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"professional", "payments": [{ "allowed_amount": 36.96, "providers": [{ "billed_charge": 221.76, "npi": [1639791007] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.14, "providers": [{ "billed_charge": 762.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 765.60, "providers": [{ "billed_charge": 3731.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9055.20, "providers": [{ "billed_charge": 36220.80, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 179.52, "providers": [{ "billed_charge": 1190.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 276582.57, "providers": [{ "billed_charge": 3106199.64, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.56, "providers": [{ "billed_charge": 110.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 992.22, "providers": [{ "billed_charge": 3643.20, "npi": [1730617523] } ] }, { "allowed_amount": 7.19, "providers": [{ "billed_charge": 26.40, "npi": [1730617523] } ] } ] } ] }, { "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": 9002.40, "providers": [{ "billed_charge": 97516.52, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 917.90, "providers": [{ "billed_charge": 1834.43, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 361.53, "providers": [{ "billed_charge": 810.00, "npi": [1689687360] } ] }, { "allowed_amount": 45.52, "providers": [{ "billed_charge": 120.00, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 274.70, "providers": [{ "billed_charge": 697.00, "npi": [1487429874] } ] }, { "allowed_amount": 26.80, "providers": [{ "billed_charge": 68.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1162.30, "providers": [{ "billed_charge": 5100.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.70, "providers": [{ "billed_charge": 830.18, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 91.04, "providers": [{ "billed_charge": 880.00, "npi": [1184250524] } ] }, { "allowed_amount": 68.28, "providers": [{ "billed_charge": 660.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 167.50, "providers": [{ "billed_charge": 3750.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1072.00, "providers": [{ "billed_charge": 10400.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "760068643" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.38, "providers": [{ "billed_charge": 60.00, "npi": [1649859224] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 589.60, "providers": [{ "billed_charge": 2376.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "813193170" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.72, "providers": [{ "billed_charge": 80.00, "npi": [1033524327] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.70, "providers": [{ "billed_charge": 1260.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "742515841" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.50, "providers": [{ "billed_charge": 810.00, "npi": [1932205838] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1005.00, "providers": [{ "billed_charge": 5022.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1527.60, "providers": [{ "billed_charge": 8664.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13413.40, "providers": [{ "billed_charge": 112432.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 341300.32, "providers": [{ "billed_charge": 5535717.59, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2587.24, "providers": [{ "billed_charge": 9508.32, "npi": [1730617523] } ] }, { "allowed_amount": 9.11, "providers": [{ "billed_charge": 33.48, "npi": [1730617523] } ] } ] } ] }, { "name": "RENAL FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80069", "description": "RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2349.05, "providers": [{ "billed_charge": 35090.72, "npi": [1234567893] } ] } ] } ] }, { "name": "ACUTE HEPATITIS PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80074", "description": "ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 652.31, "providers": [{ "billed_charge": 6970.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.28, "providers": [{ "billed_charge": 381.04, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7336.56, "providers": [{ "billed_charge": 59440.92, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40021.84, "providers": [{ "billed_charge": 656159.32, "npi": [1234567893] } ] } ] } ] }, { "name": "HEPATIC FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80076", "description": "HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 234.60, "providers": [{ "billed_charge": 1265.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4283.02, "providers": [{ "billed_charge": 54092.74, "npi": [1234567893] } ] } ] } ] }, { "name": "OBSTETRIC PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80081", "description": "OBSTETRIC PANEL (INCLUDES HIV TESTING)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23913.07, "providers": [{ "billed_charge": 263002.08, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY, CARBAMAZEPINE, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80156", "description": "CARBAMAZEPINE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.11, "providers": [{ "billed_charge": 1514.70, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY DIPROPYLACETIC ACD TOT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80164", "description": "VALPROIC ACID (DIPROPYLACETIC ACID); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 603.06, "providers": [{ "billed_charge": 9258.03, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCRN QUAN LEVETIRACETAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80177", "description": "LEVETIRACETAM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 484.37, "providers": [{ "billed_charge": 7842.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LITHIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80178", "description": "LITHIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.08, "providers": [{ "billed_charge": 2469.32, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCRN QUANT OXCARBAZEPIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80183", "description": "OXCARBAZEPINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.88, "providers": [{ "billed_charge": 848.60, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TACROLIMUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80197", "description": "TACROLIMUS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 370.36, "providers": [{ "billed_charge": 10569.14, "npi": [1234567893] } ] } ] } ] }, { "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": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24834.89, "providers": [{ "billed_charge": 403995.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "464163620" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17353.22, "providers": [{ "billed_charge": 55400.00, "npi": [1265854855] } ] } ] }, { "tin": { "type": "ein", "value": "993314772" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1269.40, "providers": [{ "billed_charge": 6524.70, "npi": [1275369233] } ] } ] }, { "tin": { "type": "ein", "value": "453717894" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 559.26, "providers": [{ "billed_charge": 789.00, "npi": [1730466590] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3635.19, "providers": [{ "billed_charge": 21811.14, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "364568253" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.63, "providers": [{ "billed_charge": 900.00, "npi": [1023269313] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4629.43, "providers": [{ "billed_charge": 18517.72, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2299.18, "providers": [{ "billed_charge": 11100.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "830973361" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13142.61, "providers": [{ "billed_charge": 105140.88, "npi": [1447814272] } ] } ] }, { "tin": { "type": "ein", "value": "461242694" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 597.84, "providers": [{ "billed_charge": 1125.00, "npi": [1134559685] } ] } ] }, { "tin": { "type": "ein", "value": "471489220" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 652.47, "providers": [{ "billed_charge": 3262.35, "npi": [1861895500] } ] } ] }, { "tin": { "type": "ein", "value": "472177895" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 776.75, "providers": [{ "billed_charge": 3282.48, "npi": [1477925188] } ] } ] }, { "tin": { "type": "ein", "value": "880241758" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.21, "providers": [{ "billed_charge": 726.00, "npi": [1699782722] } ] } ] }, { "tin": { "type": "ein", "value": "800686939" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1304.94, "providers": [{ "billed_charge": 2856.00, "npi": [1699045674] } ] } ] }, { "tin": { "type": "ein", "value": "611803788" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1770.99, "providers": [{ "billed_charge": 6840.00, "npi": [1053841023] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 372.84, "providers": [{ "billed_charge": 1491.36, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1318.20, "providers": [{ "billed_charge": 6075.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 807.82, "providers": [{ "billed_charge": 4121.