{"reporting_entity_name":"Northwest Administrators Inc.","reporting_entity_type":"Third Party","plan_id_type":"ein","plan_name":"Printing Specialties and Paper Products","plan_id":"956035137","plan_market_type":"group","last_updated_on":"2026-04-20","version":"1.0.0.0","out_of_network":[{"name":"Chiropractic manipulative treatment (CMT); spinal, 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","description":"Chiropractic manipulative treatment (CMT); spinal, 3-4 regions","allowed_amounts":[{"tin":{"type":"ein","value":"452860804"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1881917300]}]}]},{"tin":{"type":"ein","value":"274501363"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.20,"providers":[{"billed_charge":79.20,"npi":[1487308367]}]}]},{"tin":{"type":"ein","value":"465098700"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1932901329]}]}]},{"tin":{"type":"ein","value":"843154967"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1558548677]}]}]},{"tin":{"type":"ein","value":"605748373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":55.00,"providers":[{"billed_charge":55.00,"npi":[1982168977]}]}]},{"tin":{"type":"ein","value":"834449661"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":96.65,"providers":[{"billed_charge":104.00,"npi":[1932673647]}]}]}]},{"name":"Partial hospitalization services, less than 24 hours, per diem (Not payable by Medicare)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0201","description":"Partial hospitalization services, less than 24 hours, per diem (Not payable by Medicare)","allowed_amounts":[{"tin":{"type":"ein","value":"852038045"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":3494.94,"providers":[{"billed_charge":3800.00,"npi":[1053088336,0]}]}]}]}]}