{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator", "version": "2.0.0","last_updated_on":"2026-03-04","out_of_network":[{"name":"RESIDENTIAL TREATMENT-PSYCHI","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1001","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"872691481"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":36256.00,"npi":[1598410524]}]}]},{"tin":{"type":"ein","value":"814939539"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":30666.09,"providers":[{"billed_charge":167700.00,"npi":[1275132326]}]},{"allowed_amount":5504.17,"providers":[{"billed_charge":30100.00,"npi":[1912506064]}]}]}]},{"name":"RESIDENTIAL TREATMENT - CHEM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"272229373"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":56062.40,"npi":[1780177378]}]}]},{"tin":{"type":"ein","value":"332430512"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":10999.30,"providers":[{"billed_charge":96000.00,"npi":[1649069162]}]}]},{"tin":{"type":"ein","value":"472687888"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":6439.42,"providers":[{"billed_charge":20375.00,"npi":[1790288009]}]}]},{"tin":{"type":"ein","value":"811576189"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":5495.13,"providers":[{"billed_charge":31844.75,"npi":[1396247003]}]}]},{"tin":{"type":"ein","value":"883742034"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":8712.26,"providers":[{"billed_charge":37800.00,"npi":[1700560695]}]}]},{"tin":{"type":"ein","value":"921756382"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":66400.00,"npi":[1942071642]}]}]},{"tin":{"type":"ein","value":"821318623"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":9435.72,"providers":[{"billed_charge":48000.00,"npi":[1194250258]}]}]},{"tin":{"type":"ein","value":"825046031"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":65600.00,"npi":[1710475231]}]}]},{"tin":{"type":"ein","value":"883954678"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":7076.79,"providers":[{"billed_charge":62100.00,"npi":[1003536830]}]}]},{"tin":{"type":"ein","value":"844192543"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":428676.71,"providers":[{"billed_charge":2383800.00,"npi":[1639719131]}]}]},{"tin":{"type":"ein","value":"920977973"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":786.31,"providers":[{"billed_charge":9200.00,"npi":[1922708395]}]}]},{"tin":{"type":"ein","value":"863506468"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":9435.72,"providers":[{"billed_charge":98400.00,"npi":[1366101289]}]}]},{"tin":{"type":"ein","value":"882987316"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":2358.93,"providers":[{"billed_charge":24900.00,"npi":[1881318624]}]}]},{"tin":{"type":"ein","value":"921890639"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":1572.62,"providers":[{"billed_charge":17500.00,"npi":[1437846656]}]}]},{"tin":{"type":"ein","value":"923811334"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":4717.86,"providers":[{"billed_charge":37200.00,"npi":[1770353526]}]}]},{"tin":{"type":"ein","value":"833689959"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":68393.25,"providers":[{"billed_charge":697000.00,"npi":[1114541547]}]}]}]},{"name":"ROOM-BOARD/SEMI","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"120","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"953522679"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":127555.67,"providers":[{"billed_charge":90383.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":35999.94,"providers":[{"billed_charge":56129.25,"npi":[1114971660]}]}]}]},{"name":"DETOX/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"126","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -DETOXIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"811576189"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":21261.11,"providers":[{"billed_charge":86032.75,"npi":[1396247003]}]}]},{"tin":{"type":"ein","value":"844192543"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":222739.33,"providers":[{"billed_charge":1203500.00,"npi":[1639719131]}]}]},{"tin":{"type":"ein","value":"920977973"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":3931.55,"providers":[{"billed_charge":47500.00,"npi":[1922708395]}]}]},{"tin":{"type":"ein","value":"331670466"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":5504.17,"providers":[{"billed_charge":69300.00,"npi":[1740005453]}]}]},{"tin":{"type":"ein","value":"833689959"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":12580.96,"providers":[{"billed_charge":136000.00,"npi":[1114541547]}]}]},{"tin":{"type":"ein","value":"923554150"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":786.31,"providers":[{"billed_charge":8500.00,"npi":[1053192849]}]}]},{"tin":{"type":"ein","value":"825046031"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":68000.00,"npi":[1710475231]}]}]},{"tin":{"type":"ein","value":"992581521"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3931.55,"providers":[{"billed_charge":42500.00,"npi":[1679309058]}]}]}]},{"name":"PSTAY/WARD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"154","description":"ROOM AND BOARD - WARD -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"883425229"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":21767.27,"providers":[{"billed_charge":44100.00,"npi":[1598455859]}]}]}]},{"name":"REHAB/WARD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"158","description":"ROOM AND BOARD - WARD -REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"811576189"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":6290.48,"providers":[{"billed_charge":52743.50,"npi":[1396247003]}]}]},{"tin":{"type":"ein","value":"844192543"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":28915.20,"providers":[{"billed_charge":92400.00,"npi":[1639719131]}]}]},{"tin":{"type":"ein","value":"365103242"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":35915.86,"providers":[{"billed_charge":136000.00,"npi":[1972351716]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":222.24,"providers":[{"billed_charge":549.00,"npi":[1689608150]}]},{"allowed_amount":72800.58,"providers":[{"billed_charge":157356.00,"npi":[1689608150]}]},{"allowed_amount":2226.10,"providers":[{"billed_charge":12068.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"760385534"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":121.25,"providers":[{"billed_charge":255.20,"npi":[1780655670]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":466.03,"providers":[{"billed_charge":1307.91,"npi":[1811080526]}]},{"allowed_amount":12431.34,"providers":[{"billed_charge":2045.85,"npi":[1811080526]}]},{"allowed_amount":8984.21,"providers":[{"billed_charge":26724.59,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8981.04,"providers":[{"billed_charge":464.95,"npi":[1831188275]}]},{"allowed_amount":15756.02,"providers":[{"billed_charge":1292.49,"npi":[1831188275]}]},{"allowed_amount":248.87,"providers":[{"billed_charge":3659.68,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":641.27,"providers":[{"billed_charge":754.40,"npi":[1427176569]}]},{"allowed_amount":865.17,"providers":[{"billed_charge":1075.85,"npi":[1427176569]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4315.00,"providers":[{"billed_charge":6960.00,"npi":[1639172372]}]},{"allowed_amount":15779.98,"providers":[{"billed_charge":336817.92,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":800358.24,"providers":[{"billed_charge":10694.50,"npi":[1417554528]}]},{"allowed_amount":43142.07,"providers":[{"billed_charge":1923.75,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":167.55,"providers":[{"billed_charge":304.86,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":25952.20,"providers":[{"billed_charge":553.30,"npi":[1043215379]}]},{"allowed_amount":155.96,"providers":[{"billed_charge":1738.45,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":4676.03,"providers":[{"billed_charge":14.70,"npi":[1912914821]}]},{"allowed_amount":15.17,"providers":[{"billed_charge":69930.65,"npi":[1912914821]}]},{"allowed_amount":9720.00,"providers":[{"billed_charge":46.24,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8350.18,"providers":[{"billed_charge":124.93,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":43442.18,"providers":[{"billed_charge":13711.75,"npi":[1114971660]}]},{"allowed_amount":383.54,"providers":[{"billed_charge":21944.27,"npi":[1114971660]}]},{"allowed_amount":24315.03,"providers":[{"billed_charge":4640.00,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12746.35,"providers":[{"billed_charge":19312.65,"npi":[1518951300]}]},{"allowed_amount":599.40,"providers":[{"billed_charge":908.15,"npi":[1518951300]}]}]}]},{"name":"DRUGS/INCIDNT OTHER DX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"254","description":"PHARMACY - DRUGS INCIDENT TO OTHER DIAGNOSTIC SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":15120.00,"providers":[{"billed_charge":153.33,"npi":[1912914821]}]},{"allowed_amount":262.18,"providers":[{"billed_charge":2226.53,"npi":[1912914821]}]},{"allowed_amount":16414.84,"providers":[{"billed_charge":1212.25,"npi":[1912914821]}]},{"allowed_amount":3451.46,"providers":[{"billed_charge":807.04,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":438.12,"providers":[{"billed_charge":1256.13,"npi":[1588908388]}]}]}]},{"name":"IV SOLUTIONS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"258","description":"PHARMACY - IV SOLUTIONS","allowed_amounts":[{"tin":{"type":"ein","value":"746001118"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":62.43,"providers":[{"billed_charge":73.45,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":760.32,"providers":[{"billed_charge":1152.00,"npi":[1518951300]}]},{"allowed_amount":650.63,"providers":[{"billed_charge":985.80,"npi":[1518951300]}]}]}]},{"name":"DRUGS/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"259","description":"PHARMACY - OTHER PHARMACY","allowed_amounts":[{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":4762.76,"providers":[{"billed_charge":129.89,"npi":[1912914821]}]},{"allowed_amount":309.24,"providers":[{"billed_charge":37905.49,"npi":[1912914821]}]},{"allowed_amount":13002.44,"providers":[{"billed_charge":248.92,"npi":[1912914821]}]},{"allowed_amount":8685.94,"providers":[{"billed_charge":105.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":207.90,"providers":[{"billed_charge":1963.98,"npi":[1588908388]}]},{"allowed_amount":87.07,"providers":[{"billed_charge":250.31,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":348.45,"providers":[{"billed_charge":725.67,"npi":[1821159195]}]},{"allowed_amount":766.64,"providers":[{"billed_charge":1853.32,"npi":[1821159195]}]}]}]},{"name":"IV THERAPY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"260","description":"IV THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":341534.99,"providers":[{"billed_charge":76191.50,"npi":[1417554528]}]},{"allowed_amount":464.81,"providers":[{"billed_charge":6464.25,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":18772.87,"providers":[{"billed_charge":4920.00,"npi":[1689608150]}]},{"allowed_amount":17921.05,"providers":[{"billed_charge":10141.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4593.40,"providers":[{"billed_charge":5404.00,"npi":[1174582050]}]},{"allowed_amount":2261.85,"providers":[{"billed_charge":2661.00,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2533.00,"providers":[{"billed_charge":3106.00,"npi":[1811080526]}]},{"allowed_amount":351.80,"providers":[{"billed_charge":2722.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","20"],"billing_class":"institutional","payments":[{"allowed_amount":448.50,"providers":[{"billed_charge":20488.00,"npi":[1912914821]}]},{"allowed_amount":5157.25,"providers":[{"billed_charge":7392.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1273.71,"providers":[{"billed_charge":13784.75,"npi":[1114971660]}]}]}]},{"name":"STERILE SUPPLY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"272","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":613.16,"providers":[{"billed_charge":1886.65,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":42925.01,"providers":[{"billed_charge":10387.90,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":3220.38,"providers":[{"billed_charge":29.04,"npi":[1912914821]}]},{"allowed_amount":1902.54,"providers":[{"billed_charge":41011.71,"npi":[1912914821]}]},{"allowed_amount":4.16,"providers":[{"billed_charge":19155.15,"npi":[1912914821]}]},{"allowed_amount":3407.17,"providers":[{"billed_charge":182.68,"npi":[1912914821]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":41927.70,"providers":[{"billed_charge":41416.98,"npi":[1689608150]}]},{"allowed_amount":110884.25,"providers":[{"billed_charge":52011.05,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"956006143"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":241.66,"providers":[{"billed_charge":320.00,"npi":[1902803315]}]},{"allowed_amount":5294.60,"providers":[{"billed_charge":6670.00,"npi":[1902803315]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":127.71,"providers":[{"billed_charge":12530.00,"npi":[1811080526]}]},{"allowed_amount":7358.06,"providers":[{"billed_charge":9681.00,"npi":[1811080526]}]},{"allowed_amount":3473.98,"providers":[{"billed_charge":27823.27,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":14.01,"providers":[{"billed_charge":42.00,"npi":[1831188275]}]},{"allowed_amount":1079.17,"providers":[{"billed_charge":19392.00,"npi":[1831188275]}]},{"allowed_amount":1265.96,"providers":[{"billed_charge":2878.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3499.91,"providers":[{"billed_charge":7276.23,"npi":[1821159195]}]},{"allowed_amount":250.16,"providers":[{"billed_charge":1443.71,"npi":[1821159195]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1289.18,"providers":[{"billed_charge":24613.57,"npi":[1639172372]}]},{"allowed_amount":1236.10,"providers":[{"billed_charge":3803.36,"npi":[1639172372]}]},{"allowed_amount":11008.83,"providers":[{"billed_charge":33873.41,"npi":[1891940326]}]},{"allowed_amount":609.76,"providers":[{"billed_charge":3050.53,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"270636387"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11.79,"providers":[{"billed_charge":1065.89,"npi":[1114239068]}]},{"allowed_amount":685.59,"providers":[{"billed_charge":11269.17,"npi":[1114239068]}]},{"allowed_amount":53.50,"providers":[{"billed_charge":452.75,"npi":[1467764308]}]}]},{"tin":{"type":"ein","value":"956002748"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":223.67,"providers":[{"billed_charge":343.00,"npi":[1558410217]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9002.17,"providers":[{"billed_charge":25598.00,"npi":[1013514199]}]},{"allowed_amount":47597.64,"providers":[{"billed_charge":45583.11,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"300804393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":57.56,"providers":[{"billed_charge":230.24,"npi":[1043632938]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":74.75,"providers":[{"billed_charge":124.00,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"66000798"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":81.73,"providers":[{"billed_charge":731.00,"npi":[1669466561]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":40.92,"providers":[{"billed_charge":270.00,"npi":[1043215379]}]},{"allowed_amount":25472.05,"providers":[{"billed_charge":4961.00,"npi":[1043215379]}]},{"allowed_amount":1124.64,"providers":[{"billed_charge":18749.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"951903935"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":146.85,"providers":[{"billed_charge":909.00,"npi":[1265433551]}]},{"allowed_amount":377.52,"providers":[{"billed_charge":633.00,"npi":[1265433551]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2324.50,"providers":[{"billed_charge":6639.47,"npi":[1588908388]}]},{"allowed_amount":544.32,"providers":[{"billed_charge":4267.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":6922.46,"providers":[{"billed_charge":400532.99,"npi":[1912914821]}]},{"allowed_amount":15369.58,"providers":[{"billed_charge":7155.00,"npi":[1912914821]}]},{"allowed_amount":5020.53,"providers":[{"billed_charge":1228.00,"npi":[1912914821]}]},{"allowed_amount":3133.94,"providers":[{"billed_charge":7104.