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 302.04, "providers": [{ "billed_charge": 1304.94, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41621.90, "providers": [{ "billed_charge": 219894.81, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREEN QUANTALCOHOLS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80320", "description": "ALCOHOLS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.45, "providers": [{ "billed_charge": 21.78, "npi": [1234567893] } ] } ] } ] }, { "name": "ALCOHOLS BIOMARKERS 1OR 2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80321", "description": "ALCOHOL BIOMARKERS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1443.45, "providers": [{ "billed_charge": 5773.34, "npi": [1234567893] } ] } ] } ] }, { "name": "ALKALOIDS NOS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80323", "description": "ALKALOIDS, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 462.15, "providers": [{ "billed_charge": 1266.68, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 161.51, "providers": [{ "billed_charge": 645.86, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREEN AMPHETAMINES 1/2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80324", "description": "AMPHETAMINES; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.18, "providers": [{ "billed_charge": 818.64, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 78.65, "providers": [{ "billed_charge": 214.20, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1147.81, "providers": [{ "billed_charge": 4591.03, "npi": [1234567893] } ] } ] } ] }, { "name": "AMPHETAMINES 3OR 4", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80325", "description": "AMPHETAMINES; 3 OR 4", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 443.88, "providers": [{ "billed_charge": 2180.16, "npi": [1982091617] } ] } ] } ] }, { "name": "ANTIDEPRESSANTS CLASS 1 OR 2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80332", "description": "ANTIDEPRESSANTS, SEROTONERGIC CLASS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.51, "providers": [{ "billed_charge": 415.80, "npi": [1164017422] } ] } ] } ] }, { "name": "ANTIDEPRESSANTS CLASS 3-5", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80333", "description": "ANTIDEPRESSANTS, SEROTONERGIC CLASS; 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"providers": [{ "billed_charge": 217.42, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.23, "providers": [{ "billed_charge": 126.21, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1015.44, "providers": [{ "billed_charge": 4061.76, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREENING BUPRENORPHINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80348", "description": "BUPRENORPHINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.96, "providers": [{ "billed_charge": 883.44, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], 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"type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.18, "providers": [{ "billed_charge": 823.50, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 561.47, "providers": [{ "billed_charge": 2039.44, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.90, "providers": [{ "billed_charge": 180.30, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 307.25, "providers": [{ "billed_charge": 1228.69, "npi": [1234567893] } ] } ] } ] }, { "name": "GABAPENTIN, NON-BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80355", 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1291.86, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.94, "providers": [{ "billed_charge": 547.63, "npi": [1234567893] } ] } ] } ] }, { "name": "METHYLENEDIOXYAMPHETAMINES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80359", "description": "METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.11, "providers": [{ "billed_charge": 546.48, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 467.93, "providers": [{ "billed_charge": 1287.72, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], 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"billed_charge": 408.94, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1207.49, "providers": [{ "billed_charge": 4829.44, "npi": [1234567893] } ] } ] } ] }, { "name": "OPIOIDS & OPIATE ANALOGS 1/2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80362", "description": "OPIOIDS AND OPIATE ANALOGS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.11, "providers": [{ "billed_charge": 745.20, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.51, "providers": [{ "billed_charge": 267.82, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], 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"allowed_amount": 122.76, "providers": [{ "billed_charge": 324.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 109.12, "providers": [{ "billed_charge": 436.16, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 913.88, "providers": [{ "billed_charge": 7650.06, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59497.95, "providers": [{ "billed_charge": 692679.22, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 402.38, "providers": [{ "billed_charge": 1593.00, "npi": [1174172845] } ] } ] }, { "tin": { 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"providers": [{ "billed_charge": 2136.10, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 588.00, "providers": [{ "billed_charge": 2940.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 124.95, "providers": [{ "billed_charge": 323.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.50, "providers": [{ "billed_charge": 294.00, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.16, "providers": [{ "billed_charge": 740.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 676.20, "providers": [{ "billed_charge": 2616.60, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2469.60, "providers": [{ "billed_charge": 20704.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46463.85, "providers": [{ "billed_charge": 599126.73, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 580.65, "providers": [{ "billed_charge": 2686.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 320.32, "providers": [{ "billed_charge": 1176.00, "npi": [1730617523] } ] }, { "allowed_amount": 10.01, "providers": [{ "billed_charge": 36.75, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID, RBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82747", "description": "FOLIC ACID; RBC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 820.03, "providers": [{ "billed_charge": 12626.77, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY IGA/IGD/IGG/IGM EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82784", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5267.80, "providers": [{ "billed_charge": 65403.70, 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"billing_class": "professional", "payments": [{ "allowed_amount": 114.31, "providers": [{ "billed_charge": 2858.58, "npi": [1234567893] } ] } ] } ] }, { "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": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.56, "providers": [{ "billed_charge": 545.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.42, "providers": [{ "billed_charge": 120.02, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.34, "providers": [{ "billed_charge": 1100.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4398.40, "providers": [{ "billed_charge": 11903.22, "npi": [1234567893] } ] } ] } ] }, { "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": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 226.80, "providers": [{ "billed_charge": 1800.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 188.32, "providers": [{ "billed_charge": 440.00, "npi": [1538526702] } ] }, { "allowed_amount": 265.36, "providers": [{ "billed_charge": 620.00, "npi": [1003273731] } ] }, { "allowed_amount": 154.08, "providers": [{ "billed_charge": 360.00, "npi": [1669082723] } ] } ] } ] }, { "name": "GLUCOSE TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82950", "description": "GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.28, "providers": [{ "billed_charge": 96.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1697.85, "providers": [{ "billed_charge": 21363.88, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE TOLERANCE TEST (GTT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82951", "description": "GLUCOSE; TOLERANCE TEST (GTT), 3 SPECIMENS (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 879.46, "providers": [{ "billed_charge": 10561.84, "npi": [1234567893] } ] } ] } ] }, { "name": "GTT-ADDED SAMPLES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82952", "description": "GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 218.57, "providers": [{ "billed_charge": 2352.20, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF G6PD ENZYME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82955", "description": "GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 319.37, "providers": [{ "billed_charge": 4512.13, "npi": [1234567893] } ] } ] } ] }, { "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": "752354465" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.20, "providers": [{ "billed_charge": 14.00, "npi": [1144282989] } ] }, { "allowed_amount": 153.30, "providers": [{ "billed_charge": 511.00, "npi": [1144282989] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.76, "providers": [{ "billed_charge": 135.00, "npi": [1942400601] } ] }, { "allowed_amount": 4.92, "providers": [{ "billed_charge": 45.00, "npi": [1982050241] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 117.60, "providers": [{ "billed_charge": 392.00, "npi": [1265493688] } ] }, { "allowed_amount": 2.40, "providers": [{ "billed_charge": 8.00, "npi": [1265493688] } ] }, { "allowed_amount": 50.40, "providers": [{ "billed_charge": 120.00, "npi": [1326017872] } ] }, { "allowed_amount": 3.36, "providers": [{ "billed_charge": 8.00, "npi": [1326017872] } ] }, { "allowed_amount": 70.56, "providers": [{ "billed_charge": 168.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.04, "providers": [{ "billed_charge": 165.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.44, "providers": [{ "billed_charge": 126.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GGT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82977", "description": "GLUTAMYLTRANSFERASE, GAMMA (GGT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 200.00, "providers": [{ "billed_charge": 1327.58, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.00, "providers": [{ "billed_charge": 135.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.60, "providers": [{ "billed_charge": 784.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8020.66, "providers": [{ "billed_charge": 59186.54, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 399.60, "providers": [{ "billed_charge": 1776.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (FSH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83001", "description": "GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 994.07, "providers": [{ "billed_charge": 10268.21, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 287.99, "providers": [{ "billed_charge": 1439.95, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 306.57, "providers": [{ "billed_charge": 1226.28, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.20, "providers": [{ "billed_charge": 208.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.29, "providers": [{ "billed_charge": 37.16, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1960.19, "providers": [{ "billed_charge": 16439.01, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 343.73, "providers": [{ "billed_charge": 2294.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25734.53, "providers": [{ "billed_charge": 306991.17, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 929.00, "providers": [{ "billed_charge": 4300.