"tin":{"type":"ein","value":"27-1504911","business_name":"MEMORIALCARE MEDICAL FOUNDATION"}}]},{"provider_group_id":3225,"network_name":["H1"],"provider_groups":[{"npi":[1902930381],"tin":{"type":"ein","value":"94-3008941","business_name":"SANTA CLARA CNTY IPA"}}]},{"provider_group_id":3226,"network_name":["H1"],"provider_groups":[{"npi":[1487075578,1649503319],"tin":{"type":"ein","value":"27-2767291","business_name":"CHAFFEY MEDICAL GROUP"}}]},{"provider_group_id":3227,"network_name":["H1"],"provider_groups":[{"npi":[1780746610],"tin":{"type":"ein","value":"77-0339753","business_name":"KEY MEDICAL GROUP"}}]},{"provider_group_id":3228,"network_name":["H1"],"provider_groups":[{"npi":[1881720001],"tin":{"type":"ein","value":"95-4582920","business_name":"HERITAGE PROVIDER NETWORK INC"}}]},{"provider_group_id":3229,"network_name":["H1"],"provider_groups":[{"npi":[1912982216],"tin":{"type":"ein","value":"95-1643359","business_name":"ST JOSEPH HOSPITAL"}}]},{"provider_group_id":3230,"network_name":["H1"],"provider_groups":[{"npi":[1144497678],"tin":{"type":"ein","value":"57-1205856","business_name":"DIGNITY HEALTH MEDICAL FOUNDATION"}}]},{"provider_group_id":3231,"network_name":["H1"],"provider_groups":[{"npi":[1477074474],"tin":{"type":"ein","value":"35-2567959","business_name":"DIGNITY HEALTH MEDICAL NETWORK - SANTA CRUZ"}}]},{"provider_group_id":3232,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":3233,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":3234,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":3235,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":3236,"network_name":["H1"],"provider_groups":[{"npi":[1841407665],"tin":{"type":"ein","value":"68-0360801","business_name":"JOHN MUIR PHYSICIAN NETWORK"}}]},{"provider_group_id":3237,"network_name":["H1"],"provider_groups":[{"npi":[1932121514],"tin":{"type":"ein","value":"95-6419205","business_name":"SANSUM CLINIC"}}]}],"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":[3191],"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":[3192],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3193],"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":[3194],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":94.68,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3195],"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":[3196],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":99.06,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3197],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":100.02,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3198],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":102.13,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3199],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":110.72,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3200],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":115.63,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3201],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":115.73,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3202],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":119,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3203],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":124.58,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3204],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":125.11,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3205],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3206],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":134.17,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3207],"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":[3208],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":138.11,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3209],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":138.6,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3210],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":139.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3211],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3212],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":141.53,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3213],"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":[3214],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":144.02,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3215],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":147.39,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3216],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3217],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":148.33,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3218],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":149.9,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3219],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":151.53,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3220],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":153.62,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3221],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":154.01,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3222],"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":[3223],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":157.42,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3224],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":157.55,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3225],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":159.42,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3226],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":166.88,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3227],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":168.05,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3228],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":170.92,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3229],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":176.95,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"institutional"}]},{"provider_references":[3230],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":176.95,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3231],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":191.88,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3232],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":193.46,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3233],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":196.21,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3234],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":196.63,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3235],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":199.43,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3236],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":208.87,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[3237],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":239.62,"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"}]}]}