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8622.05,"providers":[{"billed_charge":6167.00,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"941603784"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":99.75,"providers":[{"billed_charge":105.00,"npi":[1417901091]}]},{"allowed_amount":885.34,"providers":[{"billed_charge":931.95,"npi":[1417901091]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5265.59,"providers":[{"billed_charge":7978.16,"npi":[1518951300]}]},{"allowed_amount":12155.83,"providers":[{"billed_charge":18418.12,"npi":[1518951300]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"831960549"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":38.35,"providers":[{"billed_charge":22267.46,"npi":[1124596382]}]}]},{"tin":{"type":"ein","value":"760385534"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3207.21,"providers":[{"billed_charge":4009.02,"npi":[1780655670]}]}]},{"tin":{"type":"ein","value":"953782169"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":56.48,"providers":[{"billed_charge":1449.00,"npi":[1407839921]}]},{"allowed_amount":5194.53,"providers":[{"billed_charge":8328.00,"npi":[1407839921]}]},{"allowed_amount":458.00,"providers":[{"billed_charge":3306.00,"npi":[1407839921]}]}]},{"tin":{"type":"ein","value":"956006143"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5585.92,"providers":[{"billed_charge":7450.92,"npi":[1902803315]}]},{"allowed_amount":3870.00,"providers":[{"billed_charge":2030.00,"npi":[1801653969]}]},{"allowed_amount":2849.30,"providers":[{"billed_charge":7910.00,"npi":[1902803315]}]}]},{"tin":{"type":"ein","value":"851634852"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":945.92,"providers":[{"billed_charge":1958.25,"npi":[1033716147]}]},{"allowed_amount":2145.08,"providers":[{"billed_charge":8670.00,"npi":[1033716147]}]}]},{"tin":{"type":"ein","value":"952321136"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18996.72,"providers":[{"billed_charge":39648.85,"npi":[1306890389]}]}]},{"tin":{"type":"ein","value":"951690977"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":381.63,"providers":[{"billed_charge":2539.36,"npi":[1124073366]}]},{"allowed_amount":255.00,"providers":[{"billed_charge":255.00,"npi":[1124073366]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2432.83,"providers":[{"billed_charge":2862.18,"npi":[1427176569]}]},{"allowed_amount":1151.57,"providers":[{"billed_charge":1357.46,"npi":[1427176569]}]}]},{"tin":{"type":"ein","value":"956005217"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":431.12,"providers":[{"billed_charge":1953.00,"npi":[1366419517]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3060.81,"providers":[{"billed_charge":19301.89,"npi":[1821159195]}]},{"allowed_amount":28087.97,"providers":[{"billed_charge":58394.77,"npi":[1821159195]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":23398.57,"providers":[{"billed_charge":377730.26,"npi":[1639172372]}]},{"allowed_amount":19958.91,"providers":[{"billed_charge":61411.56,"npi":[1891940326]}]},{"allowed_amount":26717.77,"providers":[{"billed_charge":90451.11,"npi":[1639172372]}]},{"allowed_amount":62350.38,"providers":[{"billed_charge":113315.20,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5158.71,"providers":[{"billed_charge":9572.50,"npi":[1013514199]}]},{"allowed_amount":29786.62,"providers":[{"billed_charge":95878.66,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"300804393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1903.02,"providers":[{"billed_charge":5080.38,"npi":[1043632938]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1896.32,"providers":[{"billed_charge":9041.00,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"201645949"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2109.87,"providers":[{"billed_charge":9286.42,"npi":[1942269725]}]},{"allowed_amount":2383.23,"providers":[{"billed_charge":10832.64,"npi":[1942269725]}]}]},{"tin":{"type":"ein","value":"954541687"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":8353.31,"providers":[{"billed_charge":980.00,"npi":[1427055839]}]},{"allowed_amount":1226.93,"providers":[{"billed_charge":1506.67,"npi":[1427055839]}]}]},{"tin":{"type":"ein","value":"951903935"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1224.57,"providers":[{"billed_charge":21496.00,"npi":[1265433551]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":139.37,"providers":[{"billed_charge":3900.00,"npi":[1043215379]}]},{"allowed_amount":3360.49,"providers":[{"billed_charge":72524.00,"npi":[1043215379]}]},{"allowed_amount":20687.22,"providers":[{"billed_charge":38611.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":617.21,"providers":[{"billed_charge":1994.00,"npi":[1558080861]}]},{"allowed_amount":14.56,"providers":[{"billed_charge":124.00,"npi":[1821143777]}]},{"allowed_amount":3223.34,"providers":[{"billed_charge":5695.00,"npi":[1821143777]}]},{"allowed_amount":5447.26,"providers":[{"billed_charge":11132.00,"npi":[1477608271]}]},{"allowed_amount":71.76,"providers":[{"billed_charge":138.00,"npi":[1295880912]}]},{"allowed_amount":772.72,"providers":[{"billed_charge":1486.00,"npi":[1013062769]}]},{"allowed_amount":157.91,"providers":[{"billed_charge":812.00,"npi":[1356496772]}]},{"allowed_amount":2670.97,"providers":[{"billed_charge":5404.00,"npi":[1376698043]}]},{"allowed_amount":17299.20,"providers":[{"billed_charge":36040.00,"npi":[1356496772]}]},{"allowed_amount":642.06,"providers":[{"billed_charge":1855.00,"npi":[1144375056]}]},{"allowed_amount":47.54,"providers":[{"billed_charge":84.00,"npi":[1134274897]}]},{"allowed_amount":34.60,"providers":[{"billed_charge":118.00,"npi":[1144375056]}]},{"allowed_amount":911.90,"providers":[{"billed_charge":1649.00,"npi":[1336294040]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":21672.48,"providers":[{"billed_charge":417830.42,"npi":[1912914821]}]},{"allowed_amount":676.51,"providers":[{"billed_charge":4000.68,"npi":[1912914821]}]},{"allowed_amount":7707.84,"providers":[{"billed_charge":17398.00,"npi":[1912914821]}]},{"allowed_amount":3140.41,"providers":[{"billed_charge":43086.20,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22270.63,"providers":[{"billed_charge":33479.54,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":180719.74,"providers":[{"billed_charge":426015.25,"npi":[1114971660]}]},{"allowed_amount":14150.98,"providers":[{"billed_charge":276036.19,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13090.73,"providers":[{"billed_charge":1259.00,"npi":[1689608150]}]},{"allowed_amount":61.99,"providers":[{"billed_charge":79.94,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":322.15,"providers":[{"billed_charge":379.00,"npi":[1174582050]}]},{"allowed_amount":5842.90,"providers":[{"billed_charge":6874.00,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1260.99,"providers":[{"billed_charge":4657.00,"npi":[1811080526]}]},{"allowed_amount":8086.19,"providers":[{"billed_charge":35723.00,"npi":[1811080526]}]},{"allowed_amount":19.31,"providers":[{"billed_charge":12742.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1899.04,"providers":[{"billed_charge":7022.45,"npi":[1831188275]}]},{"allowed_amount":2446.09,"providers":[{"billed_charge":50408.00,"npi":[1831188275]}]},{"allowed_amount":26551.43,"providers":[{"billed_charge":73949.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"330449527"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":59.30,"providers":[{"billed_charge":134.00,"npi":[1528041811]}]},{"allowed_amount":60.00,"providers":[{"billed_charge":821.00,"npi":[1528041811]}]}]},{"tin":{"type":"ein","value":"956002748"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5593.31,"providers":[{"billed_charge":6988.47,"npi":[1558410217]}]},{"allowed_amount":3671.20,"providers":[{"billed_charge":15407.00,"npi":[1558410217]}]}]},{"tin":{"type":"ein","value":"951644036"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":237.48,"providers":[{"billed_charge":879.00,"npi":[1407828429]}]}]},{"tin":{"type":"ein","value":"951115230"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1059.42,"providers":[{"billed_charge":8480.00,"npi":[1407813660]}]},{"allowed_amount":6558.42,"providers":[{"billed_charge":10716.00,"npi":[1407813660]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":11236.52,"providers":[{"billed_charge":68570.04,"npi":[1588908388]}]},{"allowed_amount":23.97,"providers":[{"billed_charge":124.00,"npi":[1588908388]}]},{"allowed_amount":24343.06,"providers":[{"billed_charge":69689.53,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12258.43,"providers":[{"billed_charge":18573.37,"npi":[1518951300]}]},{"allowed_amount":20668.54,"providers":[{"billed_charge":31315.85,"npi":[1518951300]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4088.19,"providers":[{"billed_charge":8973.44,"npi":[1639172372]}]},{"allowed_amount":10204.87,"providers":[{"billed_charge":62718.53,"npi":[1639172372]}]},{"allowed_amount":13559.47,"providers":[{"billed_charge":41721.42,"npi":[1891940326]}]},{"allowed_amount":833.05,"providers":[{"billed_charge":8059.72,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":398.55,"providers":[{"billed_charge":1863.21,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":282.66,"providers":[{"billed_charge":3351.00,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1024.37,"providers":[{"billed_charge":22106.00,"npi":[1114971660]}]},{"allowed_amount":5534.63,"providers":[{"billed_charge":11492.40,"npi":[1114971660]}]},{"allowed_amount":27.91,"providers":[{"billed_charge":2689.50,"npi":[1114971660]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"953782169"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":54.05,"providers":[{"billed_charge":326.00,"npi":[1407839921]}]},{"allowed_amount":238.54,"providers":[{"billed_charge":673.00,"npi":[1407839921]}]}]},{"tin":{"type":"ein","value":"956006143"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":699.81,"providers":[{"billed_charge":965.00,"npi":[1902803315]}]},{"allowed_amount":343.99,"providers":[{"billed_charge":1540.00,"npi":[1902803315]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":453.05,"providers":[{"billed_charge":533.00,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":3496.27,"providers":[{"billed_charge":18137.00,"npi":[1811080526]}]},{"allowed_amount":908.62,"providers":[{"billed_charge":10695.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":23.32,"providers":[{"billed_charge":188.00,"npi":[1831188275]}]},{"allowed_amount":5178.95,"providers":[{"billed_charge":12701.00,"npi":[1831188275]}]},{"allowed_amount":913.55,"providers":[{"billed_charge":11769.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"952321136"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":312.38,"providers":[{"billed_charge":6101.16,"npi":[1306890389]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":125.52,"providers":[{"billed_charge":147.66,"npi":[1427176569]}]},{"allowed_amount":246.74,"providers":[{"billed_charge":290.28,"npi":[1427176569]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":471.22,"providers":[{"billed_charge":1908.97,"npi":[1821159195]}]},{"allowed_amount":4848.01,"providers":[{"billed_charge":10078.85,"npi":[1821159195]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2767.97,"providers":[{"billed_charge":10019.00,"npi":[1639172372]}]},{"allowed_amount":4491.00,"providers":[{"billed_charge":13818.32,"npi":[1891940326]}]},{"allowed_amount":10111.49,"providers":[{"billed_charge":55078.95,"npi":[1639172372]}]},{"allowed_amount":23842.74,"providers":[{"billed_charge":42464.78,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"956002748"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":210.00,"providers":[{"billed_charge":210.00,"npi":[1558410217]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1625.63,"providers":[{"billed_charge":3866.75,"npi":[1013514199]}]},{"allowed_amount":2743.07,"providers":[{"billed_charge":29632.25,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":346.58,"providers":[{"billed_charge":1135.00,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"300804393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":200.10,"providers":[{"billed_charge":1131.20,"npi":[1043632938]}]}]},{"tin":{"type":"ein","value":"201645949"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":319.78,"providers":[{"billed_charge":764.87,"npi":[1942269725]}]},{"allowed_amount":262.75,"providers":[{"billed_charge":1156.46,"npi":[1942269725]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2013.12,"providers":[{"billed_charge":4194.00,"npi":[1356496772]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":50.44,"providers":[{"billed_charge":1551.00,"npi":[1043215379]}]},{"allowed_amount":489.43,"providers":[{"billed_charge":24931.00,"npi":[1043215379]}]},{"allowed_amount":3272.53,"providers":[{"billed_charge":10806.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"951903935"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90.79,"providers":[{"billed_charge":2240.00,"npi":[1265433551]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":39.00,"providers":[{"billed_charge":955.04,"npi":[1912914821]}]},{"allowed_amount":610.12,"providers":[{"billed_charge":7073.40,"npi":[1912914821]}]},{"allowed_amount":1958.46,"providers":[{"billed_charge":50087.28,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5669.00,"providers":[{"billed_charge":16210.76,"npi":[1588908388]}]},{"allowed_amount":25.17,"providers":[{"billed_charge":141.00,"npi":[1588908388]}]},{"allowed_amount":1707.76,"providers":[{"billed_charge":8048.08,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":301.90,"providers":[{"billed_charge":4324.00,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2112.66,"providers":[{"billed_charge":50093.75,"npi":[1114971660]}]},{"allowed_amount":26221.68,"providers":[{"billed_charge":65312.50,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":6177.25,"providers":[{"billed_charge":9359.61,"npi":[1518951300]}]},{"allowed_amount":1399.78,"providers":[{"billed_charge":2120.87,"npi":[1518951300]}]}]}]},{"name":"LAB/BACT-MIRCO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"306","description":"LABORATORY - BACTERIOLOGY & MICROBIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1858.31,"providers":[{"billed_charge":44617.50,"npi":[1639172372]}]},{"allowed_amount":19070.08,"providers":[{"billed_charge":23931.42,"npi":[1639172372]}]},{"allowed_amount":2323.13,"providers":[{"billed_charge":8586.31,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":80.76,"providers":[{"billed_charge":291.00,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"956006143"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":134.81,"providers":[{"billed_charge":170.00,"npi":[1902803315]}]},{"allowed_amount":3296.88,"providers":[{"billed_charge":4435.00,"npi":[1902803315]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":780.18,"providers":[{"billed_charge":1402.00,"npi":[1811080526]}]},{"allowed_amount":1181.86,"providers":[{"billed_charge":5139.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":990.11,"providers":[{"billed_charge":4125.00,"npi":[1831188275]}]},{"allowed_amount":700.51,"providers":[{"billed_charge":2380.20,"npi":[1831188275]}]},{"allowed_amount":3063.48,"providers":[{"billed_charge":4956.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":844.68,"providers":[{"billed_charge":2412.00,"npi":[1588908388]}]},{"allowed_amount":137.98,"providers":[{"billed_charge":392.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":943.35,"providers":[{"billed_charge":17542.69,"npi":[1912914821]}]},{"allowed_amount":104.06,"providers":[{"billed_charge":1930.69,"npi":[1912914821]}]},{"allowed_amount":61.57,"providers":[{"billed_charge":84.00,"npi":[1912914821]}]},{"allowed_amount":4322.76,"providers":[{"billed_charge":2018.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3954.71,"providers":[{"billed_charge":12650.25,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3184.82,"providers":[{"billed_charge":4825.48,"npi":[1518951300]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":288.26,"providers":[{"billed_charge":1330.41,"npi":[1639172372]}]},{"allowed_amount":3326.99,"providers":[{"billed_charge":5606.97,"npi":[1639172372]}]},{"allowed_amount":293.02,"providers":[{"billed_charge":918.04,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4626.45,"providers":[{"billed_charge":2194.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":376.08,"providers":[{"billed_charge":426.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":24.75,"providers":[{"billed_charge":165.00,"npi":[1912914821]}]},{"allowed_amount":30.49,"providers":[{"billed_charge":945.00,"npi":[1912914821]}]},{"allowed_amount":20.86,"providers":[{"billed_charge":945.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":471.15,"providers":[{"billed_charge":1350.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2837.91,"providers":[{"billed_charge":7078.50,"npi":[1114971660]}]},{"allowed_amount":68.21,"providers":[{"billed_charge":1378.25,"npi":[1114971660]}]}]}]},{"name":"LAB/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"309","description":"LABORATORY - OTHER LABORATORY","allowed_amounts":[{"tin":{"type":"ein","value":"770225395"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9.71,"providers":[{"billed_charge":9.71,"npi":[1205852209]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":265.41,"providers":[{"billed_charge":225.74,"npi":[1639172372]}]}]}]},{"name":"PATHOLOGY LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"310","description":"LABORATORY PATHOLOGICAL - GENERAL CLASSIFIATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":16416.30,"providers":[{"billed_charge":30281.00,"npi":[1689608150]}]}]}]},{"name":"PATHOL/HYSTOL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"312","description":"LABORATORY PATHOLOGICAL - HISTOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"951816017"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":326.60,"providers":[{"billed_charge":2545.00,"npi":[1831188275]}]}]}]},{"name":"DX X-RAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"320","description":"RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3543.60,"providers":[{"billed_charge":10903.32,"npi":[1639172372]}]},{"allowed_amount":899.65,"providers":[{"billed_charge":16878.63,"npi":[1639172372]}]},{"allowed_amount":2162.72,"providers":[{"billed_charge":10785.43,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":17388.59,"providers":[{"billed_charge":21614.00,"npi":[1689608150]}]},{"allowed_amount":10749.61,"providers":[{"billed_charge":11890.