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 202.40, "providers": [{ "billed_charge": 743.20, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (LH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83002", "description": "GONADOTROPIN; LUTEINIZING HORMONE (LH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 527.26, "providers": [{ "billed_charge": 5585.63, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 250.02, "providers": [{ "billed_charge": 1250.10, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.04, "providers": [{ "billed_charge": 208.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.82, "providers": [{ "billed_charge": 259.28, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.60, "providers": [{ "billed_charge": 620.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1879.78, "providers": [{ "billed_charge": 15760.92, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21371.70, "providers": [{ "billed_charge": 253478.42, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 907.48, "providers": [{ "billed_charge": 4116.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 365.40, "providers": [{ "billed_charge": 1342.70, "npi": [1730617523] } ] }, { "allowed_amount": 12.60, "providers": [{ "billed_charge": 46.30, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY, GROWTH HORMONE (HGH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83003", "description": "GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 191.82, "providers": [{ "billed_charge": 958.64, "npi": [1740715333] } ] } ] } ] }, { "name": "ASSAY OF HAPTOGLOBIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83010", "description": "HAPTOGLOBIN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 922.67, "providers": [{ "billed_charge": 14645.64, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI 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[1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.60, "providers": [{ "billed_charge": 800.00, "npi": [1184250524] } ] }, { "allowed_amount": 37.17, "providers": [{ "billed_charge": 360.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 223.56, "providers": [{ "billed_charge": 893.32, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 204.12, "providers": [{ "billed_charge": 546.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "760622208" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.44, "providers": [{ "billed_charge": 297.00, "npi": [1609603836] } ] } ] }, { 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[{ "allowed_amount": 87.48, "providers": [{ "billed_charge": 792.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 518.00, "npi": [1982050241] } ] }, { "allowed_amount": 9.72, "providers": [{ "billed_charge": 148.00, "npi": [1417335571] } ] }, { "allowed_amount": 72.90, "providers": [{ "billed_charge": 1110.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 685.26, "providers": [{ "billed_charge": 3423.48, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1095.93, "providers": [{ "billed_charge": 5412.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" 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"providers": [{ "billed_charge": 1475.00, "npi": [1538526702] } ] }, { "allowed_amount": 173.46, "providers": [{ "billed_charge": 1050.00, "npi": [1669082723, 1003273731] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1394.71, "providers": [{ "billed_charge": 5123.08, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF B HEXOSAMINIDASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83080", "description": "B-HEXOSAMINIDASE, EACH ASSAY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.63, "providers": [{ "billed_charge": 160.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF HOMOCYSTINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83090", "description": "HOMOCYSTEINE", "allowed_amounts": 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"providers": [{ "billed_charge": 4090.49, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY QUANT NOS NONAB", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83520", "description": "IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.08, "providers": [{ "billed_charge": 949.96, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7964.27, "providers": [{ "billed_charge": 99704.49, "npi": [1234567893] } ] } ] } ] }, { "name": "IG LIGHT CHAINS FREE EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83521", "description": "IMMUNOGLOBULIN LIGHT CHAINS FREE EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3487.39, "providers": [{ "billed_charge": 57434.96, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF INSULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83525", "description": "INSULIN; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 277.90, "providers": [{ "billed_charge": 3735.53, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 85.80, "providers": [{ "billed_charge": 225.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.36, "providers": [{ "billed_charge": 297.18, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1052.48, "providers": [{ "billed_charge": 8820.96, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8102.98, "providers": [{ "billed_charge": 90779.90, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 731.52, "providers": [{ "billed_charge": 2944.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 217.84, "providers": [{ "billed_charge": 800.24, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF INSULIN", "billing_code_type": 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"service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 84.24, "providers": [{ "billed_charge": 1143.48, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.44, "providers": [{ "billed_charge": 77.64, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.56, "providers": [{ "billed_charge": 171.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.18, "providers": [{ "billed_charge": 349.38, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 210.60, "providers": [{ "billed_charge": 975.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 83.79, "providers": [{ "billed_charge": 1482.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 395.28, "providers": [{ "billed_charge": 1973.96, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.56, "providers": [{ "billed_charge": 380.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 430.92, "providers": [{ "billed_charge": 3610.95, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25449.29, "providers": [{ "billed_charge": 236038.53, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.71, "providers": [{ "billed_charge": 501.58, "npi": [1730617523] } ] }, { "allowed_amount": 30.87, "providers": [{ "billed_charge": 113.26, "npi": [1730617523] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 522.02, "providers": [{ "billed_charge": 4156.35, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.62, "providers": [{ "billed_charge": 1544.92, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 83.03, "providers": [{ "billed_charge": 209.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.22, "providers": [{ "billed_charge": 104.88, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.48, "providers": [{ "billed_charge": 146.52, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28581.40, "providers": [{ "billed_charge": 292504.33, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 142.80, "providers": [{ "billed_charge": 524.40, "npi": [1730617523] } ] } ] } ] }, { "name": "LACTATE (LD) (LDH) ENZYME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83615", "description": "LACTATE DEHYDROGENASE (LD), (LDH);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.19, "providers": [{ "billed_charge": 66.85, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.22, "providers": [{ "billed_charge": 220.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.30, "providers": [{ "billed_charge": 120.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4619.39, "providers": [{ "billed_charge": 28188.15, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 335.22, "providers": [{ "billed_charge": 1443.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LDH ENZYMES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83625", "description": "LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.93, "providers": [{ "billed_charge": 1847.78, "npi": [1234567893] } ] } ] 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{ "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 317.40, "providers": [{ "billed_charge": 1380.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN(A)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83695", "description": "LIPOPROTEIN (A)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 766.12, "providers": [{ "billed_charge": 6420.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3999.00, "providers": [{ "billed_charge": 54506.18, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY LIPOPROTEIN PLA2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83698", "description": 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"type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 308.20, "providers": [{ "billed_charge": 1541.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.10, "providers": [{ "billed_charge": 117.00, "npi": [1265493688] } ] }, { "allowed_amount": 16.38, "providers": [{ "billed_charge": 39.00, "npi": [1326017872] } ] }, { "allowed_amount": 43.68, "providers": [{ "billed_charge": 104.00, "npi": [1326017872] } ] }, { "allowed_amount": 20.10, "providers": [{ "billed_charge": 234.00, "npi": [1265493688] } ] }, { "allowed_amount": 3.90, "providers": [{ "billed_charge": 13.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.75, "providers": [{ "billed_charge": 900.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.60, "providers": [{ "billed_charge": 144.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.70, "providers": [{ "billed_charge": 617.76, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10514.24, "providers": [{ "billed_charge": 137869.74, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.35, "providers": [{ "billed_charge": 189.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF METANEPHRINES", "billing_code_type": "CPT", 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"providers": [{ "billed_charge": 18010.84, "npi": [1234567893] } ] } ] } ] }, { "name": "ANESTH, SURG LOWER ABDOMEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "840", "description": "ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHERWISE SPEC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "742569713" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 18543.96, "providers": [{ "billed_charge": 59580.00, "npi": [1063041523] } ] }, { "allowed_amount": 1563.90, "providers": [{ "billed_charge": 5020.00, "npi": [1063041523] } ] } ] }, { "tin": { "type": "ein", "value": "760482007" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 822.51, "providers": [{ "billed_charge": 4720.00, "npi": [1689872228] } ] }, { "allowed_amount": 9238.26, "providers": [{ "billed_charge": 49610.00, "npi": [1689872228] } ] }, { 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"service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 328.24, "providers": [{ "billed_charge": 2998.14, "npi": [1234567893] } ] } ] } ] }, { "name": "CAPD/COMPOSIT", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "841", "description": "CONT AMBULATORY PERITONEAL DIALYSIS - CAPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 85297.76, "providers": [{ "billed_charge": 697490.00, "npi": [1234567893] } ] }, { "allowed_amount": 23082.34, "providers": [{ "billed_charge": 226486.