{"reporting_entity_name":"Molina-Healthcare-of-Illinois","reporting_entity_type":"health insurance issuer","last_updated_on":"2026-07-15","version":"2.0.0","provider_references":[{"provider_group_id":212069,"network_name":["IL NETWORK"],"provider_groups":[{"npi":[1376743260],"tin":{"type":"ein","value":"364161801","business_name":"FRIEND FAMILY HEALTH CENTER INC"}},{"npi":[1376743260],"tin":{"type":"ein","value":"","business_name":null}}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"Clinic - General","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0510","description":"Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Free Standing - SNF,NF, or ICF MR or other residential fac","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0525","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Family Practice Clinic","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0523","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - General","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0520","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Home visit by RHC/FQHC practioner","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0522","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Nurse to members house in HH shortage","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0527","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Other Freestanding Clinic","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0529","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - RHC/FQHC at a SNF - Part A covered","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0524","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - RHC/FQHC to other non-RHC/FQHC site","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0528","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Urgent Care Clinic","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0526","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]},{"negotiation_arrangement":"ffs","name":"Freestanding Clinic - Visit by member to RHC/FQHC","billing_code_type":"REV","billing_code_type_version":"2022","billing_code":"0521","description":"Free-Standing Clinic","negotiated_rates":[{"provider_references":[212069],"negotiated_prices":[{"setting":"outpatient","negotiated_type":"negotiated","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","service_code":["11"]}]}]}]}