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":222.84,"providers":[{"billed_charge":3963.00,"npi":[1811080526]}]},{"allowed_amount":2631.43,"providers":[{"billed_charge":11641.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7413.44,"providers":[{"billed_charge":16235.00,"npi":[1043215379]}]},{"allowed_amount":712.61,"providers":[{"billed_charge":3329.00,"npi":[1043215379]}]},{"allowed_amount":573.18,"providers":[{"billed_charge":5760.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3451.20,"providers":[{"billed_charge":7190.00,"npi":[1356496772]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":200.02,"providers":[{"billed_charge":3632.00,"npi":[1912914821]}]},{"allowed_amount":417.10,"providers":[{"billed_charge":4783.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":277.43,"providers":[{"billed_charge":3578.75,"npi":[1114971660]}]},{"allowed_amount":11004.77,"providers":[{"billed_charge":21239.00,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3387.30,"providers":[{"billed_charge":7042.22,"npi":[1821159195]}]},{"allowed_amount":501.94,"providers":[{"billed_charge":2828.19,"npi":[1821159195]}]}]}]},{"name":"DX X-RAY/CHEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"324","description":"RADIOLOGY - DIAGNOSTIC - CHEST X-RAY","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4269.99,"providers":[{"billed_charge":10586.94,"npi":[1639172372]}]},{"allowed_amount":568.04,"providers":[{"billed_charge":5243.40,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":584.49,"providers":[{"billed_charge":643.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":649.00,"providers":[{"billed_charge":2217.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1356.75,"providers":[{"billed_charge":43172.00,"npi":[1912914821]}]},{"allowed_amount":1228.71,"providers":[{"billed_charge":9993.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2176.36,"providers":[{"billed_charge":6226.00,"npi":[1588908388]}]},{"allowed_amount":267.52,"providers":[{"billed_charge":760.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":572.85,"providers":[{"billed_charge":9548.25,"npi":[1114971660]}]},{"allowed_amount":8867.74,"providers":[{"billed_charge":21323.75,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4151.29,"providers":[{"billed_charge":8630.57,"npi":[1821159195]}]}]}]},{"name":"CHEMOTHER/INJ","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"331","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--INJECTED","allowed_amounts":[{"tin":{"type":"ein","value":"952321786"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6232.20,"providers":[{"billed_charge":20246.00,"npi":[1811080526]}]}]}]},{"name":"RADIATION RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"RADIOLOGY--THERAPEUTIC - RADIATION THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5638.53,"providers":[{"billed_charge":20289.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":36380.00,"providers":[{"billed_charge":42800.00,"npi":[1174582050]}]},{"allowed_amount":20842.85,"providers":[{"billed_charge":24521.00,"npi":[1174582050]}]}]}]},{"name":"CHEMOTHERP-IV","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"335","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--IV","allowed_amounts":[{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":48336.97,"providers":[{"billed_charge":248488.75,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1581.65,"providers":[{"billed_charge":1740.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6507.60,"providers":[{"billed_charge":7656.00,"npi":[1174582050]}]},{"allowed_amount":642.60,"providers":[{"billed_charge":756.00,"npi":[1174582050]}]}]}]},{"name":"CT SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"350","description":"CT SCAN - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2223.14,"providers":[{"billed_charge":2427.00,"npi":[1689608150]}]},{"allowed_amount":28254.72,"providers":[{"billed_charge":78619.00,"npi":[1689608150]}]}]}]},{"name":"CT SCAN/HEAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"351","description":"CT SCAN - HEAD SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"953522679"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":1914.22,"providers":[{"billed_charge":5089.00,"npi":[1912914821]}]},{"allowed_amount":732.00,"providers":[{"billed_charge":18088.00,"npi":[1912914821]}]},{"allowed_amount":3759.64,"providers":[{"billed_charge":18933.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7415.50,"providers":[{"billed_charge":29800.00,"npi":[1114971660]}]}]}]},{"name":"CT SCAN/BODY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"CT SCAN - BODY SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9892.13,"providers":[{"billed_charge":44350.62,"npi":[1639172372]}]},{"allowed_amount":7206.98,"providers":[{"billed_charge":31863.49,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3260.91,"providers":[{"billed_charge":7602.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":20902.58,"providers":[{"billed_charge":161372.00,"npi":[1912914821]}]},{"allowed_amount":3608.66,"providers":[{"billed_charge":18604.00,"npi":[1912914821]}]},{"allowed_amount":2685.15,"providers":[{"billed_charge":55039.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2033.13,"providers":[{"billed_charge":5851.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4658.66,"providers":[{"billed_charge":41178.00,"npi":[1114971660]}]},{"allowed_amount":2367.89,"providers":[{"billed_charge":102581.50,"npi":[1114971660]}]},{"allowed_amount":259874.59,"providers":[{"billed_charge":488846.50,"npi":[1114971660]}]}]}]},{"name":"OR SERVICES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"360","description":"OPERATING ROOM SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":188666.93,"providers":[{"billed_charge":287040.51,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":3298.61,"providers":[{"billed_charge":116354.00,"npi":[1114971660]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.08,"providers":[{"billed_charge":229.50,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18.18,"providers":[{"billed_charge":60.00,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":110.91,"providers":[{"billed_charge":330.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"237064656"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":365.84,"providers":[{"billed_charge":374.00,"npi":[1083636294]}]}]},{"tin":{"type":"ein","value":"843172409"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1003437500]}]}]},{"tin":{"type":"ein","value":"202138632"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":199.98,"providers":[{"billed_charge":660.00,"npi":[1780796235]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1858.05,"providers":[{"billed_charge":12586.98,"npi":[1366479099]}]},{"allowed_amount":54.54,"providers":[{"billed_charge":220.22,"npi":[1780620526]}]},{"allowed_amount":69.01,"providers":[{"billed_charge":485.94,"npi":[1619913449]}]}]},{"tin":{"type":"ein","value":"680273974"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":540.55,"providers":[{"billed_charge":569.00,"npi":[1770688129]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":59.08,"providers":[{"billed_charge":90.00,"npi":[1245275106]}]}]},{"tin":{"type":"ein","value":"814698474"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.50,"providers":[{"billed_charge":10.00,"npi":[1861565285]}]}]}]},{"name":"ANESTHESIA","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"370","description":"ANESTHESIA - GENERAL CLASSIFICATIION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":19883.48,"providers":[{"billed_charge":41537.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":587.39,"providers":[{"billed_charge":1431.00,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":985.70,"providers":[{"billed_charge":36102.75,"npi":[1114971660]}]}]}]},{"name":"ULTRASOUND","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"402","description":"OTHER IMAGING SERVICES - ULTRASOUND","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1498.03,"providers":[{"billed_charge":7271.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":257.84,"providers":[{"billed_charge":2572.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3281.88,"providers":[{"billed_charge":7474.75,"npi":[1114971660]}]}]}]},{"name":"PHYSICAL THERP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"420","description":"PHYSICAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"951643989"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":231.90,"providers":[{"billed_charge":669.80,"npi":[1952777245]}]}]}]},{"name":"EGD DIAGNOSTIC BRUSH WASH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"43235","description":"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY ","allowed_amounts":[{"tin":{"type":"ein","value":"954722860"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":4253.93,"providers":[{"billed_charge":8000.00,"npi":[1679650675]}]}]}]},{"name":"EGD BIOPSY SINGLE/MULTIPLE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"43239","description":"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE","allowed_amounts":[{"tin":{"type":"ein","value":"954722860"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":2843.35,"providers":[{"billed_charge":4200.00,"npi":[1679650675]}]}]}]},{"name":"EMERG ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"831960549"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31129.30,"providers":[{"billed_charge":108427.27,"npi":[1124596382]}]}]},{"tin":{"type":"ein","value":"760385534"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":36378.55,"providers":[{"billed_charge":64462.97,"npi":[1780655670]}]}]},{"tin":{"type":"ein","value":"952321136"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":27215.68,"providers":[{"billed_charge":50815.37,"npi":[1306890389]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":40082.78,"providers":[{"billed_charge":47156.18,"npi":[1427176569]}]}]},{"tin":{"type":"ein","value":"956005217"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9636.69,"providers":[{"billed_charge":26195.00,"npi":[1366419517]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":257832.74,"providers":[{"billed_charge":536488.22,"npi":[1821159195]}]},{"allowed_amount":12687.31,"providers":[{"billed_charge":26376.94,"npi":[1821159195]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":27921.44,"providers":[{"billed_charge":206840.25,"npi":[1639172372]}]},{"allowed_amount":365569.56,"providers":[{"billed_charge":682279.96,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":190708.56,"providers":[{"billed_charge":275750.00,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"201645949"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2400.85,"providers":[{"billed_charge":10567.14,"npi":[1942269725]}]},{"allowed_amount":16794.72,"providers":[{"billed_charge":30962.24,"npi":[1942269725]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11439.28,"providers":[{"billed_charge":22652.00,"npi":[1477608271]}]},{"allowed_amount":103965.12,"providers":[{"billed_charge":216594.00,"npi":[1356496772]}]}]},{"tin":{"type":"ein","value":"951903935"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":6561.00,"providers":[{"billed_charge":11001.00,"npi":[1265433551]}]},{"allowed_amount":41118.57,"providers":[{"billed_charge":82649.00,"npi":[1265433551]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":75631.10,"providers":[{"billed_charge":124720.00,"npi":[1043215379]}]},{"allowed_amount":919.21,"providers":[{"billed_charge":16413.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":41061.06,"providers":[{"billed_charge":157809.00,"npi":[1912914821]}]},{"allowed_amount":15812.91,"providers":[{"billed_charge":103068.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330528802"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1508.49,"providers":[{"billed_charge":3537.00,"npi":[1699868398]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9932.80,"providers":[{"billed_charge":87247.00,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":18326.10,"providers":[{"billed_charge":295314.25,"npi":[1114971660]}]},{"allowed_amount":660364.13,"providers":[{"billed_charge":1387173.50,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":112638.66,"providers":[{"billed_charge":224413.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3955.11,"providers":[{"billed_charge":12535.00,"npi":[1811080526]}]},{"allowed_amount":46971.59,"providers":[{"billed_charge":88976.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":85889.74,"providers":[{"billed_charge":234275.00,"npi":[1831188275]}]},{"allowed_amount":2023.74,"providers":[{"billed_charge":6976.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"270636387"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13352.84,"providers":[{"billed_charge":24059.18,"npi":[1114239068]}]}]},{"tin":{"type":"ein","value":"956002748"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13091.56,"providers":[{"billed_charge":25513.00,"npi":[1558410217]}]}]},{"tin":{"type":"ein","value":"951644036"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9275.57,"providers":[{"billed_charge":44749.31,"npi":[1407828429]}]}]},{"tin":{"type":"ein","value":"951115230"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3451.60,"providers":[{"billed_charge":12347.00,"npi":[1407813660]}]},{"allowed_amount":1761.07,"providers":[{"billed_charge":4710.00,"npi":[1407813660]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":106651.30,"providers":[{"billed_charge":305351.00,"npi":[1588908388]}]},{"allowed_amount":8476.36,"providers":[{"billed_charge":30660.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"951183919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4570.21,"providers":[{"billed_charge":17285.00,"npi":[1780681189]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8954.79,"providers":[{"billed_charge":13567.87,"npi":[1518951300]}]},{"allowed_amount":86173.23,"providers":[{"billed_charge":130565.45,"npi":[1518951300]}]}]}]},{"name":"DIAGNOSTIC COLONOSCOPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"45378","description":"COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN ","allowed_amounts":[{"tin":{"type":"ein","value":"954722860"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":7274.12,"providers":[{"billed_charge":16800.00,"npi":[1679650675]}]}]}]},{"name":"URGENT CARE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"456","description":"EMERGENCY ROOM - URGENT CARE","allowed_amounts":[{"tin":{"type":"ein","value":"953522679"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":11692.22,"providers":[{"billed_charge":45601.00,"npi":[1912914821]}]}]}]},{"name":"AMBUL SURG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"490","description":"AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"330537914"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":3009.00,"providers":[{"billed_charge":7837.00,"npi":[1053412189]}]}]},{"tin":{"type":"ein","value":"954816334"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":22377.36,"providers":[{"billed_charge":213195.15,"npi":[1588679179]}]}]},{"tin":{"type":"ein","value":"330018673"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":8829.47,"providers":[{"billed_charge":20836.00,"npi":[1942265939]}]}]},{"tin":{"type":"ein","value":"954775738"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":76077.38,"providers":[{"billed_charge":218100.00,"npi":[1225188808]}]}]},{"tin":{"type":"ein","value":"330595220"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":549.24,"providers":[{"billed_charge":5921.00,"npi":[1083670970]}]}]},{"tin":{"type":"ein","value":"465183505"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":2005.04,"providers":[{"billed_charge":195000.00,"npi":[1225439508]}]}]}]},{"name":"CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"510","description":"CLINIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2461.14,"providers":[{"billed_charge":7111.14,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9506.81,"providers":[{"billed_charge":32551.25,"npi":[1417554528]}]},{"allowed_amount":6461.60,"providers":[{"billed_charge":11615.75,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10140.76,"providers":[{"billed_charge":10440.