{
  "reporting_entity_name": "RGA",
  "reporting_entity_type": "THIRD PARTY ADMINISTRATOR",
  "issuer_name": "Regence Group Administrators",
  "plan_sponsor_name": "OAK HARBOR FREIGHT LINES",
  "plan_name": "** OAK HARBOR - HDPPO (PPO), OAK HARBOR FREIGHT LINES",
  "plan_id_type": "ein",
  "plan_id": "910909217",
  "plan_market_type": "group",
  "last_updated_on": "2026-11-05",
  "version": "2.0.0",
  "out_of_network": [
    {
      "name": "ALCOHOL AND/OR DRUG SERVICES",
      "billing_code_type": "HCPCS",
      "billing_code_type_version": "2026",
      "billing_code": "H0020",
      "description": "ALCOHOL AND/OR DRUG SERVICES",
      "allowed_amounts": [
        {
          "tin": {
            "type": "ein",
            "value": "911488160"
          },
          "service_code": ["22"],
          "billing_class": "professional",
          "payments": [
            {
              "allowed_amount": 35.28,
              "providers": [
                {
                  "billed_charge": 35.28,
                  "npi": [1639822786]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}