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PHOSPHORUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84100", "description": "PHOSPHORUS INORGANIC (PHOSPHATE);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.54, "providers": [{ "billed_charge": 165.57, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.14, "providers": [{ "billed_charge": 1026.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.85, "providers": [{ "billed_charge": 155.00, "npi": [1265493688] } ] }, { "allowed_amount": 18.90, "providers": [{ "billed_charge": 45.00, "npi": [1326017872] } ] }, { "allowed_amount": 2.70, "providers": [{ "billed_charge": 9.00, "npi": [1265493688] } ] }, { "allowed_amount": 16.20, "providers": [{ "billed_charge": 54.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4534.22, "providers": [{ "billed_charge": 21866.14, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.77, "providers": [{ "billed_charge": 231.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.23, "providers": [{ "billed_charge": 11.85, "npi": [1730617523] } ] }, { "allowed_amount": 80.75, "providers": [{ "billed_charge": 296.25, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF SERUM POTASSIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84132", "description": "POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.07, "providers": [{ "billed_charge": 37.28, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4619.69, "providers": [{ "billed_charge": 9450.42, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF URINE POTASSIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84133", "description": "POTASSIUM; URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.02, "providers": [{ "billed_charge": 386.71, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PREALBUMIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84134", "description": "PREALBUMIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 343.34, "providers": [{ "billed_charge": 4640.44, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 391.23, "providers": [{ "billed_charge": 3967.58, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 344.19, "providers": [{ "billed_charge": 1720.95, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.86, "providers": [{ "billed_charge": 54.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.44, "providers": [{ "billed_charge": 90.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.31, "providers": [{ "billed_charge": 709.24, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 730.10, "providers": [{ "billed_charge": 6121.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.31, "providers": [{ "billed_charge": 1190.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14592.78, "providers": [{ "billed_charge": 162016.84, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 636.23, "providers": [{ "billed_charge": 2928.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 198.80, "providers": [{ "billed_charge": 730.10, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF PROLACTIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84146", "description": "PROLACTIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 498.02, "providers": [{ "billed_charge": 5739.11, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 261.63, "providers": [{ "billed_charge": 1308.15, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 969.00, "providers": [{ "billed_charge": 8124.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18323.86, "providers": [{ "billed_charge": 242858.72, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 581.40, "providers": [{ "billed_charge": 2640.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 158.28, "providers": [{ "billed_charge": 581.40, "npi": 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"payments": [{ "allowed_amount": 101.20, "providers": [{ "billed_charge": 514.58, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 230.00, "providers": [{ "billed_charge": 1300.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2493.20, "providers": [{ "billed_charge": 20894.10, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49390.78, "providers": [{ "billed_charge": 653616.72, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 175.28, "providers": [{ "billed_charge": 643.72, "npi": [1730617523] } ] } ] } 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"billing_class": "professional", "payments": [{ "allowed_amount": 103.20, "providers": [{ "billed_charge": 592.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 219.47, "providers": [{ "billed_charge": 561.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.82, "providers": [{ "billed_charge": 103.24, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 955.32, "providers": [{ "billed_charge": 3665.02, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 413.12, "providers": [{ "billed_charge": 2752.00, 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134.40, "providers": [{ "billed_charge": 265.60, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 999.60, "providers": [{ "billed_charge": 1999.20, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 285.60, "providers": [{ "billed_charge": 1142.40, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.20, "providers": [{ "billed_charge": 284.80, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 285.60, "providers": [{ "billed_charge": 714.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": 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"providers": [{ "billed_charge": 58721.94, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177899.25, "providers": [{ "billed_charge": 2041996.24, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 469.04, "providers": [{ "billed_charge": 1722.00, "npi": [1730617523] } ] }, { "allowed_amount": 11.44, "providers": [{ "billed_charge": 42.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF TSI GLOBULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84445", "description": "THYROID STIMULATING IMMUNE GLOBULINS (TSI)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 543.68, "providers": [{ "billed_charge": 5600.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5172.28, "providers": [{ "billed_charge": 73183.73, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN E", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84446", "description": "TOCOPHEROL ALPHA (VITAMIN E)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 127.65, "providers": [{ "billed_charge": 2030.40, "npi": [1234567893] } ] } ] } ] }, { "name": "TRANSFERASE (AST) (SGOT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84450", "description": "TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": 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"providers": [{ "billed_charge": 10768.41, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 395.56, "providers": [{ "billed_charge": 1860.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF TRIGLYCERIDES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84478", "description": "TRIGLYCERIDES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 184.13, "providers": [{ "billed_charge": 1843.83, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.61, "providers": [{ "billed_charge": 39.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF THYROID (T3 OR T4)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84479", "description": "THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 273.89, "providers": [{ "billed_charge": 2750.43, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13427.53, "providers": [{ "billed_charge": 167042.94, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY, TRIIODOTHYRONINE (T3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84480", "description": "TRIIODOTHYRONINE T3; TOTAL (TT-3)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 383.76, "providers": [{ "billed_charge": 4926.29, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18392.48, "providers": [{ "billed_charge": 255702.23, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 811.44, "providers": [{ "billed_charge": 15400.85, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 592.90, "providers": [{ "billed_charge": 1185.80, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 110.11, "providers": [{ "billed_charge": 220.22, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 135.52, "providers": [{ "billed_charge": 352.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.76, "providers": [{ "billed_charge": 271.04, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 592.90, "providers": [{ "billed_charge": 2269.96, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 703.01, "providers": [{ "billed_charge": 2822.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1151.92, "providers": [{ "billed_charge": 5759.60, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.48, "providers": [{ "billed_charge": 48.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.47, "providers": [{ "billed_charge": 56.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 491.26, "providers": [{ "billed_charge": 4118.58, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37871.86, "providers": [{ "billed_charge": 857789.99, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.53, "providers": [{ "billed_charge": 42.35, "npi": [1730617523] } ] }, { "allowed_amount": 841.69, "providers": [{ "billed_charge": 3091.55, "npi": [1730617523] } ] } ] } ] }, { "name": "T3 REVERSE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84482", "description": "TRIIODOTHYRONINE T3; REVERSE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 364.94, "providers": [{ "billed_charge": 11604.12, "npi": [1234567893] } ] } ] } ] }, { "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 746.49, "providers": [{ "billed_charge": 14600.52, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF UREA NITROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84520", "description": "UREA NITROGEN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.35, "providers": [{ "billed_charge": 61.45, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.69, "providers": [{ "billed_charge": 48.