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1093.95,"providers":[{"billed_charge":1287.00,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":3912.56,"providers":[{"billed_charge":3313.00,"npi":[1811080526]}]},{"allowed_amount":328.02,"providers":[{"billed_charge":1976.00,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1263.48,"providers":[{"billed_charge":1486.44,"npi":[1427176569]}]}]}]},{"name":"SKILLED NURSE/VISIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"551","description":"SKILLED NURSING - VISIT CHARGE","allowed_amounts":[{"tin":{"type":"ein","value":"830750832"},"service_code":["12"],"billing_class":"institutional","payments":[{"allowed_amount":320.00,"providers":[{"billed_charge":320.00,"npi":[1104305036]}]}]}]},{"name":"DRUG/DETAIL CODE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"DRUGS REQ SPEC IDENTIFICATION - DRUGS REQ DETAILED CODING*","allowed_amounts":[{"tin":{"type":"ein","value":"831960549"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11.13,"providers":[{"billed_charge":6652.80,"npi":[1124596382]}]},{"allowed_amount":1.75,"providers":[{"billed_charge":3398.15,"npi":[1124596382]}]}]},{"tin":{"type":"ein","value":"760385534"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":892.60,"providers":[{"billed_charge":1880.04,"npi":[1780655670]}]}]},{"tin":{"type":"ein","value":"953782169"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":177.44,"providers":[{"billed_charge":474.60,"npi":[1407839921]}]},{"allowed_amount":62.74,"providers":[{"billed_charge":74.37,"npi":[1407839921]}]}]},{"tin":{"type":"ein","value":"956006143"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1577.81,"providers":[{"billed_charge":2060.17,"npi":[1902803315]}]},{"allowed_amount":67.24,"providers":[{"billed_charge":164.80,"npi":[1902803315]}]}]},{"tin":{"type":"ein","value":"851634852"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":393.65,"providers":[{"billed_charge":3829.25,"npi":[1033716147]}]},{"allowed_amount":260.29,"providers":[{"billed_charge":2531.90,"npi":[1033716147]}]},{"allowed_amount":999.71,"providers":[{"billed_charge":9724.65,"npi":[1033716147]}]}]},{"tin":{"type":"ein","value":"952321136"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":910.28,"providers":[{"billed_charge":3398.85,"npi":[1306890389]}]}]},{"tin":{"type":"ein","value":"475618278"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":885.77,"providers":[{"billed_charge":1042.05,"npi":[1427176569]}]},{"allowed_amount":11388.50,"providers":[{"billed_charge":13439.25,"npi":[1427176569]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1371.03,"providers":[{"billed_charge":2851.67,"npi":[1821159195]}]},{"allowed_amount":284.15,"providers":[{"billed_charge":655.38,"npi":[1821159195]}]}]},{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":21780.35,"providers":[{"billed_charge":74556.45,"npi":[1639172372]}]},{"allowed_amount":9555.72,"providers":[{"billed_charge":18912.94,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":80047.19,"providers":[{"billed_charge":2092791.35,"npi":[1417554528]}]},{"allowed_amount":152071.95,"providers":[{"billed_charge":394471.08,"npi":[1013514199]}]},{"allowed_amount":25926.00,"providers":[{"billed_charge":77988.00,"npi":[1013514199]}]}]},{"tin":{"type":"ein","value":"951914489"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1758.21,"providers":[{"billed_charge":3121.83,"npi":[1710109186]}]},{"allowed_amount":59.00,"providers":[{"billed_charge":1569.18,"npi":[1710109186]}]}]},{"tin":{"type":"ein","value":"300804393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":414.79,"providers":[{"billed_charge":1935.25,"npi":[1043632938]}]}]},{"tin":{"type":"ein","value":"66000798"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16.50,"providers":[{"billed_charge":22.00,"npi":[1669466561]}]}]},{"tin":{"type":"ein","value":"201645949"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":390.30,"providers":[{"billed_charge":3151.01,"npi":[1942269725]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2799.50,"providers":[{"billed_charge":2853.06,"npi":[1043215379]}]},{"allowed_amount":1998.07,"providers":[{"billed_charge":9207.70,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"941105628"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":828.06,"providers":[{"billed_charge":1725.05,"npi":[1356496772]}]}]},{"tin":{"type":"ein","value":"951903935"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":168.66,"providers":[{"billed_charge":2201.60,"npi":[1265433551]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":395.45,"providers":[{"billed_charge":844.90,"npi":[1912914821]}]},{"allowed_amount":249.25,"providers":[{"billed_charge":456.82,"npi":[1912914821]}]},{"allowed_amount":1862.22,"providers":[{"billed_charge":93968.72,"npi":[1912914821]}]},{"allowed_amount":1892.68,"providers":[{"billed_charge":281538.24,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"952294234"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":374.10,"providers":[{"billed_charge":9106.09,"npi":[1538157508]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4319.34,"providers":[{"billed_charge":33724.09,"npi":[1114971660]}]},{"allowed_amount":17620.73,"providers":[{"billed_charge":131105.28,"npi":[1114971660]}]},{"allowed_amount":15803.61,"providers":[{"billed_charge":45386.13,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2146.74,"providers":[{"billed_charge":5235.90,"npi":[1689608150]}]},{"allowed_amount":129786.14,"providers":[{"billed_charge":216806.85,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"746001118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":24090.96,"providers":[{"billed_charge":28342.32,"npi":[1174582050]}]},{"allowed_amount":643.92,"providers":[{"billed_charge":757.55,"npi":[1174582050]}]}]},{"tin":{"type":"ein","value":"952321786"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":78507.12,"providers":[{"billed_charge":440903.61,"npi":[1811080526]}]},{"allowed_amount":1408.64,"providers":[{"billed_charge":25909.37,"npi":[1811080526]}]},{"allowed_amount":132.21,"providers":[{"billed_charge":4023.73,"npi":[1811080526]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9246.39,"providers":[{"billed_charge":51033.08,"npi":[1831188275]}]},{"allowed_amount":11328.74,"providers":[{"billed_charge":32603.88,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"330449527"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":33.28,"providers":[{"billed_charge":61.93,"npi":[1528041811]}]}]},{"tin":{"type":"ein","value":"270636387"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":7.16,"providers":[{"billed_charge":956.34,"npi":[1114239068]}]},{"allowed_amount":3.06,"providers":[{"billed_charge":2254.94,"npi":[1114239068]}]}]},{"tin":{"type":"ein","value":"951644036"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13.13,"providers":[{"billed_charge":4515.41,"npi":[1407828429]}]},{"allowed_amount":1.32,"providers":[{"billed_charge":380.00,"npi":[1407828429]}]}]},{"tin":{"type":"ein","value":"770258013"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":37.95,"providers":[{"billed_charge":69.00,"npi":[1144237272]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1732.29,"providers":[{"billed_charge":9840.17,"npi":[1588908388]}]},{"allowed_amount":457.11,"providers":[{"billed_charge":1316.76,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"951643327"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3609.62,"providers":[{"billed_charge":5469.09,"npi":[1518951300]}]}]}]},{"name":"RECOVERY ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"710","description":"RECOVERY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10450.61,"providers":[{"billed_charge":23858.00,"npi":[1689608150]}]}]}]},{"name":"X-RAY EXAM CHEST 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71046","description":"RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"200797926"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":511.36,"providers":[{"billed_charge":1785.00,"npi":[1134150071]}]}]}]},{"name":"EKG/ECG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"730","description":"EKG/ECG - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"951644600"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2191.03,"providers":[{"billed_charge":37753.24,"npi":[1639172372]}]},{"allowed_amount":9132.38,"providers":[{"billed_charge":14831.63,"npi":[1639172372]}]},{"allowed_amount":337.09,"providers":[{"billed_charge":1037.19,"npi":[1639172372]}]}]},{"tin":{"type":"ein","value":"952226406"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":618.97,"providers":[{"billed_charge":4140.00,"npi":[1689608150]}]}]},{"tin":{"type":"ein","value":"851644866"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1568.52,"providers":[{"billed_charge":7914.50,"npi":[1417554528]}]}]},{"tin":{"type":"ein","value":"951934652"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1323.47,"providers":[{"billed_charge":2380.00,"npi":[1043215379]}]},{"allowed_amount":129.12,"providers":[{"billed_charge":595.00,"npi":[1043215379]}]}]},{"tin":{"type":"ein","value":"951816017"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3802.71,"providers":[{"billed_charge":9960.00,"npi":[1831188275]}]}]},{"tin":{"type":"ein","value":"371705906"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6330.03,"providers":[{"billed_charge":18081.00,"npi":[1588908388]}]}]},{"tin":{"type":"ein","value":"953522679"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":873.75,"providers":[{"billed_charge":1165.00,"npi":[1912914821]}]},{"allowed_amount":1400.94,"providers":[{"billed_charge":13980.00,"npi":[1912914821]}]},{"allowed_amount":1091.48,"providers":[{"billed_charge":20970.00,"npi":[1912914821]}]}]},{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":24864.25,"providers":[{"billed_charge":69957.50,"npi":[1114971660]}]},{"allowed_amount":1433.01,"providers":[{"billed_charge":16896.25,"npi":[1114971660]}]}]},{"tin":{"type":"ein","value":"956000930"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6516.90,"providers":[{"billed_charge":13548.75,"npi":[1821159195]}]}]}]},{"name":"TREATMENT ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"761","description":"TREATMENT OR OBSERVATION ROOM - TREATMENT ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"952226406"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":792.08,"providers":[{"billed_charge":1386.00,"npi":[1689608150]}]}]}]},{"name":"OBSERVATION ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"762","description":"TREATMENT OR OBSERVATION ROOM - OBSERVATION ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"330751869"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4890.25,"providers":[{"billed_charge":57375.00,"npi":[1114971660]}]},{"allowed_amount":22861.35,"providers":[{"billed_charge":80704.50,"npi":[1114971660]}]}]}]},{"name":"ULTRASOUND BREAST COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76641","description":"ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED;","allowed_amounts":[{"tin":{"type":"ein","value":"954747393"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":290.13,"providers":[{"billed_charge":1113.00,"npi":[1386893006]}]}]}]},{"name":"US EXAM, ABDOM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76700","description":"ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE","allowed_amounts":[{"tin":{"type":"ein","value":"200797926"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3705.84,"providers":[{"billed_charge":15444.00,"npi":[1134150071]}]}]}]},{"name":"US EXAM, PELVIC, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76856","description":"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE","allowed_amounts":[{"tin":{"type":"ein","value":"200797926"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":421.42,"providers":[{"billed_charge":1935.00,"npi":[1134150071]}]}]}]},{"name":"CT SCAN FOR THERAPY GUIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77014","description":"COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS","allowed_amounts":[{"tin":{"type":"ein","value":"874757210"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2233.26,"providers":[{"billed_charge":9069.12,"npi":[1386756245]}]}]},{"tin":{"type":"ein","value":"954547089"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":764.00,"providers":[{"billed_charge":764.00,"npi":[1891254165]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77063","description":"SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P","allowed_amounts":[{"tin":{"type":"ein","value":"471856737"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":89.56,"providers":[{"billed_charge":122.00,"npi":[1235174111]}]}]}]},{"name":"SCR MAMMO BI INCL CAD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77067","description":"SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (","allowed_amounts":[{"tin":{"type":"ein","value":"200797926"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5879.58,"providers":[{"billed_charge":24480.00,"npi":[1134150071]}]}]},{"tin":{"type":"ein","value":"834721282"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":53.39,"providers":[{"billed_charge":295.00,"npi":[1073855607]}]}]},{"tin":{"type":"ein","value":"954747393"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":857.64,"providers":[{"billed_charge":3311.00,"npi":[1073855607]}]},{"allowed_amount":4043.16,"providers":[{"billed_charge":15609.00,"npi":[1386893006]}]},{"allowed_amount":31.72,"providers":[{"billed_charge":201.00,"npi":[1386893006]}]}]},{"tin":{"type":"ein","value":"471856737"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":106.78,"providers":[{"billed_charge":200.00,"npi":[1235174111]}]}]}]},{"name":"DXA BONE DENSITY, AXIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77080","description":"DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIP","allowed_amounts":[{"tin":{"type":"ein","value":"954747393"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":75.24,"providers":[{"billed_charge":504.00,"npi":[1982660387]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":90.57,"providers":[{"billed_charge":150.00,"npi":[1477794808]}]},{"allowed_amount":170.98,"providers":[{"billed_charge":270.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.72,"providers":[{"billed_charge":553.74,"npi":[1366479099]}]}]}]},{"name":"GENERAL HEALTH PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80050","description":"GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL","allowed_amounts":[{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4356.82,"providers":[{"billed_charge":8700.00,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1848.13,"providers":[{"billed_charge":1870.00,"npi":[1245275106]}]}]},{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1172.99,"providers":[{"billed_charge":2030.00,"npi":[1346467354]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80053","description":"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA","allowed_amounts":[{"tin":{"type":"ein","value":"911879977"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":202.28,"providers":[{"billed_charge":326.60,"npi":[1972598472]}]}]},{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":73.92,"providers":[{"billed_charge":202.56,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":264.24,"providers":[{"billed_charge":1076.40,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":348.65,"providers":[{"billed_charge":425.00,"npi":[1477794808]}]},{"allowed_amount":847.80,"providers":[{"billed_charge":1946.00,"npi":[1477794808]}]},{"allowed_amount":745.26,"providers":[{"billed_charge":1423.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2180.92,"providers":[{"billed_charge":33818.19,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":158.40,"providers":[{"billed_charge":1485.00,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":625.02,"providers":[{"billed_charge":1419.96,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"933656161"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.36,"providers":[{"billed_charge":135.00,"npi":[1316782063]}]}]},{"tin":{"type":"ein","value":"261238275"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":380.16,"providers":[{"billed_charge":2160.00,"npi":[1851403224]}]}]}]},{"name":"LIPID PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80061","description":"LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":213.90,"providers":[{"billed_charge":1242.18,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":107.12,"providers":[{"billed_charge":423.99,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":107.87,"providers":[{"billed_charge":286.00,"npi":[1477794808]}]},{"allowed_amount":70.86,"providers":[{"billed_charge":192.