{"reporting_entity_name":"Allegiance Benefit Plan Mgmt","reporting_entity_type":"third party","last_updated_on":"2026-07-28","version":"2.0.0","out_of_network":[{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code":"90837","billing_code_type_version":"2026","description":"PSYTX W PT 60 MINUTES","allowed_amounts":[{"tin":{"type":"npi","value":"991758316"},"service_code":["11"],"billing_class":"professional","setting":"outpatient","payments":[{"allowed_amount":155.00,"billing_code_modifier":["  "],"providers":[{"billed_charge":155.00,"npi":[1417471715]}]}]}]}]}