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4797.07, "providers": [{ "billed_charge": 6684.41, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.44, "providers": [{ "billed_charge": 2644.99, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.20, "providers": [{ "billed_charge": 226.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.68, "providers": [{ "billed_charge": 108.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.08, "providers": [{ "billed_charge": 80.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.47, "providers": [{ "billed_charge": 152.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 474.60, "providers": [{ "billed_charge": 3975.30, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12414.45, "providers": [{ "billed_charge": 152269.03, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "371925902" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.00, "providers": [{ "billed_charge": 22.00, "npi": [1144367426] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 126.56, "providers": [{ "billed_charge": 616.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN A", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84590", "description": "VITAMIN A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 173.63, "providers": [{ "billed_charge": 4287.74, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN K", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84597", "description": "VITAMIN K", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1020.14, "providers": [{ "billed_charge": 25888.66, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ZINC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84630", "description": "ZINC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 617.85, "providers": [{ "billed_charge": 8140.52, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF C-PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84681", "description": "C-PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1998.72, "providers": [{ "billed_charge": 16744.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4288.25, "providers": [{ "billed_charge": 33229.00, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84702", "description": "GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 156.90, "providers": [{ "billed_charge": 1799.50, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.12, "providers": [{ "billed_charge": 200.76, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.77, "providers": [{ "billed_charge": 451.71, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11716.45, "providers": [{ "billed_charge": 186988.31, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN ASSAY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84703", "description": "GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1278.39, "providers": [{ "billed_charge": 24270.12, "npi": [1234567893] } ] } ] } ] }, { "name": "BL SMEAR W/O DIFF WBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85008", "description": "BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITHOUT MANUAL DIFFERENTIAL WBC COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.72, "providers": [{ "billed_charge": 556.08, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMATOCRIT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85014", "description": "BLOOD COUNT; HEMATOCRIT (HCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.16, "providers": [{ "billed_charge": 522.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 381.96, "providers": [{ "billed_charge": 3320.76, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMOGLOBIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85018", "description": "BLOOD COUNT; HEMOGLOBIN (HGB)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 609.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 444.62, "providers": [{ "billed_charge": 3975.30, "npi": [1234567893] } ] } ] } ] }, { "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": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 72.80, "providers": [{ "billed_charge": 840.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4603.06, "providers": [{ "billed_charge": 28808.73, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.96, "providers": [{ "billed_charge": 122.40, "npi": [1821077728] } ] }, { "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 451.24, "providers": [{ "billed_charge": 1740.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.25, "providers": [{ "billed_charge": 582.75, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "751369692" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.56, "providers": [{ "billed_charge": 25.00, "npi": [1700960655] } ] }, { "allowed_amount": 5.77, "providers": [{ "billed_charge": 12.50, "npi": [1700960655] } ] }, { "allowed_amount": 12.50, "providers": [{ "billed_charge": 12.50, "npi": [1700960655] } ] } ] }, { "tin": { "type": "ein", "value": "844939989" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.23, "providers": [{ "billed_charge": 163.17, "npi": [1639791007] } ] } ] }, { "tin": { "type": "ein", "value": "742515841" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.46, "providers": [{ "billed_charge": 1148.00, "npi": [1932205838] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5010.32, "providers": [{ "billed_charge": 19987.04, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 132768.57, "providers": [{ "billed_charge": 1122701.42, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.34, "providers": [{ "billed_charge": 216.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.23, "providers": [{ "billed_charge": 385.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 476.10, "providers": [{ "billed_charge": 1748.70, "npi": [1730617523] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 509.59, "providers": [{ "billed_charge": 1017.87, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.39, "providers": [{ "billed_charge": 134.26, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.59, "providers": [{ "billed_charge": 930.00, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.45, "providers": [{ "billed_charge": 235.00, "npi": [1265493688] } ] }, { "allowed_amount": 6.30, "providers": [{ "billed_charge": 15.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 346.21, "providers": [{ "billed_charge": 1383.06, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 182.83, "providers": [{ "billed_charge": 470.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 373.44, "providers": [{ "billed_charge": 3360.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760430777" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.12, "providers": [{ "billed_charge": 62.16, "npi": [1780730606] } ] } ] }, { "tin": { "type": "ein", "value": "760068643" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.30, "providers": [{ "billed_charge": 20.00, "npi": [1649859224] } ] } ] }, { "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.01, "providers": [{ "billed_charge": 297.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 225.62, "providers": [{ "billed_charge": 2004.32, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "710892430" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.44, "providers": [{ "billed_charge": 72.00, "npi": [1154379907] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 89.93, "providers": [{ "billed_charge": 1598.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 921.51, "providers": [{ "billed_charge": 4720.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.52, "providers": [{ "billed_charge": 2108.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1670.55, "providers": [{ "billed_charge": 2990.00, "npi": [1972519544] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 242.46, "providers": [{ "billed_charge": 1754.17, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] }, { "allowed_amount": 69.36, "providers": [{ "billed_charge": 173.40, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.22, "providers": [{ "billed_charge": 91.00, "npi": [1326017872] } ] }, { "allowed_amount": 27.30, "providers": [{ "billed_charge": 65.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 90.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 116.64, "providers": [{ "billed_charge": 976.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.44, "providers": [{ "billed_charge": 132.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13837.80, "providers": [{ "billed_charge": 127598.20, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "371925902" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 130.00, "providers": [{ "billed_charge": 270.00, "npi": [1144367426] } ] } ] } ] }, { "name": "AUTOMATED RBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85041", "description": "BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 170.54, "providers": [{ "billed_charge": 1190.81, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED RETICULOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85045", "description": "BLOOD COUNT; RETICULOCYTE, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.92, "providers": [{ "billed_charge": 376.18, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.48, "providers": [{ "billed_charge": 432.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.00, "providers": [{ "billed_charge": 168.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1761.40, "providers": [{ "billed_charge": 27566.85, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 232.00, "providers": [{ "billed_charge": 928.00, "npi": [1174172845] } ] } ] } ] }, { "name": "RETICYTE/HGB CONCENTRATE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85046", "description": "BLOOD COUNT; RETICULOCYTES, AUTOMATED, INCLUDING 1 OR MORE CELLULAR PARAMETERS (EG, RETICULOCYTE HEM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.19, "providers": [{ "billed_charge": 420.00, "npi": [1134585946] } ] } ] } ] }, { "name": "AUTOMATED LEUKOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85048", "description": "BLOOD COUNT; LEUKOCYTE (WBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.60, "providers": [{ "billed_charge": 31.65, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED PLATELET COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85049", "description": "BLOOD COUNT; PLATELET, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 333.10, "providers": [{ "billed_charge": 2402.50, "npi": [1234567893] } ] } ] } ] }, { "name": "BLOOD SMEAR INTERPRETATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85060", "description": "BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "746106575" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.27, "providers": [{ "billed_charge": 258.00, "npi": [1598181943] } ] }, { "allowed_amount": 11.09, "providers": [{ "billed_charge": 86.00, "npi": [1598181943] } ] } ] } ] }, { "name": "CCPD/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "851", "description": "CCPD - OUTPT OR HOME - CCPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 51460.82, "providers": [{ "billed_charge": 505238.00, "npi": [1234567893] } ] }, { "allowed_amount": 980716.86, "providers": [{ "billed_charge": 8348720.