{"reporting_entity_name":"Blue Cross Blue Shield of North Carolina","reporting_entity_type":"Health Insurance Issuer","plan_name":"ELON UNIVERSITY","plan_id_type":"EIN","plan_id":"560532303","plan_market_type":"Group","last_updated_on":"2026-07-17","version":"2.0.0","out_of_network":[{"name":"Therapeutic Activities","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","description":"Therapeutic Activities","allowed_amounts":[{"tin":[{"type":"ein","value":"55-0796656"}],"service_code":["11"],"billing_class":"Professional","payments":[{"allowed_amount":92.44,"providers":[{"billed_charge":121.8,"npi":[1851958821]},{"billed_charge":174,"npi":[1972349017]}]}]}]}]}