{"reporting_entity_name":"Blue Cross Blue Shield of North Carolina","reporting_entity_type":"Health Insurance Issuer","plan_name":"Blue Local Bronze 7000 with Atrium Health","plan_id_type":"HIOS","plan_id":"11512NC0410046","plan_market_type":"Individual","last_updated_on":"2026-06-17","version":"2.0.0","out_of_network":[{"name":"Docrev Cur Meds By Elig Clin","billing_code_type":"HCPCS","billing_code_type_version":"2025","billing_code":"G8427","description":"Docrev Cur Meds By Elig Clin","allowed_amounts":[{"tin":[{"type":"ein","value":"58-1728803"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1396368205,1508814633]}]}]},{"tin":[{"type":"ein","value":"56-0928089"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1245461128,1720461544,1801324686,1851351951]}]}]}]},{"name":"Pre-Prxd Rsk Et Al DOCD","billing_code_type":"CPT","billing_code_type_version":"2025","billing_code":"3017F","description":"Pre-Prxd Rsk Et Al DOCD","allowed_amounts":[{"tin":[{"type":"ein","value":"56-0928089"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1245461128,1720461544,1801324686,1851351951]}]}]},{"tin":[{"type":"ein","value":"58-1728803"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1396368205,1508814633]}]}]}]},{"name":"Docrev Cur Meds By Elig Clin","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8427","description":"Docrev Cur Meds By Elig Clin","allowed_amounts":[{"tin":[{"type":"ein","value":"84-4067176"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1528773181]}]}]},{"tin":[{"type":"ein","value":"46-0682600"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1881879310]}]}]},{"tin":[{"type":"ein","value":"56-0928089"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1235514340,1568968881,1578991576,1609201748,1720461544,1801026810,1902838006]}]}]},{"tin":[{"type":"ein","value":"58-1728803"}],"service_code":["10","11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1194221929,1245298249,1326744145,1336111301,1427791979,1508321043,1578511911,1598437121,1619228632,1831119098,1902589310]}]}]}]},{"name":"Pre-Prxd Rsk Et Al DOCD","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3017F","description":"Pre-Prxd Rsk Et Al DOCD","allowed_amounts":[{"tin":[{"type":"ein","value":"46-0682600"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1881879310]}]}]},{"tin":[{"type":"ein","value":"58-1728803"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1245298249,1326744145,1336111301,1427791979,1578511911,1598437121,1619228632]}]}]},{"tin":[{"type":"ein","value":"56-0928089"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1235514340,1568968881,1609201748,1801026810,1902838006]}]}]},{"tin":[{"type":"ein","value":"84-4067176"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":0,"providers":[{"billed_charge":0,"npi":[1528773181]}]}]}]}]}