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "853224374" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 19087.91, "providers": [{ "billed_charge": 615304.32, "npi": [1609473941] } ] } ] } ] }, { "name": "CLOT FACTOR VIII AHG 1 STAGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85240", "description": "CLOTTING; FACTOR VIII (AHG), 1-STAGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 300.12, "providers": [{ "billed_charge": 7326.53, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW RISTOCTN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85245", "description": "CLOTTING; FACTOR VIII, VW FACTOR, RISTOCETIN COFACTOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 226.67, "providers": [{ "billed_charge": 3281.21, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85246", "description": "CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 310.82, "providers": [{ "billed_charge": 5713.05, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTITHROMBIN III ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85300", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 128.80, "providers": [{ "billed_charge": 5242.36, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT C ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85303", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 133.76, "providers": [{ "billed_charge": 3692.89, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT S FREE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85306", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 192.13, "providers": [{ "billed_charge": 5295.77, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRIN DEGRADATION, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85379", 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"npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.40, "providers": [{ "billed_charge": 33.50, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3268.16, "providers": [{ "billed_charge": 54458.98, "npi": [1234567893] } ] } ] } ] }, { "name": "RUSSELL VIPER VENOM, DILUTED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85613", "description": "RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 468.65, "providers": [{ "billed_charge": 7855.29, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.20, "providers": [{ "billed_charge": 1574.20, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "752848936" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.75, "providers": [{ "billed_charge": 54.00, "npi": [1295513000] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.34, "providers": [{ "billed_charge": 120.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5568.12, "providers": [{ "billed_charge": 132277.01, "npi": 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"payments": [{ "allowed_amount": 3350.58, "providers": [{ "billed_charge": 54276.84, "npi": [1234567893] } ] } ] } ] }, { "name": "ALLERGEN SPECIFIC IGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86003", "description": "ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20273.19, "providers": [{ "billed_charge": 222824.87, "npi": [1234567893] } ] } ] } ] }, { "name": "ACTIN ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86015", "description": "ACTIN SMOOTH MUSCLE ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2370.63, "providers": [{ "billed_charge": 37854.28, "npi": [1234567893] } ] } ] } ] }, { "name": "WBC ANTIBODY IDENTIFICATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86021", "description": "ANTIBODY IDENTIFICATION; LEUKOCYTE ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 514.71, "providers": [{ "billed_charge": 16004.43, "npi": [1234567893] } ] } ] } ] }, { "name": "ANCA SCREEN EACH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86036", "description": "ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 753.81, "providers": [{ "billed_charge": 16126.10, "npi": [1234567893] } ] } ] } ] }, { "name": "ANCA TITER EACH ANTIBODY", "billing_code_type": "CPT", 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} ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20825.85, "providers": [{ "billed_charge": 282237.35, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTINUCLEAR ANTIBODIES (ANA)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86039", "description": "ANTINUCLEAR ANTIBODIES (ANA); TITER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3967.45, "providers": [{ "billed_charge": 39721.08, "npi": [1234567893] } ] } ] } ] }, { "name": "Acetylcholine Receptor (AChR) Binding Antibody", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86041", "description": "Acetylcholine Receptor (AChR) Binding Antibody", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.58, "providers": [{ "billed_charge": 932.24, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTISTREPTOLYSIN O, TITER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86060", "description": "ANTISTREPTOLYSIN 0; TITER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 568.12, "providers": [{ "billed_charge": 7933.65, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 122.06, "providers": [{ "billed_charge": 2331.97, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.16, "providers": [{ "billed_charge": 124.32, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "752848936" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.95, "providers": [{ "billed_charge": 103.60, "npi": [1295513000] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.18, "providers": [{ "billed_charge": 25.90, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.34, "providers": [{ "billed_charge": 563.94, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9347.32, "providers": [{ "billed_charge": 228683.85, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.60, "providers": [{ "billed_charge": 388.50, "npi": [1730617523] } ] }, { "allowed_amount": 3.52, "providers": [{ "billed_charge": 12.95, "npi": [1730617523] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN, HS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86141", "description": "C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.92, "providers": [{ "billed_charge": 51.80, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.72, "providers": [{ "billed_charge": 238.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1911.60, "providers": [{ "billed_charge": 16009.65, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3576.09, "providers": [{ "billed_charge": 43722.62, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 473.04, "providers": [{ "billed_charge": 2190.00, "npi": [1174172845] } ] } ] } ] }, { "name": "BETA-2 GLYCOPROTEIN ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86146", "description": "BETA 2 GLYCOPROTEIN I ANTIBODY, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8921.56, "providers": [{ "billed_charge": 87281.83, "npi": [1234567893] } ] } ] } ] }, { "name": "CARDIOLIPIN ANTIBODY EA IG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86147", "description": "CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10505.06, "providers": [{ "billed_charge": 82635.58, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLEMENT, ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86160", "description": "COMPLEMENT; ANTIGEN, EACH COMPONENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.00, "providers": [{ "billed_charge": 2032.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8433.52, "providers": [{ "billed_charge": 137991.09, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLEMENT, TOTAL (CH50)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86162", "description": "COMPLEMENT; TOTAL HEMOLYTIC (CH50)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 121.38, "providers": [{ "billed_charge": 1441.24, "npi": [1234567893] } ] } ] } ] }, { "name": "CCP ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86200", "description": "CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.92, "providers": [{ "billed_charge": 360.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8142.11, "providers": [{ "billed_charge": 145829.81, "npi": [1234567893] } ] } ] } ] }, { "name": "DNA ANTIBODY NATIVE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86225", "description": "DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.83, "providers": [{ "billed_charge": 518.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4301.93, "providers": [{ "billed_charge": 75706.17, "npi": [1234567893] } ] } ] } ] }, { "name": "EMA EACH IG CLASS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86231", "description": "ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.17, "providers": [{ "billed_charge": 582.77, "npi": [1234567893] } ] } ] } ] }, { "name": "NUCLEAR ANTIGEN ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86235", "description": "EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 394.50, "providers": [{ "billed_charge": 3307.92, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51786.75, "providers": [{ "billed_charge": 525089.39, "npi": [1234567893] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86255", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 296.80, "providers": [{ "billed_charge": 296.80, "npi": [1346207214] } ] }, { "allowed_amount": 169.60, "providers": [{ "billed_charge": 169.60, "npi": [1346207214] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2193.93, "providers": [{ "billed_charge": 51547.88, "npi": [1234567893] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, TITER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86256", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 102.63, "providers": [{ "billed_charge": 1382.09, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "203304074" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.25, "providers": [{ "billed_charge": 8.25, "npi": [1679580849] } ] } ] } ] }, { "name": "DGP ANTIBODY EACH IG CLASS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86258", "description": "GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 368.93, "providers": [{ "billed_charge": 8230.31, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 15-3", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86300", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4501.00, "providers": [{ "billed_charge": 55235.25, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 19-9", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86301", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1423.90, "providers": [{ "billed_charge": 21023.32, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 125", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86304", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.69, "providers": [{ "billed_charge": 374.58, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3285.04, "providers": [{ "billed_charge": 46500.69, "npi": [1234567893] } ] } ] } ] }, { "name": "HETEROPHILE ANTIBODY SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86308", "description": "HETEROPHILE ANTIBODIES; SCREENING", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.39, "providers": [{ "billed_charge": 412.68, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY INFECTIOUS AGENT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86317", "description": "IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6197.59, "providers": [{ "billed_charge": 65169.96, "npi": [1234567893] } ] } ] } ] }, { "name": "IA INFECTIOUS AGENT ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86318", "description": "IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.10, "providers": [{ "billed_charge": 80.00, "npi": [1336758952] } ] } ] } ] }, { "name": "IMMUNOFIX E-PHORESIS, SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86334", "description": "IMMUNOFIXATION ELECTROPHORESIS; SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3309.84, "providers": [{ "billed_charge": 51876.53, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNFIX E-PHORSIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86335", "description": "IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION (EG, URINE, CSF)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 739.39, "providers": [{ "billed_charge": 8655.19, "npi": [1234567893] } ] } ] } ] }, { "name": "INSULIN ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86337", "description": "INSULIN ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 277.20, "providers": [{ "billed_charge": 4508.61, "npi": [1234567893] } ] } ] } ] }, { "name": "ISLET CELL ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86341", "description": "ISLET CELL ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1376.21, "providers": [{ "billed_charge": 23855.15, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELLS, TOTAL COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86359", "description": "T CELLS; TOTAL COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 255.19, "providers": [{ "billed_charge": 2200.51, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT/RATIO", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86360", "description": "T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12814.09, "providers": [{ "billed_charge": 142872.04, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86361", "description": "T CELLS; ABSOLUTE CD4 COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3499.52, "providers": [{ "billed_charge": 36358.68, "npi": [1234567893] } ] } ] } ] }, { "name": "TISS TRNSGLTMNASE EA IG CLAS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86364", "description": "TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1659.81, "providers": [{ "billed_charge": 44656.46, "npi": [1234567893] } ] } ] } ] }, { "name": "MICROSOMAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86376", "description": "MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.39, "providers": [{ "billed_charge": 4815.53, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 334.86, "providers": [{ "billed_charge": 1251.30, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 276.64, "providers": [{ "billed_charge": 2317.62, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18126.16, "providers": [{ "billed_charge": 242851.45, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 385.84, "providers": [{ "billed_charge": 1802.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 603.90, "providers": [{ "billed_charge": 2219.18, "npi": [1730617523] } ] } ] } ] }, { "name": "MITOCHONDRIAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86381", "description": "MITOCHONDRIAL ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3698.06, "providers": [{ "billed_charge": 35583.18, "npi": [1234567893] } ] } ] } ] }, { "name": "RHEUMATOID FACTOR, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86431", "description": "RHEUMATOID FACTOR; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.22, "providers": [{ "billed_charge": 705.82, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 42.60, "providers": [{ "billed_charge": 212.70, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.97, "providers": [{ "billed_charge": 160.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.12, "providers": [{ "billed_charge": 428.22, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7191.93, "providers": [{ "billed_charge": 125787.29, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 210.16, "providers": [{ "billed_charge": 814.00, "npi": [1174172845] } ] } ] } ] }, { "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": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 185.94, "providers": [{ "billed_charge": 1560.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48820.00, "providers": [{ "billed_charge": 402326.85, "npi": [1234567893] } ] } ] } ] }, { "name": "TB AG RESPONSE T-CELL SUSP", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86481", "description": "TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5040.00, "providers": [{ "billed_charge": 28348.32, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.18, "providers": [{ "billed_charge": 4174.92, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 57.78, "providers": [{ "billed_charge": 464.13, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22091.39, "providers": [{ "billed_charge": 352513.37, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.64, "providers": [{ "billed_charge": 42.72, "npi": [1730617523] } ] } ] } ] }, { "name": "SYPHILIS TEST NON-TREP QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86593", "description": "SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1626.44, "providers": [{ "billed_charge": 24054.32, "npi": [1234567893] } ] } ] } ] }, { "name": "BARTONELLA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86611", "description": "ANTIBODY; BARTONELLA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.11, "providers": [{ "billed_charge": 120.98, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86631", "description": "ANTIBODY; CHLAMYDIA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 875.98, "providers": [{ "billed_charge": 11233.57, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA IGM ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86632", "description": "ANTIBODY; CHLAMYDIA, IGM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 491.42, "providers": [{ "billed_charge": 6362.12, "npi": [1234567893] } ] } ] } ] }, { "name": "EPSTEIN-BARR NUCLEAR ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86664", "description": "ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 488.59, "providers": [{ "billed_charge": 6015.94, "npi": [1234567893] } ] } ] } ] }, { "name": "EPSTEIN-BARR CAPSID VCA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86665", "description": "ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1488.08, "providers": [{ "billed_charge": 17938.58, "npi": [1234567893] } ] } ] } ] }, { "name": "FUNGUS NES ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86671", "description": "ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 199.80, "providers": [{ "billed_charge": 3621.22, "npi": [1234567893] } ] } ] } ] }, { "name": "HELMINTH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86682", "description": "ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.89, "providers": [{ "billed_charge": 893.96, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX TYPE 1 TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86695", "description": "ANTIBODY; HERPES SIMPLEX, TYPE 1", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.60, "providers": [{ "billed_charge": 884.64, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15309.88, "providers": [{ "billed_charge": 185875.01, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX TYPE 2 TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86696", "description": "ANTIBODY; HERPES SIMPLEX, TYPE 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 222.64, "providers": [{ "billed_charge": 1866.45, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27991.23, "providers": 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514.42, "npi": [1114995586] } ] } ] }, { "tin": { "type": "ein", "value": "264304912" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1680.00, "providers": [{ "billed_charge": 4200.00, "npi": [1871724864] } ] } ] }, { "tin": { "type": "ein", "value": "746000278" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1248.00, "providers": [{ "billed_charge": 3120.00, "npi": [1982695268] } ] } ] }, { "tin": { "type": "ein", "value": "746002544" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.00, "providers": [{ "billed_charge": 300.00, "npi": [1073588612] } ] } ] }, { "tin": { "type": "ein", "value": "741772120" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1100.00, "providers": [{ "billed_charge": 2750.00, "npi": [1437218062] } ] } ] }, { "tin": { "type": "ein", "value": "760133493" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1279.20, "providers": [{ "billed_charge": 3198.00, "npi": [1760033526] } ] } ] }, { "tin": { "type": "ein", "value": "746000574" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 2052.36, "providers": [{ "billed_charge": 5131.09, "npi": [1972609337] } ] } ] } ] }, { "name": "INFUS SPL EXT RX INFUS PUMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4222", "description": "INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943295573" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 928.80, "providers": [{ "billed_charge": 1584.00, "npi": [1790730596] } ] } ] } ] }, { "name": "INFUS SET EXT INSULIN PUMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4230", 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"billing_class": "professional", "payments": [{ "allowed_amount": 207.35, "providers": [{ "billed_charge": 260.00, "npi": [1326676362] } ] } ] }, { "tin": { "type": "ein", "value": "824771503" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1164.35, "providers": [{ "billed_charge": 