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1970.06,"providers":[{"billed_charge":41001.18,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":174.07,"providers":[{"billed_charge":786.50,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81","50"],"billing_class":"professional","payments":[{"allowed_amount":528.92,"providers":[{"billed_charge":778.08,"npi":[1477711521]}]},{"allowed_amount":13.39,"providers":[{"billed_charge":21.00,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":281.94,"providers":[{"billed_charge":1080.00,"npi":[1245275106]}]}]},{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":160.68,"providers":[{"billed_charge":1680.00,"npi":[1346467354]}]}]},{"tin":{"type":"ein","value":"261238275"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.39,"providers":[{"billed_charge":55.00,"npi":[1851403224]}]}]}]},{"name":"DRUG TEST PRSMV DIR OPT OBS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80305","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE ","allowed_amounts":[{"tin":{"type":"ein","value":"931558843"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":226.80,"providers":[{"billed_charge":15300.00,"npi":[1225258965]}]}]}]},{"name":"DRUG TEST PRSMV CHEM ANLYZR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80307","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR","allowed_amounts":[{"tin":{"type":"ein","value":"812855195"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1429.22,"providers":[{"billed_charge":2858.44,"npi":[1922459577]}]}]},{"tin":{"type":"ein","value":"853668979"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10004.54,"providers":[{"billed_charge":35015.89,"npi":[1144810284]}]}]},{"tin":{"type":"ein","value":"813115799"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3945.50,"providers":[{"billed_charge":59644.80,"npi":[1306381694]}]}]},{"tin":{"type":"ein","value":"823146637"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13391.26,"providers":[{"billed_charge":480489.20,"npi":[1861994600]}]}]},{"tin":{"type":"ein","value":"371420589"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":372.84,"providers":[{"billed_charge":2280.00,"npi":[1043352586]}]}]},{"tin":{"type":"ein","value":"843172409"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35206.26,"providers":[{"billed_charge":2099200.00,"npi":[1003437500]}]}]},{"tin":{"type":"ein","value":"843045583"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6214.00,"providers":[{"billed_charge":427528.00,"npi":[1508499393]}]}]},{"tin":{"type":"ein","value":"452215107"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14665.04,"providers":[{"billed_charge":43622.28,"npi":[1801226543]}]}]},{"tin":{"type":"ein","value":"853163633"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29765.06,"providers":[{"billed_charge":1578750.47,"npi":[1063011898]}]}]},{"tin":{"type":"ein","value":"920971049"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3790.54,"providers":[{"billed_charge":30500.00,"npi":[1952189086]}]}]},{"tin":{"type":"ein","value":"932666543"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2112.76,"providers":[{"billed_charge":5281.90,"npi":[1073398723]}]}]},{"tin":{"type":"ein","value":"264686185"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":497.12,"providers":[{"billed_charge":1242.80,"npi":[1902032121]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.34,"providers":[{"billed_charge":45.83,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":13.30,"providers":[{"billed_charge":22.00,"npi":[1477794808]}]},{"allowed_amount":27.59,"providers":[{"billed_charge":55.00,"npi":[1477794808]}]},{"allowed_amount":33.61,"providers":[{"billed_charge":77.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":214.07,"providers":[{"billed_charge":6012.36,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":15.54,"providers":[{"billed_charge":45.00,"npi":[1245275106]}]}]}]},{"name":"URINALYSIS NONAUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81002","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":312.33,"providers":[{"billed_charge":1310.00,"npi":[1174757553]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":124.69,"providers":[{"billed_charge":5035.00,"npi":[1255957205]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":42.18,"providers":[{"billed_charge":200.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":137.75,"providers":[{"billed_charge":375.00,"npi":[1174757553]}]}]}]},{"name":"FETAL CHRMOML ANEUPLOIDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81420","description":"FETAL CHROMOSOMAL ANEUPLOIDY (EG, TRISOMY 21, MONOSOMY X) GENOMIC SEQUENCE ANALYSIS PANEL, CIRCULATI","allowed_amounts":[{"tin":{"type":"ein","value":"943402381"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7224.00,"providers":[{"billed_charge":7224.00,"npi":[1588712020]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4.01,"providers":[{"billed_charge":75.62,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":201.26,"providers":[{"billed_charge":4851.12,"npi":[1366479099]}]}]}]},{"name":"HEMO/COMPOSITE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"HEMODIALYSIS - OUTPT OR HOME - HEMODIALYSIS/COMPOSITE RATE","allowed_amounts":[{"tin":{"type":"ein","value":"953372911"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":472.77,"providers":[{"billed_charge":17910.00,"npi":[1326002882]}]}]}]},{"name":"ASSAY OF APOLIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82172","description":"APOLIPOPROTEIN, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":168.72,"providers":[{"billed_charge":1200.00,"npi":[1346467354]}]}]}]},{"name":"ASSAY TEST FOR BLOOD, FECAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82274","description":"BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE, FECES, 1-3 SIMULTANEOU","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":28.65,"providers":[{"billed_charge":401.52,"npi":[1366479099]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":61.68,"providers":[{"billed_charge":364.62,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1438.56,"providers":[{"billed_charge":22553.98,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":621.60,"providers":[{"billed_charge":2887.50,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":266.40,"providers":[{"billed_charge":900.00,"npi":[1346467354]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":244.20,"providers":[{"billed_charge":960.00,"npi":[1245275106]}]}]},{"tin":{"type":"ein","value":"933656161"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":88.80,"providers":[{"billed_charge":135.00,"npi":[1316782063]}]}]},{"tin":{"type":"ein","value":"261238275"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":207.20,"providers":[{"billed_charge":700.00,"npi":[1851403224]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82570","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":198.00,"providers":[{"billed_charge":4155.60,"npi":[1366479099]}]}]}]},{"name":"VITAMIN B-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82607","description":"CYANOCOBALAMIN (VITAMIN B-12);","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":208.15,"providers":[{"billed_charge":3167.10,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":60.32,"providers":[{"billed_charge":300.00,"npi":[1346467354]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":139.06,"providers":[{"billed_charge":2195.45,"npi":[1366479099]}]}]}]},{"name":"ASSAY OF FOLIC ACID SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82746","description":"FOLIC ACID; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.82,"providers":[{"billed_charge":135.12,"npi":[1366479099]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82947","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"954802576"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.28,"providers":[{"billed_charge":60.00,"npi":[1134168891]}]}]}]},{"name":"REAGENT STRIP/BLOOD GLUCOSE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82948","description":"GLUCOSE; BLOOD, REAGENT STRIP","allowed_amounts":[{"tin":{"type":"ein","value":"371689457"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":78.75,"providers":[{"billed_charge":105.00,"npi":[1467446013]}]}]}]},{"name":"GLUCOSE BLOOD TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82962","description":"GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE","allowed_amounts":[{"tin":{"type":"ein","value":"462606289"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.56,"providers":[{"billed_charge":40.00,"npi":[1679718399]}]}]}]},{"name":"HEMOGLOBIN CHROMOTOGRAPHY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83021","description":"HEMOGLOBIN FRACTIONATION AND QUANTITATION; CHROMATOGRAPHY (EG, A2, S, C, AND/OR F)","allowed_amounts":[{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":108.36,"providers":[{"billed_charge":360.00,"npi":[1346467354]}]}]},{"tin":{"type":"ein","value":"261238275"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":505.68,"providers":[{"billed_charge":2100.00,"npi":[1851403224]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":106.81,"providers":[{"billed_charge":460.62,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":101.10,"providers":[{"billed_charge":574.26,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":36.34,"providers":[{"billed_charge":102.00,"npi":[1477794808]}]},{"allowed_amount":84.33,"providers":[{"billed_charge":238.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1391.40,"providers":[{"billed_charge":20048.20,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81","50"],"billing_class":"professional","payments":[{"allowed_amount":473.37,"providers":[{"billed_charge":1086.09,"npi":[1477711521]}]},{"allowed_amount":19.42,"providers":[{"billed_charge":51.64,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":145.65,"providers":[{"billed_charge":1155.00,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":124.70,"providers":[{"billed_charge":600.00,"npi":[1245275106]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":77.60,"providers":[{"billed_charge":885.12,"npi":[1366479099]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83550","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.56,"providers":[{"billed_charge":1084.05,"npi":[1366479099]}]}]}]},{"name":"ASSAY OF LACTIC ACID","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83605","description":"LACTATE (LACTIC ACID)","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":23.14,"providers":[{"billed_charge":80.00,"npi":[1477794808]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":37.64,"providers":[{"billed_charge":92.00,"npi":[1477794808]}]},{"allowed_amount":204.16,"providers":[{"billed_charge":575.00,"npi":[1477794808]}]},{"allowed_amount":21.85,"providers":[{"billed_charge":23.00,"npi":[1477794808]}]}]}]},{"name":"ASSAY OF PSA, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84153","description":"PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":341.93,"providers":[{"billed_charge":4635.16,"npi":[1366479099]}]}]}]},{"name":"ASSAY OF TOTAL TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84403","description":"TESTOSTERONE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":129.05,"providers":[{"billed_charge":1091.34,"npi":[1780620526]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":241.65,"providers":[{"billed_charge":6952.80,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.10,"providers":[{"billed_charge":300.00,"npi":[1346467354]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84443","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.80,"providers":[{"billed_charge":51.00,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":298.65,"providers":[{"billed_charge":661.00,"npi":[1477794808]}]},{"allowed_amount":73.07,"providers":[{"billed_charge":120.00,"npi":[1477794808]}]},{"allowed_amount":43.95,"providers":[{"billed_charge":122.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1061.76,"providers":[{"billed_charge":15115.34,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":54.60,"providers":[{"billed_charge":83.73,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"933656161"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":84.00,"providers":[{"billed_charge":113.00,"npi":[1316782063]}]}]}]},{"name":"FREE ASSAY (FT-3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84481","description":"TRIIODOTHYRONINE T3; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"330488938"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":72.00,"providers":[{"billed_charge":320.00,"npi":[1346467354]}]}]}]},{"name":"ASSAY OF TROPONIN, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84484","description":"TROPONIN, QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":167.20,"providers":[{"billed_charge":176.00,"npi":[1477794808]}]},{"allowed_amount":26.52,"providers":[{"billed_charge":44.00,"npi":[1477794808]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84550","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.84,"providers":[{"billed_charge":195.56,"npi":[1366479099]}]}]}]},{"name":"COMPLETE CBC W/AUTO DIFF WBC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85025","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE","allowed_amounts":[{"tin":{"type":"ein","value":"911879977"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":72.00,"providers":[{"billed_charge":222.84,"npi":[1972598472]}]}]},{"tin":{"type":"ein","value":"455080644"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":62.16,"providers":[{"billed_charge":206.65,"npi":[1861413023]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.07,"providers":[{"billed_charge":243.38,"npi":[1659352276]}]}]},{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":409.18,"providers":[{"billed_charge":472.00,"npi":[1477794808]}]},{"allowed_amount":598.42,"providers":[{"billed_charge":1221.00,"npi":[1477794808]}]},{"allowed_amount":750.40,"providers":[{"billed_charge":1983.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":980.17,"providers":[{"billed_charge":10774.84,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"680273974"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":201.40,"providers":[{"billed_charge":212.00,"npi":[1770688129]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":170.23,"providers":[{"billed_charge":366.60,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"954524103"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":62.16,"providers":[{"billed_charge":308.00,"npi":[1548225428]}]}]},{"tin":{"type":"ein","value":"571195765"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7.77,"providers":[{"billed_charge":35.00,"npi":[1245275106]}]}]},{"tin":{"type":"ein","value":"933656161"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.85,"providers":[{"billed_charge":73.00,"npi":[1316782063]}]}]},{"tin":{"type":"ein","value":"261238275"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31.08,"providers":[{"billed_charge":160.00,"npi":[1851403224]}]}]}]},{"name":"COMPLETE CBC, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85027","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":20.60,"providers":[{"billed_charge":46.00,"npi":[1477794808]}]},{"allowed_amount":34.73,"providers":[{"billed_charge":69.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":139.68,"providers":[{"billed_charge":1400.25,"npi":[1366479099]}]}]}]},{"name":"PROTHROMBIN TIME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85610","description":"PROTHROMBIN TIME;","allowed_amounts":[{"tin":{"type":"ein","value":"954457756"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":29.37,"providers":[{"billed_charge":75.00,"npi":[1477794808]}]},{"allowed_amount":88.71,"providers":[{"billed_charge":135.00,"npi":[1477794808]}]},{"allowed_amount":3.86,"providers":[{"billed_charge":15.00,"npi":[1477794808]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":28.27,"providers":[{"billed_charge":460.92,"npi":[1366479099]}]}]}]},{"name":"RBC SED RATE, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85652","description":"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.78,"providers":[{"billed_charge":806.74,"npi":[1366479099]}]}]}]},{"name":"C-REACTIVE PROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86140","description":"C-REACTIVE PROTEIN;","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":43.54,"providers":[{"billed_charge":1207.22,"npi":[1366479099]}]}]}]},{"name":"TB TEST CELL IMMUN MEASURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86480","description":"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":111.57,"providers":[{"billed_charge":1154.31,"npi":[1366479099]}]}]}]},{"name":"SYPHILIS TEST NON-TREP QUAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86592","description":"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":93.87,"providers":[{"billed_charge":1574.37,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":4.27,"providers":[{"billed_charge":11.35,"npi":[1477711521]}]},{"allowed_amount":85.57,"providers":[{"billed_charge":182.61,"npi":[1477711521]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":202.59,"providers":[{"billed_charge":3818.00,"npi":[1366479099]}]}]},{"tin":{"type":"ein","value":"952833205"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40.63,"providers":[{"billed_charge":92.00,"npi":[1477711521]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.25,"providers":[{"billed_charge":186.60,"npi":[1366479099]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":266.20,"providers":[{"billed_charge":3786.80,"npi":[1366479099]}]}]}]},{"name":"URINE BACTERIA CULTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87088","description":"CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":160.05,"providers":[{"billed_charge":1231.56,"npi":[1366479099]}]}]}]},{"name":"MICROBE SUSCEPTIBLE MIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87186","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONC","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25.95,"providers":[{"billed_charge":405.40,"npi":[1366479099]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":47.53,"providers":[{"billed_charge":675.57,"npi":[1366479099]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":327.53,"providers":[{"billed_charge":2722.28,"npi":[1366479099]}]}]}]},{"name":"CANDIDA, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87481","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2280.85,"providers":[{"billed_charge":2737.15,"npi":[1558150078]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3754.63,"providers":[{"billed_charge":3754.63,"npi":[1689639544]}]}]}]},{"name":"CHYLMD PNEUM, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87486","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"921249599"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":175.45,"providers":[{"billed_charge":350.90,"npi":[1790470763]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1649.23,"providers":[{"billed_charge":1649.23,"npi":[1689639544]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87491","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1368.35,"providers":[{"billed_charge":7695.35,"npi":[1366479099]}]}]}]},{"name":"C