{"reporting_entity_name": "Imagine360", "reporting_entity_type": "Third party administrator", "last_updated_on": "2026-04-23", "version": "1.0.0", "out_of_network": [{"name": "ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES", "billing_code_type": "CPT", "billing_code_type_version": "1.0.0", "billing_code": "99423", "description": "ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "81-1884841"}, "service_code": ["12"], "billing_class": "professional", "payments": [{"allowed_amount": 48.49, "providers": [{"billed_charge": 51.61, "npi": [0]}]}]}]}]}