1460.00, "npi": [1598990772] } ] } ] }, { "tin": { "type": "ein", "value": "760540476" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.50, "providers": [{ "billed_charge": 76.00, "npi": [1609288208] } ] } ] }, { "tin": { "type": "ein", "value": "742515841" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 889.11, "providers": [{ "billed_charge": 12960.00, "npi": [1932205838] } ] } ] }, { "tin": { "type": "ein", "value": "824472878" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 416.26, "providers": [{ "billed_charge": 650.00, "npi": [1477916708] } ] } ] }, { "tin": { "type": "ein", "value": "202798379" }, "service_code": ["11", "10"], "billing_class": "professional", "payments": [{ "allowed_amount": 159.73, "providers": [{ "billed_charge": 478.50, "npi": [1598129702] } ] }, { "allowed_amount": 15.95, "providers": [{ "billed_charge": 47.85, "npi": [1093212821] } ] }, { "allowed_amount": 350.90, "providers": [{ "billed_charge": 1052.70, "npi": [1093212821] } ] } ] }, { "tin": { "type": "ein", "value": "752600873" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 554.40, "providers": [{ "billed_charge": 768.00, "npi": [1295350999] } ] } ] }, { "tin": { "type": "ein", "value": "741282696" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 285.26, "providers": [{ "billed_charge": 680.00, "npi": [1679953749] } ] } ] }, { "tin": { "type": "ein", "value": "921381983" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.50, "providers": [{ "billed_charge": 100.00, "npi": [1619394756] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11", "02"], "billing_class": "professional", "payments": [{ "allowed_amount": 732.00, "providers": [{ "billed_charge": 2346.00, "npi": [1316188725] } ] }, { "allowed_amount": 25.92, "providers": [{ "billed_charge": 82.00, "npi": [1033954771] } ] }, { "allowed_amount": 45.75, "providers": [{ "billed_charge": 150.00, "npi": [1316188725] } ] } ] }, { "tin": { "type": "ein", "value": "263275773" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1314.96, "providers": [{ "billed_charge": 10100.00, "npi": [1467182865] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC;METHDONE ADM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG BY A LI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274250532" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1175.40, "providers": [{ "billed_charge": 2615.28, "npi": [1770781106] } ] } ] }, { "tin": { "type": "ein", "value": "852856491" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 891.00, "providers": [{ "billed_charge": 1485.00, "npi": [1205582822] } ] } ] } ] }, { "name": "BHVAL HEALTH PREV EDUCATION", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0025", "description": "BEHAVIORAL HEALTH PREVENTION EDUCATION SERVICE (DELIVERY OF SERVICES WITH TARGET POPULATION TO AFFEC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810965592" }, "service_code": ["10"], "billing_class": "professional", "payments": [{ "allowed_amount": 4650.00, "providers": [{ "billed_charge": 4650.00, "npi": [1538480686] } ] } ] } ] }, { "name": "ORAL MEDADMIN DIR OBSERV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0033", "description": "ORAL MEDICATION ADMINISTRATION, DIRECT OBSERVATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741547909" }, "service_code": ["57", "58"], "billing_class": "professional", "payments": [{ "allowed_amount": 3251.50, "providers": [{ "billed_charge": 13006.00, "npi": [1245769223] } ] }, { "allowed_amount": 1002.00, "providers": [{ "billed_charge": 4008.00, "npi": [1245769223] } ] } ] } ] }, { "name": "ALCOHOL &OR OTH DRUG ABS SRV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0047", "description": "ALCOHOL AND/OR OTHER DRUG ABUSE SERVICES, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751249456" }, "service_code": ["55"], "billing_class": "professional", "payments": [{ "allowed_amount": 261.60, "providers": [{ "billed_charge": 872.00, "npi": [1376590422] } ] } ] } ] }, { "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": "760537608" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 433.33, "providers": [{ "billed_charge": 1075.00, "npi": [1770583411] } ] } ] } ] }, { "name": "ALCOHOL &OR OTH DRUG TX PROG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2035", "description": "ALCOHOL AND/OR OTHER DRUG TREATMENT PROGRAM, PER HOUR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751249456" }, "service_code": ["55"], "billing_class": "professional", "payments": [{ "allowed_amount": 565.50, "providers": [{ "billed_charge": 1885.00, "npi": [1376590422] } ] } ] } ] }, { "name": "INJ CEFTRIAXONE SODM PER 250", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0696", "description": "INJECTION, CEFTRIAXONE SODIUM, PER 250 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.98, "providers": [{ "billed_charge": 1760.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.40, "providers": [{ "billed_charge": 1325.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.09, "providers": [{ "billed_charge": 60.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 676.80, "providers": [{ "billed_charge": 60571.15, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 175.23, "providers": [{ "billed_charge": 819.36, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.64, "providers": [{ "billed_charge": 51.84, "npi": [1447747860] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 171.75, "providers": [{ "billed_charge": 9625.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "461513436" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.16, "providers": [{ "billed_charge": 300.00, "npi": [1629099221] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 192.27, "providers": [{ "billed_charge": 34400.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.51, "providers": [{ "billed_charge": 790.00, "npi": [1316188725] } ] } ] } ] }, { "name": "njection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0872", "description": "njection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1345.00, "providers": [{ "billed_charge": 112140.00, "npi": [1234567893] } ] } ] } ] }, { "name": "INJECTION DAPTOMYCIN 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0878", "description": "INJECTION, DAPTOMYCIN, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 453.00, "providers": [{ "billed_charge": 1057.00, "npi": [1447747860] } ] } ] } ] }, { "name": "Injection, methylprednisolone acetate, 1 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1010", "description": "Injection, methylprednisolone acetate, 1 mg ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 492.96, "providers": [{ "billed_charge": 1503.52, "npi": [1972519544] } ] } ] } ] }, { "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": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.05, "providers": [{ "billed_charge": 3460.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "933075034" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 0.94, "providers": [{ "billed_charge": 45.00, "npi": [1831544808] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.27, "providers": [{ "billed_charge": 4040.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.87, "providers": [{ "billed_charge": 1440.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.21, "providers": [{ "billed_charge": 570.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "813564692" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.90, "providers": [{ "billed_charge": 150.00, "npi": [1972823169] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.94, "providers": [{ "billed_charge": 187.86, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.30, "providers": [{ "billed_charge": 143.00, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.56, "providers": [{ "billed_charge": 8415.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.72, "providers": [{ "billed_charge": 7140.00, "npi": [1316188725] } ] } ] } ] }, { "name": "INJ ERTAPENEM SODIUM 500MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1335", "description": "INJECTION, ERTAPENEM SODIUM, 500 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2082.72, "providers": [{ "billed_charge": 58487.73, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ KETOROLAC TROMETHAMINE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1885", "description": "INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.50, "providers": [{ "billed_charge": 715.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.39, "providers": [{ "billed_charge": 1045.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.60, "providers": [{ "billed_charge": 480.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.52, "providers": [{ "billed_charge": 545.04, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 202.22, "providers": [{ "billed_charge": 6420.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.52, "providers": [{ "billed_charge": 2100.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.40, "providers": [{ "billed_charge": 570.00, "npi": [1316188725] } ] } ] } ] }, { "name": "INJECTION MEROPENEM 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2185", "description": "INJECTION, MEROPENEM, 100 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1975.45, "providers": [{ "billed_charge": 58117.29, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ ONDANSETRON HCL PER 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2405", "description": "INJECTION, ONDANSETRON HCL, PER 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.52, "providers": [{ "billed_charge": 358.24, "npi": [1972519544] } ] } ] } ] }, { "name": "INJ PROMETHAZINE HCL UPTO 50", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2550", "description": "INJECTION, PROMETHAZINE HCL, UP TO 50 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.90, "providers": [{ "billed_charge": 40.00, "npi": [1144275355] } ] } ] } ] }, { "name": "Injection, methylprednisolone sodium succinate, 5 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2919", "description": "Injection, methylprednisolone sodium succinate, 5 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.25, "providers": [{ "billed_charge": 1560.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 169.94, "providers": [{ "billed_charge": 1892.38, "npi": [1972519544] } ] } ] } ] }, { "name": "Vancomycin Hydrochloride, 10 mg,", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3373", "description": "Vancomycin Hydrochloride, 10 mg,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 147.00, "providers": [{ "billed_charge": 3896.95, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ PYRIDOXINE HCL 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3415", "description": "INJECTION, PYRIDOXINE HCL, 100 MG", 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