services. (II) Any other extenuating circumstances with respect to the furnishing of such services that relate to the acuity of the individual receiving such services or the complexity of furnishing such services to such individual. (III) The training, education, experience, and quality of the medical personnel that furnished such services. (IV) Ambulance vehicle type, including the clinical capability level of such vehicle. (V) Population density of the pick up location (such as urban, suburban, rural, or frontier). (iv) Prohibition on consideration of billed charges In determining which final offer is the alternative payment amount to be applied with respect to items and services (or air ambulance services) furnished by a provider or facility and included in the request under the IDR process, the certified IDR entity selected under subsection (c)(3) with respect to such request shall not consider the amount that would have been billed by such provider or facility with respect to such items and services had the provisions of section 2799A–1, 2799A–2, or 2799A–4 of the Public Health Service Act (as applicable) not applied. (C) Effects of determination (i) In general A determination of a certified IDR entity under subparagraph (A) shall be binding. (ii) Limitation on certain subsequent IDR claims In the case of a determination of a certified IDR entity under subparagraph (A), with respect to a request submitted under subsection (a)(1)(A) and the two parties involved with such request, the party that submitted such initial request may not submit during the 90-day period following such determination a subsequent request under such subsection involving the same other party to such request with respect to such an item or service (or air ambulance service) that was the subject of such initial request. (D) Costs of independent dispute resolution process In the case of a request made by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering health