{"reporting_entity_name":"Molina-Healthcare-of-Florida","reporting_entity_type":"health insurance issuer","last_updated_on":"2026-08-07","version":"2.0.0","provider_references":[{"provider_group_id":215480,"network_name":["IN NETWORK"],"provider_groups":[{"npi":[1164163812,1578985792,1699905240,1861485112,1891154167,1962019232],"tin":{"type":"ein","value":"650950817","business_name":"WOUND TECHNOLOGY NETWORK INC"}}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99334","description":"DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["32"]}]}]},{"negotiation_arrangement":"ffs","name":"DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99328","description":"DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["32"]}]}]},{"negotiation_arrangement":"ffs","name":"HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99349","description":"HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["12","13","32"]}]}]},{"negotiation_arrangement":"ffs","name":"HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99349","description":"HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["12","13","32"]}]}]},{"negotiation_arrangement":"ffs","name":"HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99349","description":"HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["12","13","32"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE OUTPATIENT NEW 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99204","description":"OFFICE OUTPATIENT NEW 45 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE OUTPATIENT VISIT 5 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99211","description":"OFFICE OUTPATIENT VISIT 5 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99211","description":"OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99211","description":"OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99204","description":"OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99309","description":"SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["31"]}]}]},{"negotiation_arrangement":"ffs","name":"SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":null,"billing_code":"99309","description":"SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["31"]}]}]},{"negotiation_arrangement":"ffs","name":"SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99309","description":"SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES","negotiated_rates":[{"provider_references":[215480],"negotiated_prices":[{"setting":"inpatient","negotiated_type":"FLATRATE","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"Professional","service_code":["31"]}]}]}]}