{
  "reporting_entity_name": "UMR, INC.",
  "reporting_entity_type": "TPA",
  "last_updated_on": "2020-08-27",
  "version": "1.0.0",
  "out_of_network":[{ 
    "name": "Established Patient Office or Other Outpatient Services",
    "billing_code_type": "CPT",
    "billing_code_type_version": "2020",
    "billing_code": "99214",
    "description": "office or other outpatient visits for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision making of moderate complexity",
    "allowed_amounts": [{
      "tin": {
        "type": "ein",
        "value": "1234567890"
      },
      "service_code": ["01", "02", "03"],
      "billing_class": "professional",
      "payments": [{
        "allowed_amount": 25.00,
        "billing_code_modifier": ["25"],
        "providers": [{
          "billed_charge": 50.00,
          "npi": [1234567891,1234567892,1234567893]
        },{
          "billed_charge": 60.00,
          "npi": [1111111111]
        },{
          "billed_charge": 70.00,
          "npi": [2222222222,3333333333,4444444444,5555555555]
        }]
      }]
    }]
  }]
}