DIFF AMPLIFIED PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87493","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CLOSTRIDIUM DIFFICILE, TOXIN GENE(S), AMPLI","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":111.81,"providers":[{"billed_charge":126.33,"npi":[1558150078]}]}]}]},{"name":"VANOMYCIN DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87500","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); VANCOMYCIN RESISTANCE (EG, ENTEROCOCCUS SPE","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":287.74,"providers":[{"billed_charge":336.88,"npi":[1558150078]}]}]}]},{"name":"GARDNER VAG, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87511","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":350.90,"providers":[{"billed_charge":350.90,"npi":[1689639544]}]}]}]},{"name":"HSV, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87529","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":449.16,"providers":[{"billed_charge":505.32,"npi":[1558150078]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":947.43,"providers":[{"billed_charge":947.43,"npi":[1689639544]}]}]}]},{"name":"HIV-1 QUANT&REVRSE TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87536","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION, INCLUDES REVERSE TRA","allowed_amounts":[{"tin":{"type":"ein","value":"952833205"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":361.68,"providers":[{"billed_charge":607.00,"npi":[1477711521]}]}]}]},{"name":"M.TUBERCULO, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87556","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOSIS, AMPLIFIED PROBE ","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":208.83,"providers":[{"billed_charge":210.55,"npi":[1558150078]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":217.56,"providers":[{"billed_charge":252.66,"npi":[1558150078]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":842.16,"providers":[{"billed_charge":842.16,"npi":[1689639544]}]}]}]},{"name":"M.PNEUMON, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87581","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"921249599"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":245.63,"providers":[{"billed_charge":456.17,"npi":[1790470763]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1719.41,"providers":[{"billed_charge":1719.41,"npi":[1689639544]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87591","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1284.14,"providers":[{"billed_charge":7221.79,"npi":[1366479099]}]}]}]},{"name":"HPV HIGH-RISK TYPES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87624","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":947.25,"providers":[{"billed_charge":6737.40,"npi":[1366479099]}]}]}]},{"name":"RESP VIRUS 3-5 TARGETS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87631","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ","allowed_amounts":[{"tin":{"type":"ein","value":"921249599"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1889.85,"providers":[{"billed_charge":3708.38,"npi":[1790470763]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8129.91,"providers":[{"billed_charge":8129.91,"npi":[1689639544]}]}]}]},{"name":"SARS-COV-2 COVID-19 AMP PRB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); (SARS-CoV-2) [COVID-19], amplified probe te","allowed_amounts":[{"tin":{"type":"ein","value":"843045583"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":769.65,"providers":[{"billed_charge":8658.60,"npi":[1508499393]}]}]},{"tin":{"type":"ein","value":"862686429"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":410.48,"providers":[{"billed_charge":800.88,"npi":[1912655614]}]}]}]},{"name":"SARSCOV2&INF A&B&RSV AMP PRB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","allowed_amounts":[{"tin":{"type":"ein","value":"333270035"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":230062.19,"providers":[{"billed_charge":258080.00,"npi":[1073300364]}]}]}]},{"name":"STAPH A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87640","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2315.94,"providers":[{"billed_charge":2315.94,"npi":[1689639544]}]}]}]},{"name":"MR-STAPH DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87641","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, METHICILLIN RESISTAN","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":182.47,"providers":[{"billed_charge":210.55,"npi":[1558150078]}]}]}]},{"name":"STREP A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87651","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":456.17,"providers":[{"billed_charge":547.43,"npi":[1558150078]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3228.28,"providers":[{"billed_charge":3228.28,"npi":[1689639544]}]}]}]},{"name":"STREP B, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87653","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"334777680"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":568.46,"providers":[{"billed_charge":673.76,"npi":[1558150078]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2245.76,"providers":[{"billed_charge":2245.76,"npi":[1689639544]}]}]}]},{"name":"TRICHOMONAS VAGINALIS AMPLIF","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87661","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"921249599"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.18,"providers":[{"billed_charge":105.27,"npi":[1790470763]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1122.88,"providers":[{"billed_charge":1122.88,"npi":[1689639544]}]}]}]},{"name":"DETECT AGENT NOS, DNA, AMP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87798","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE TE","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":175.45,"providers":[{"billed_charge":175.45,"npi":[1689639544]}]}]}]},{"name":"STREP A ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87880","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GR","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":66.12,"providers":[{"billed_charge":164.00,"npi":[1255957205]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":417.86,"providers":[{"billed_charge":3042.39,"npi":[1659390763]}]},{"allowed_amount":750.59,"providers":[{"billed_charge":5896.62,"npi":[1366479099]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"884268089"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":474.12,"providers":[{"billed_charge":900.88,"npi":[1093032658]}]}]},{"tin":{"type":"ein","value":"330491206"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":470.82,"providers":[{"billed_charge":900.00,"npi":[1790868735]}]}]},{"tin":{"type":"ein","value":"454809078"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":442.86,"providers":[{"billed_charge":705.00,"npi":[1780842609]}]}]},{"tin":{"type":"ein","value":"330855183"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2798.88,"providers":[{"billed_charge":6188.00,"npi":[1326234204]}]}]},{"tin":{"type":"ein","value":"710897031"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4747.12,"providers":[{"billed_charge":16860.37,"npi":[1659390763]}]}]},{"tin":{"type":"ein","value":"770375548"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1765.52,"providers":[{"billed_charge":4946.00,"npi":[1912930900]}]}]},{"tin":{"type":"ein","value":"272364631"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":316.08,"providers":[{"billed_charge":676.00,"npi":[1326076019]}]}]}]},{"name":"IMMUNIZATION ADMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90471","description":"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJE","allowed_amounts":[{"tin":{"type":"ein","value":"954727730"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":257.04,"providers":[{"billed_charge":700.00,"npi":[1902839160]}]}]}]},{"name":"BH/INTENS OP/PSYCH","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"905","description":"INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"372151107"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45322.20,"providers":[{"billed_charge":577500.00,"npi":[1346072113]}]}]},{"tin":{"type":"ein","value":"872691481"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10791.00,"providers":[{"billed_charge":48675.00,"npi":[1558006429]}]}]},{"tin":{"type":"ein","value":"861713640"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9817.71,"providers":[{"billed_charge":144000.00,"npi":[1376232728]}]}]},{"tin":{"type":"ein","value":"455137855"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6906.24,"providers":[{"billed_charge":49600.00,"npi":[1548515794]}]}]},{"tin":{"type":"ein","value":"923242581"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":71445.18,"providers":[{"billed_charge":918500.00,"npi":[1528759032]}]}]},{"tin":{"type":"ein","value":"992829545"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1271.44,"providers":[{"billed_charge":14000.00,"npi":[1154161842]}]}]},{"tin":{"type":"ein","value":"932211945"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":15451.88,"providers":[{"billed_charge":205350.00,"npi":[1356021299]}]}]},{"tin":{"type":"ein","value":"612050361"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6906.24,"providers":[{"billed_charge":64000.00,"npi":[1902522741]}]}]},{"tin":{"type":"ein","value":"813390299"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":19952.50,"providers":[{"billed_charge":39780.00,"npi":[1598348294]}]}]},{"tin":{"type":"ein","value":"994587611"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3884.76,"providers":[{"billed_charge":36000.00,"npi":[1336961853]}]}]},{"tin":{"type":"ein","value":"990964419"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3021.48,"providers":[{"billed_charge":44100.00,"npi":[1902692767]}]}]},{"tin":{"type":"ein","value":"932390418"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":56544.84,"providers":[{"billed_charge":494750.00,"npi":[1386326478]}]}]},{"tin":{"type":"ein","value":"992032506"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9349.40,"providers":[{"billed_charge":31125.00,"npi":[1972353100]}]}]}]},{"name":"BH/INTENS OP/CHEM DEP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"906","description":"INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"842945270"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2606.56,"providers":[{"billed_charge":14700.00,"npi":[1053999169]}]}]},{"tin":{"type":"ein","value":"455137855"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":577.83,"providers":[{"billed_charge":6200.00,"npi":[1548515794]}]}]},{"tin":{"type":"ein","value":"922129398"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7552.18,"providers":[{"billed_charge":143000.00,"npi":[1942901319]}]}]},{"tin":{"type":"ein","value":"922982041"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7638.70,"providers":[{"billed_charge":42900.00,"npi":[1154025930]}]}]},{"tin":{"type":"ein","value":"931525208"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1733.49,"providers":[{"billed_charge":11970.00,"npi":[1356109987]}]}]}]},{"name":"IIV3 VACC NO PRSV 0.5 ML IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90656","description":"INFLUENZA VIRUS VACCINE, TRIVALENT (IIV3), SPLIT VIRUS, PRESERVATIVE FREE, 0.5 ML DOSAGE, FOR INTRAM","allowed_amounts":[{"tin":{"type":"ein","value":"954727730"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.76,"providers":[{"billed_charge":320.00,"npi":[1902839160]}]}]}]},{"name":"PSYCH DIAG EVAL W/MED SRVCS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90792","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"451486258"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2415.96,"providers":[{"billed_charge":9663.84,"npi":[1053467720]}]}]}]},{"name":"PSYTX W PT W E/M 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90833","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"831064292"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":18110.64,"providers":[{"billed_charge":47200.00,"npi":[1699935080]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"813187452"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1387.36,"providers":[{"billed_charge":2535.00,"npi":[1396197356]}]}]}]},{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90837","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"874567228"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1350.00,"providers":[{"billed_charge":1350.00,"npi":[1639294960]}]}]},{"tin":{"type":"ein","value":"202138632"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":815.10,"providers":[{"billed_charge":2750.00,"npi":[1881357556]}]}]},{"tin":{"type":"ein","value":"823949318"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1320.56,"providers":[{"billed_charge":1440.00,"npi":[1952432692]}]}]},{"tin":{"type":"ein","value":"820767207"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":4972.14,"providers":[{"billed_charge":7200.00,"npi":[1962818484]}]}]},{"tin":{"type":"ein","value":"563065989"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":158.85,"providers":[{"billed_charge":200.00,"npi":[1447304803]}]}]}]},{"name":"PSYTX CRISIS EA ADDL 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90840","description":"PSYCHOTHERAPY FOR CRISIS; EACH ADDITIONAL 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMAR","allowed_amounts":[{"tin":{"type":"ein","value":"860795502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":700.74,"providers":[{"billed_charge":3750.00,"npi":[1477876753]}]}]}]},{"name":"GROUP PSYCHOTHERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90853","description":"GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","allowed_amounts":[{"tin":{"type":"ein","value":"924017362"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.40,"providers":[{"billed_charge":15000.00,"npi":[1588204689]}]}]},{"tin":{"type":"ein","value":"990964419"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":842.24,"providers":[{"billed_charge":168000.00,"npi":[1386318897]}]}]}]},{"name":"TCRANIAL MAGN STIM TX DELI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90868","description":"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MA","allowed_amounts":[{"tin":{"type":"ein","value":"863283419"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2872.80,"providers":[{"billed_charge":29000.00,"npi":[1730135971]}]}]},{"tin":{"type":"ein","value":"992880445"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":972.86,"providers":[{"billed_charge":2500.00,"npi":[1811221674]}]}]},{"tin":{"type":"ein","value":"954540991"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5423.22,"providers":[{"billed_charge":51300.00,"npi":[1851322887]}]}]}]},{"name":"PSTAY/REHAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"911","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"320565375"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8645.09,"providers":[{"billed_charge":40800.00,"npi":[1437794252]}]}]},{"tin":{"type":"ein","value":"931525208"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":119900.31,"providers":[{"billed_charge":258100.00,"npi":[1356109987]}]}]}]},{"name":"PSTAY/PARTIAL HOSP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"912","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - PARTIAL HOSPITALIZATION","allowed_amounts":[{"tin":{"type":"ein","value":"372094418"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":14824.74,"providers":[{"billed_charge":157500.00,"npi":[1457030132]}]}]}]},{"name":"PSYCHIATRIC CARE INTENSIVE 4","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"913","description":"PSYCHIATRIC CARE INTENSIVE 4-6 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"861713640"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":13825.76,"providers":[{"billed_charge":119000.00,"npi":[1376232728]}]}]},{"tin":{"type":"ein","value":"813390299"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":22508.71,"providers":[{"billed_charge":44805.00,"npi":[1598348294]}]}]},{"tin":{"type":"ein","value":"923242581"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":168052.30,"providers":[{"billed_charge":1345500.00,"npi":[1528759032]}]}]},{"tin":{"type":"ein","value":"320565375"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":67002.54,"providers":[{"billed_charge":306000.00,"npi":[1437794252]}]}]},{"tin":{"type":"ein","value":"922129398"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7004.70,"providers":[{"billed_charge":82500.00,"npi":[1942901319]}]}]},{"tin":{"type":"ein","value":"934593750"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4377.11,"providers":[{"billed_charge":40500.00,"npi":[1417715079]}]}]},{"tin":{"type":"ein","value":"882775097"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35334.08,"providers":[{"billed_charge":70400.00,"npi":[1497543011]}]}]},{"tin":{"type":"ein","value":"932390418"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":81328.00,"providers":[{"billed_charge":435250.00,"npi":[1386326478]}]}]},{"tin":{"type":"ein","value":"334935064"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":34971.04,"providers":[{"billed_charge":236500.00,"npi":[1497548978]}]}]},{"tin":{"type":"ein","value":"333276641"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4879.68,"providers":[{"billed_charge":30000.00,"npi":[1538041868]}]}]},{"tin":{"type":"ein","value":"932211945"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3253.12,"providers":[{"billed_charge":26000.00,"npi":[1356021299]}]}]},{"tin":{"type":"ein","value":"931525208"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":32255.22,"providers":[{"billed_charge":179800.00,"npi":[1356109987]}]}]}]},{"name":"PSTAY/INDIV RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"914","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - INDIVIDUAL THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"320565375"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5184.78,"providers":[{"billed_charge":9600.00,"npi":[1437794252]}]}]}]},{"name":"PSTAY/GROUP RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"915","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - GROUP THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"200849476"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":11490.76,"providers":[{"billed_charge":14100.00,"npi":[1528223195]}]}]},{"tin":{"type":"ein","value":"861713640"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":155191.38,"providers":[{"billed_charge":2193000.00,"npi":[1376232728]}]}]},{"tin":{"type":"ein","value":"334032295"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8080.74,"providers":[{"billed_charge":115400.00,"npi":[1437013414]}]}]},{"tin":{"type":"ein","value":"922129398"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45341.93,"providers":[{"billed_charge":484800.00,"npi":[1942901319]}]}]},{"tin":{"type":"ein","value":"924017362"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":91132.79,"providers":[{"billed_charge":1288000.00,"npi":[1518721786]}]}]},{"tin":{"type":"ein","value":"320565375"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":311164.41,"providers":[{"billed_charge":572800.00,"npi":[1437794252]}]}]},{"tin":{"type":"ein","value":"990964419"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":55002.75,"providers":[{"billed_charge":771400.00,"npi":[1902692767]}]}]},{"tin":{"type":"ein","value":"994181071"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":36593.18,"providers":[{"billed_charge":140685.00,"npi":[1518799634]}]}]},{"tin":{"type":"ein","value":"931525208"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":25813.77,"providers":[{"billed_charge":59000.00,"npi":[1356109987]}]}]}]},{"name":"EYE EXAM NEW PATIENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92004","description":"OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION W INITIATION OF DIAGNOSTIC AND TRTMNT ","allowed_amounts":[{"tin":{"type":"ein","value":"462280074"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":902.23,"providers":[{"billed_charge":1470.00,"npi":[1700109501]}]}]}]},{"name":"EYE EXAM ESTABLISH PATIENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92012","description":"OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, W INITIATION OR CONTINUATION OF DIAGN","allowed_amounts":[{"tin":{"type":"ein","value":"462280074"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":542.92,"providers":[{"billed_charge":1330.00,"npi":[1700109501]}]}]}]},{"name":"EYE EXAM&TX ESTAB PT 1/>VST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92014","description":"OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, W INITIATION OR CONTINUATION OF DIAGN","allowed_amounts":[{"tin":{"type":"ein","value":"462280074"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":437.80,"providers":[{"billed_charge":920.00,"npi":[1700109501]}]}]}]},{"name":"ELECTROCARDIOGRAM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93000","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"813049967"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.43,"providers":[{"billed_charge":85.43,"npi":[1104056845]}]}]},{"tin":{"type":"ein","value":"825388333"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":210.19,"providers":[{"billed_charge":750.00,"npi":[1407165434]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":552.41,"providers":[{"billed_charge":1750.00,"npi":[1174757553]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"264676053"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":96.00,"providers":[{"billed_charge":120.00,"npi":[1073548962]}]}]}]},{"name":"IMMUNOTHERAPY INJECTIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95117","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; 2 O","allowed_amounts":[{"tin":{"type":"ein","value":"330780739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":169.56,"providers":[{"billed_charge":480.00,"npi":[1205833563]}]}]},{"tin":{"type":"ein","value":"271860106"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.65,"providers":[{"billed_charge":250.00,"npi":[1841220621]}]}]}]},{"name":"EEG, AWAKE AND DROWSY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95816","description":"ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND DROWSY","allowed_amounts":[{"tin":{"type":"ein","value":"860795502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9727.74,"providers":[{"billed_charge":17500.00,"npi":[1477876753]}]}]}]},{"name":"DEVEL TST PHYS/QHP 1ST HR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96112","description":"DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR","allowed_amounts":[{"tin":{"type":"ein","value":"860795502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2458.62,"providers":[{"billed_charge":7200.00,"npi":[1477876753]}]}]}]},{"name":"DEVEL TST PHYS/QHP EA ADDL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96113","description":"DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"860795502"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2065.32,"providers":[{"billed_charge":14400.00,"npi":[1477876753]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"208785833"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":136.64,"providers":[{"billed_charge":980.00,"npi":[1275601478]}]}]}]},{"name":"PT-FOCUSED HLTH RISK ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96160","description":"ADMINISTRATION OF PATIENT-FOCUSED HEALTH RISK ASSESSMENT INSTRUMENT (EG, HEALTH HAZARD APPRAISAL) WI","allowed_amounts":[{"tin":{"type":"ein","value":"820823237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.56,"providers":[{"billed_charge":26.08,"npi":[1235450834]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96372","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":33.21,"providers":[{"billed_charge":250.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":238.05,"providers":[{"billed_charge":1200.00,"npi":[1174757553]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"208881215"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1526.26,"providers":[{"billed_charge":2000.00,"npi":[1174567093]}]}]},{"tin":{"type":"ein","value":"200506793"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1752.25,"providers":[{"billed_charge":2280.00,"npi":[1417981507]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"813587136"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2115.48,"providers":[{"billed_charge":14361.60,"npi":[1427699487]}]}]},{"tin":{"type":"ein","value":"800000791"},"service_code":["99","12"],"billing_class":"professional","payments":[{"allowed_amount":642.20,"providers":[{"billed_charge":1040.00,"npi":[1265785588]}]},{"allowed_amount":2134.08,"providers":[{"billed_charge":3456.00,"npi":[1265785588]}]}]},{"tin":{"type":"ein","value":"262915096"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1659.20,"providers":[{"billed_charge":5400.00,"npi":[1881974889]}]}]},{"tin":{"type":"ein","value":"770605945"},"service_code":["11","12","03"],"billing_class":"professional","payments":[{"allowed_amount":2623.61,"providers":[{"billed_charge":3063.50,"npi":[1437619954]}]},{"allowed_amount":20.74,"providers":[{"billed_charge":24.20,"npi":[1437619954]}]},{"allowed_amount":725.90,"providers":[{"billed_charge":847.00,"npi":[1437619954]}]}]}]},{"name":"GRP ADAPT BHV TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97154","description":"GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"951691313"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":15153.29,"providers":[{"billed_charge":113211.00,"npi":[1073087938]}]}]}]},{"name":"ADAPT BEHAVIOR TX PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97155","description":"ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"951691313"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1195.02,"providers":[{"billed_charge":9974.00,"npi":[1073087938]}]}]},{"tin":{"type":"ein","value":"813587136"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":277.83,"providers":[{"billed_charge":1478.40,"npi":[1427699487]}]}]}]},{"name":"RMVL DEVITAL TIS 20 CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97597","description":"DEBRIDEMENT (EG, HIGH PRESSURE WATERJET W/WOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT W SCISSORS, SCAL","allowed_amounts":[{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1587.04,"providers":[{"billed_charge":1900.00,"npi":[1174757553]}]}]}]},{"name":"SPECIMEN HANDLING OFFICE-LAB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99000","description":"HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE OFFICE TO A LABORATORY","allowed_amounts":[{"tin":{"type":"ein","value":"952833205"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":43.89,"providers":[{"billed_charge":58.50,"npi":[1477711521]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":527.52,"providers":[{"billed_charge":740.00,"npi":[1174757553]}]}]}]},{"name":"MED SERV EVE/WKEND/HOLIDAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99051","description":"SERVICE(S) PROVIDED IN THE OFFICE DURING REGULARLY SCHEDULED EVENING, WEEKEND, OR HOLIDAY OFFICE HOU","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2972.27,"providers":[{"billed_charge":7400.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"208785833"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":714.15,"providers":[{"billed_charge":3375.00,"npi":[1275601478]}]}]}]},{"name":"HYPERBARIC OXYGEN THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99183","description":"PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ATTENDANCE AND SUPERVISION OF HYPERBARIC OXYGE","allowed_amounts":[{"tin":{"type":"ein","value":"237064656"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":3257.28,"providers":[{"billed_charge":7560.00,"npi":[1104071489]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99203","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"874613640"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":326.73,"providers":[{"billed_charge":450.00,"npi":[1982853537]}]}]},{"tin":{"type":"ein","value":"454298417"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":5544.33,"providers":[{"billed_charge":17600.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"931905975"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":114.02,"providers":[{"billed_charge":173.00,"npi":[1376735688]}]}]},{"tin":{"type":"ein","value":"270909425"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":247.20,"providers":[{"billed_charge":309.00,"npi":[1437368511]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":38399.32,"providers":[{"billed_charge":79525.00,"npi":[1174757553]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"454298417"},"service_code":["20","10"],"billing_class":"professional","payments":[{"allowed_amount":35064.19,"providers":[{"billed_charge":110400.00,"npi":[1255957205]}]},{"allowed_amount":231.84,"providers":[{"billed_charge":575.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"452751949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":725.76,"providers":[{"billed_charge":1840.00,"npi":[1821030057]}]}]},{"tin":{"type":"ein","value":"208785833"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3406.80,"providers":[{"billed_charge":6638.00,"npi":[1275601478]}]}]},{"tin":{"type":"ein","value":"831064292"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2286.83,"providers":[{"billed_charge":2600.00,"npi":[1699935080]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":17925.38,"providers":[{"billed_charge":39050.00,"npi":[1174757553]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"954727730"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1178.25,"providers":[{"billed_charge":1650.00,"npi":[1902839160]}]},{"allowed_amount":314.20,"providers":[{"billed_charge":440.00,"npi":[1902839160]}]}]},{"tin":{"type":"ein","value":"454298417"},"service_code":["20","10"],"billing_class":"professional","payments":[{"allowed_amount":5975.43,"providers":[{"billed_charge":16225.00,"npi":[1255957205]}]},{"allowed_amount":121.23,"providers":[{"billed_charge":275.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"330111479"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":335.72,"providers":[{"billed_charge":480.00,"npi":[1942219944]}]}]},{"tin":{"type":"ein","value":"330739324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":237.78,"providers":[{"billed_charge":510.00,"npi":[1609898758]}]}]},{"tin":{"type":"ein","value":"202138632"},"service_code":["11","20","10"],"billing_class":"professional","payments":[{"allowed_amount":194.18,"providers":[{"billed_charge":590.00,"npi":[1780796235]}]},{"allowed_amount":1941.80,"providers":[{"billed_charge":5900.00,"npi":[1780796235]}]},{"allowed_amount":2815.61,"providers":[{"billed_charge":8555.00,"npi":[1780796235]}]}]},{"tin":{"type":"ein","value":"330802838"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":78.55,"providers":[{"billed_charge":150.00,"npi":[1346259595]}]}]},{"tin":{"type":"ein","value":"472698023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":195.10,"providers":[{"billed_charge":406.00,"npi":[1104110071]}]}]},{"tin":{"type":"ein","value":"264177521"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1522.80,"providers":[{"billed_charge":1522.80,"npi":[1508896275]}]}]},{"tin":{"type":"ein","value":"270909425"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1090.95,"providers":[{"billed_charge":2000.00,"npi":[1437368511]}]}]},{"tin":{"type":"ein","value":"813991713"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":864.05,"providers":[{"billed_charge":1320.00,"npi":[1073527099]}]}]},{"tin":{"type":"ein","value":"451486258"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9426.24,"providers":[{"billed_charge":37704.96,"npi":[1053467720]}]}]},{"tin":{"type":"ein","value":"954802576"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1335.35,"providers":[{"billed_charge":2040.00,"npi":[1134168891]}]}]},{"tin":{"type":"ein","value":"954826587"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":348.19,"providers":[{"billed_charge":500.00,"npi":[1063512812]}]}]},{"tin":{"type":"ein","value":"460959232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2332.89,"providers":[{"billed_charge":5390.05,"npi":[1013154400]}]}]},{"tin":{"type":"ein","value":"330690652"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1770.40,"providers":[{"billed_charge":3749.60,"npi":[1720074313]}]}]},{"tin":{"type":"ein","value":"821938611"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":97.09,"providers":[{"billed_charge":156.00,"npi":[1801223896]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10623.24,"providers":[{"billed_charge":26500.00,"npi":[1174757553]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99214","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"568415382"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":492.90,"providers":[{"billed_charge":1369.80,"npi":[1528000643]}]},{"allowed_amount":929.68,"providers":[{"billed_charge":1826.40,"npi":[1528000643]}]}]},{"tin":{"type":"ein","value":"454298417"},"service_code":["20","10"],"billing_class":"professional","payments":[{"allowed_amount":32938.83,"providers":[{"billed_charge":96695.00,"npi":[1255957205]}]},{"allowed_amount":198.06,"providers":[{"billed_charge":415.00,"npi":[1255957205]}]}]},{"tin":{"type":"ein","value":"452751949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1645.08,"providers":[{"billed_charge":3600.00,"npi":[1821030057]}]}]},{"tin":{"type":"ein","value":"208785833"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1047.52,"providers":[{"billed_charge":1776.00,"npi":[1275601478]}]}]},{"tin":{"type":"ein","value":"330739324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3096.75,"providers":[{"billed_charge":6720.00,"npi":[1992748883]}]}]},{"tin":{"type":"ein","value":"821512689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":652.60,"providers":[{"billed_charge":1025.00,"npi":[1891882239]}]}]},{"tin":{"type":"ein","value":"462606289"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2846.36,"providers":[{"billed_charge":7370.00,"npi":[1679718399]}]}]},{"tin":{"type":"ein","value":"954241933"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":318.27,"providers":[{"billed_charge":1281.00,"npi":[1689092470]}]}]},{"tin":{"type":"ein","value":"202138632"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":5705.30,"providers":[{"billed_charge":17850.00,"npi":[1780796235]}]},{"allowed_amount":7205.88,"providers":[{"billed_charge":22525.00,"npi":[1780796235]}]}]},{"tin":{"type":"ein","value":"825388333"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1004.32,"providers":[{"billed_charge":2000.00,"npi":[1407165434]}]}]},{"tin":{"type":"ein","value":"810600022"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3378.19,"providers":[{"billed_charge":7824.00,"npi":[1811993454]}]},{"allowed_amount":209.50,"providers":[{"billed_charge":489.00,"npi":[1811993454]}]},{"allowed_amount":419.00,"providers":[{"billed_charge":978.00,"npi":[1811993454]}]}]},{"tin":{"type":"ein","value":"813991713"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2421.32,"providers":[{"billed_charge":3520.00,"npi":[1073527099]}]}]},{"tin":{"type":"ein","value":"831064292"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":27695.04,"providers":[{"billed_charge":40800.00,"npi":[1699935080]}]}]},{"tin":{"type":"ein","value":"931950904"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2352.58,"providers":[{"billed_charge":5356.48,"npi":[1902289226]}]}]},{"tin":{"type":"ein","value":"813049967"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1718.49,"providers":[{"billed_charge":1718.49,"npi":[1104056845]}]}]},{"tin":{"type":"ein","value":"451486258"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9355.44,"providers":[{"billed_charge":37421.76,"npi":[1053467720]}]}]},{"tin":{"type":"ein","value":"820823237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":111.67,"providers":[{"billed_charge":148.89,"npi":[1235450834]}]}]},{"tin":{"type":"ein","value":"870811363"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":687.90,"providers":[{"billed_charge":875.00,"npi":[1427248319]}]}]},{"tin":{"type":"ein","value":"954461069"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":530.24,"providers":[{"billed_charge":720.00,"npi":[1982068342]}]}]},{"tin":{"type":"ein","value":"452604140"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":392.82,"providers":[{"billed_charge":1571.28,"npi":[1245568476]}]}]},{"tin":{"type":"ein","value":"474455954"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1439.25,"providers":[{"billed_charge":1919.00,"npi":[1700852696]}]}]},{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3933.52,"providers":[{"billed_charge":11300.00,"npi":[1174757553]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99215","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"568415382"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":866.98,"providers":[{"billed_charge":1525.50,"npi":[1528000643]}]}]},{"tin":{"type":"ein","value":"202138632"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":570.66,"providers":[{"billed_charge":1650.00,"npi":[1780796235]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99232","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"262923063"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":162.42,"providers":[{"billed_charge":260.00,"npi":[1447410386]}]}]},{"tin":{"type":"ein","value":"200290423"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1547.48,"providers":[{"billed_charge":1580.00,"npi":[1295732568]}]}]},{"tin":{"type":"ein","value":"272226074"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":81.21,"providers":[{"billed_charge":150.00,"npi":[1548251390]}]}]},{"tin":{"type":"ein","value":"510647287"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":799.30,"providers":[{"billed_charge":1531.60,"npi":[1770686834]}]}]},{"tin":{"type":"ein","value":"462270609"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5211.12,"providers":[{"billed_charge":10976.93,"npi":[1396751541]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99233","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"562616409"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1062.11,"providers":[{"billed_charge":2234.96,"npi":[1417008772]}]}]},{"tin":{"type":"ein","value":"611923648"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2161.25,"providers":[{"billed_charge":5200.00,"npi":[1295001493]}]}]},{"tin":{"type":"ein","value":"830999450"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":600.00,"providers":[{"billed_charge":600.00,"npi":[1932188521]}]}]},{"tin":{"type":"ein","value":"264679491"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":4336.77,"providers":[{"billed_charge":20350.00,"npi":[1740498328]}]}]},{"tin":{"type":"ein","value":"472513872"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5947.64,"providers":[{"billed_charge":9600.00,"npi":[1417123332]}]}]},{"tin":{"type":"ein","value":"954634877"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2791.74,"providers":[{"billed_charge":9200.00,"npi":[1366548620]}]}]},{"tin":{"type":"ein","value":"874605157"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":606.90,"providers":[{"billed_charge":1500.00,"npi":[1437770336]}]}]},{"tin":{"type":"ein","value":"203403714"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":364.14,"providers":[{"billed_charge":762.00,"npi":[1679951164]}]}]},{"tin":{"type":"ein","value":"454472166"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":303.46,"providers":[{"billed_charge":1736.08,"npi":[1841829793]}]}]},{"tin":{"type":"ein","value":"330578201"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":121.38,"providers":[{"billed_charge":170.00,"npi":[1255462248]}]}]},{"tin":{"type":"ein","value":"954850596"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1758.15,"providers":[{"billed_charge":2565.00,"npi":[1407972490]}]}]},{"tin":{"type":"ein","value":"954301313"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":6433.20,"providers":[{"billed_charge":11500.00,"npi":[1659445211]}]}]},{"tin":{"type":"ein","value":"203700289"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":728.28,"providers":[{"billed_charge":3300.00,"npi":[1831126739]}]}]},{"tin":{"type":"ein","value":"562336353"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1017.75,"providers":[{"billed_charge":1120.00,"npi":[1659100436]}]}]}]},{"name":"PREVENTIVE COUNSELING INDIV","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99401","description":"PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDIVIDUA","allowed_amounts":[{"tin":{"type":"ein","value":"820823237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":212.24,"providers":[{"billed_charge":282.96,"npi":[1235450834]}]}]}]},{"name":"SELF-MEAS BP PT EDUCAJ/TRAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99473","description":"SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION","allowed_amounts":[{"tin":{"type":"ein","value":"820823237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":179.59,"providers":[{"billed_charge":239.39,"npi":[1235450834]}]}]}]},{"name":"IC LBW INF 1500-2500 G SUBSQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99479","description":"SUBSEQUENT INTENSIVE CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF THE RECOVERING LOW BIRTH WE","allowed_amounts":[{"tin":{"type":"ein","value":"832155686"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3187.34,"providers":[{"billed_charge":10400.00,"npi":[1780726745]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"752474011"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20682.13,"providers":[{"billed_charge":20682.13,"npi":[1194833939]}]},{"allowed_amount":56610.44,"providers":[{"billed_charge":56610.44,"npi":[1578597886]}]}]},{"tin":{"type":"ein","value":"465348858"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20607.08,"providers":[{"billed_charge":20607.08,"npi":[1568864346]}]}]},{"tin":{"type":"ein","value":"330285453"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9687.90,"providers":[{"billed_charge":9687.90,"npi":[1639131436]}]}]},{"tin":{"type":"ein","value":"956000735"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1262.00,"providers":[{"billed_charge":1262.00,"npi":[1083789564]}]}]},{"tin":{"type":"ein","value":"952223085"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":39119.66,"providers":[{"billed_charge":39119.66,"npi":[1518075449]}]}]},{"tin":{"type":"ein","value":"952426613"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3184.40,"providers":[{"billed_charge":3184.40,"npi":[1689608994]}]}]},{"tin":{"type":"ein","value":"208895318"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31822.30,"providers":[{"billed_charge":31822.30,"npi":[1902025398]}]}]},{"tin":{"type":"ein","value":"956000776"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1680.00,"providers":[{"billed_charge":1680.00,"npi":[1043904485]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"752474011"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9487.07,"providers":[{"billed_charge":9487.07,"npi":[1194833939]}]},{"allowed_amount":241139.68,"providers":[{"billed_charge":241139.68,"npi":[1578597886]}]}]},{"tin":{"type":"ein","value":"330285453"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":102100.40,"providers":[{"billed_charge":102100.40,"npi":[1639131436]}]}]},{"tin":{"type":"ein","value":"952223085"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":154425.37,"providers":[{"billed_charge":154425.37,"npi":[1518075449]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0428","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NONEMERGENCY TRANSPORT, (BLS)","allowed_amounts":[{"tin":{"type":"ein","value":"952223085"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18956.02,"providers":[{"billed_charge":18956.02,"npi":[1518075449]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0429","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"330285453"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":42341.06,"providers":[{"billed_charge":42341.06,"npi":[1639131436]}]}]}]},{"name":"TUBING W/INTGR HEAT ELEM W/P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4604","description":"TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":40.60,"providers":[{"billed_charge":203.00,"npi":[1902863202]}]}]}]},{"name":"FULL FCE MASK POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7030","description":"FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":107.13,"providers":[{"billed_charge":174.64,"npi":[1902863202]}]}]}]},{"name":"NASL INTERFCE POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7034","description":"NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":132.16,"providers":[{"billed_charge":203.40,"npi":[1902863202]}]}]}]},{"name":"HEADGEAR USED W/POS ARWAY PR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7035","description":"HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":423.92,"providers":[{"billed_charge":820.22,"npi":[1902863202]}]}]}]},{"name":"FLTR DISPBL W/POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7038","description":"FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":270.79,"providers":[{"billed_charge":899.66,"npi":[1902863202]}]}]}]},{"name":"PRTBLE GASEOUS O2 SYS RENTAL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0431","description":"PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, HUMIDIFIE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":186.12,"providers":[{"billed_charge":610.04,"npi":[1902863202]}]}]}]},{"name":"HUMDIFIR HEAT USED W/POS ARW","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0562","description":"HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":650.50,"providers":[{"billed_charge":2900.00,"npi":[1902863202]}]}]},{"tin":{"type":"ein","value":"770573175"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":915.30,"providers":[{"billed_charge":981.36,"npi":[1174749972]}]}]}]},{"name":"CONTINUOUS POS AIRWAY PRESSU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0601","description":"CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1838.32,"providers":[{"billed_charge":9038.51,"npi":[1902863202]}]}]},{"tin":{"type":"ein","value":"770573175"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2258.73,"providers":[{"billed_charge":2258.73,"npi":[1174749972]}]}]}]},{"name":"O2 CONC 85%/>02 CONC PRSC FL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E1390","description":"OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCEN","allowed_amounts":[{"tin":{"type":"ein","value":"954021787"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":943.56,"providers":[{"billed_charge":6030.00,"npi":[1902863202]}]}]},{"tin":{"type":"ein","value":"770573175"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":184.16,"providers":[{"billed_charge":184.16,"npi":[1174749972]}]}]}]},{"name":"FCE-FCE BEHAVRL CNSL OBESITY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0447","description":"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"810600022"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":473.04,"providers":[{"billed_charge":845.28,"npi":[1811993454]}]},{"allowed_amount":26.28,"providers":[{"billed_charge":46.96,"npi":[1811993454]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 1-7","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"823146637"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3604.56,"providers":[{"billed_charge":23395.80,"npi":[1861994600]}]}]}]},{"name":"Code for Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0545","description":"Code for Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge)","allowed_amounts":[{"tin":{"type":"ein","value":"297921830"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":457.80,"providers":[{"billed_charge":920.20,"npi":[1790886869]}]}]}]},{"name":"MED ASST TX METHADONE;WEEKLY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2067","description":"MEDICATION ASSISSTED TX METHADONE; WEEKLY BUNDLE","allowed_amounts":[{"tin":{"type":"ein","value":"462568903"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":967.24,"providers":[{"billed_charge":3297.00,"npi":[1679956809]}]}]}]},{"name":"VISIT CPLX INHERENT E&M ASSO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2211","description":"VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC","allowed_amounts":[{"tin":{"type":"ein","value":"810600022"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":537.60,"providers":[{"billed_charge":1115.10,"npi":[1811993454]}]},{"allowed_amount":25.60,"providers":[{"billed_charge":53.10,"npi":[1811993454]}]}]}]},{"name":"RT D 3/> S TX AR CSTM BLK;6-","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G6012","description":"RADIATION TRTMNT DELIVERY, 3 OR MORE SEPARATE TRTMNT AREAS, CUST BLOCKING, TANGENTIAL PORTS, WEDGES,","allowed_amounts":[{"tin":{"type":"ein","value":"320325661"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":258.05,"providers":[{"billed_charge":530.00,"npi":[1619983343]}]}]}]},{"name":"INTENS MOD TX DEL 1/MX FLDS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G6015","description":"INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS, VIA NARROW SPATIALLY AND TEM","allowed_amounts":[{"tin":{"type":"ein","value":"874757210"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6631.56,"providers":[{"billed_charge":25776.00,"npi":[1386756245]}]}]}]},{"name":"ALCOHOL &/OR DRUG SCREENING","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0049","description":"ALCOHOL AND/OR DRUG SCREENING","allowed_amounts":[{"tin":{"type":"ein","value":"820823237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":141.46,"providers":[{"billed_charge":188.54,"npi":[1235450834]}]}]}]},{"name":"INJ DEXMETH SODM PHOSHA 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1100","description":"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"465459135"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":4.02,"providers":[{"billed_charge":400.00,"npi":[1174757553]}]}]}]},{"name":"INJ TRIAMCINOLON ACETONID NO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J3301","description":"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG","allowed_amounts":[{"tin":{"type":"ein","value":"931950904"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.80,"providers":[{"billed_charge":137.50,"npi":[1902289226]}]}]}]},{"name":"TRAVL 1 WAY NEC LAB SPEC; AC","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"P9603","description":"TRAVEL ALLOWANCE, ONE WAY IN CONNECTION W MEDICALLY NECESSARY LABORATORY SPECIMEN COLLECTION DRAWN F","allowed_amounts":[{"tin":{"type":"ein","value":"843172409"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":254.29,"providers":[{"billed_charge":752.35,"npi":[1003437500]}]}]}]},{"name":"TRAVL 1 WAY NEC LAB SPEC; TR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"P9604","description":"TRAVEL ALLOWANCE, ONE WAY IN CONNECTION W MEDICALLY NECESSARY LABORATORY SPECIMEN COLLECTION DRAWN F","allowed_amounts":[{"tin":{"type":"ein","value":"843045583"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":71.40,"providers":[{"billed_charge":140.00,"npi":[1508499393]}]}]}]},{"name":"PART HOSITALIZATN SRVC<24 HR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S0201","description":"PARTIAL HOSPITALIZATION SERVICES, LESS THAN 24 HOURS, PER DIEM","allowed_amounts":[{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1718.80,"providers":[{"billed_charge":5593.00,"npi":[1053919423]}]}]}]},{"name":"GLBAL FEE URGNT CARE CENTERS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9083","description":"GLOBAL FEE URGENT CARE CENTERS","allowed_amounts":[{"tin":{"type":"ein","value":"934895258"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":200.86,"providers":[{"billed_charge":330.00,"npi":[1114798071]}]}]}]},{"name":"SERVICES PROV AN URGENT CARE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9088","description":"SERVICES PROVIDED IN AN URGENT CARE CENTER (LIST IN ADDITION TO CODE FOR SERVICE)","allowed_amounts":[{"tin":{"type":"ein","value":"208785833"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":878.83,"providers":[{"billed_charge":1150.00,"npi":[1275601478]}]}]}]}]}