{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"2.0.0","last_updated_on":"2026-03-31","out_of_network":[{"name":"Caris Assure  (Caris MPI Inc.).","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"0485U","description":"Caris Assure  (Caris MPI Inc.).","allowed_amounts":[{"tin":{"type":"ein","value":"743126687"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16800.00,"providers":[{"billed_charge":42000.00,"npi":[1225872658]}]}]}]},{"name":"RESIDENTIAL TREATMENT-PSYCHI","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1001","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"922021823"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":28714.00,"providers":[{"billed_charge":220500.00,"npi":[1740987379]}]}]}]},{"name":"RESIDENTIAL TREATMENT - CHEM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"461912262"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":264286.00,"providers":[{"billed_charge":868626.00,"npi":[1558788802]}]}]},{"tin":{"type":"ein","value":"994859635"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":77212.00,"providers":[{"billed_charge":395200.00,"npi":[1891584645]}]}]},{"tin":{"type":"ein","value":"861297055"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":3150.00,"providers":[{"billed_charge":32165.00,"npi":[1346912904]}]}]},{"tin":{"type":"ein","value":"850667698"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":137874.80,"providers":[{"billed_charge":674215.00,"npi":[1649914813]}]}]},{"tin":{"type":"ein","value":"922021823"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":4688.00,"providers":[{"billed_charge":36000.00,"npi":[1740987379]}]}]},{"tin":{"type":"ein","value":"823470979"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":5670.00,"providers":[{"billed_charge":25000.00,"npi":[1265447015]}]}]},{"tin":{"type":"ein","value":"475415371"},"service_code":["56","21"],"billing_class":"institutional","payments":[{"allowed_amount":853.20,"providers":[{"billed_charge":2600.00,"npi":[1649631086]}]},{"allowed_amount":2986.20,"providers":[{"billed_charge":9100.00,"npi":[1649631086]}]}]},{"tin":{"type":"ein","value":"922964801"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":6368.00,"providers":[{"billed_charge":40000.00,"npi":[1316629249]}]}]}]},{"name":"DEB SUBQ TISSUE 20 SQ CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"11042","description":"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LE","allowed_amounts":[{"tin":{"type":"ein","value":"863437270"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1311.19,"providers":[{"billed_charge":3508.80,"npi":[1790461044]}]}]},{"tin":{"type":"ein","value":"550840991"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1159.20,"providers":[{"billed_charge":3248.00,"npi":[1881229045]}]}]}]},{"name":"MED-SUR-GY/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"111","description":"ROOM AND BOARD - PRIVATE -MEDICAL/SURGICAL/GYN","allowed_amounts":[{"tin":{"type":"ein","value":"580566256"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":36094.76,"providers":[{"billed_charge":31665.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":3383104.19,"providers":[{"billed_charge":1365817.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":2003440.59,"providers":[{"billed_charge":976297.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":191228.77,"providers":[{"billed_charge":92884.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":489607.46,"providers":[{"billed_charge":158208.00,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":242487.60,"providers":[{"billed_charge":77784.00,"npi":[1952340994]}]},{"allowed_amount":461757.43,"providers":[{"billed_charge":272151.00,"npi":[1457396079]}]},{"allowed_amount":173276.84,"providers":[{"billed_charge":91934.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":165310.13,"providers":[{"billed_charge":54886.00,"npi":[1962403865]}]},{"allowed_amount":252352.06,"providers":[{"billed_charge":132993.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":270222.45,"providers":[{"billed_charge":809810.00,"npi":[1053824292]}]}]}]},{"name":"PSTAY/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"114","description":"ROOM AND BOARD - PRIVATE -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"581973570"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":96498.20,"providers":[{"billed_charge":78648.00,"npi":[1023057775]}]}]}]},{"name":"MED-SUR-GY/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"121","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -MEDICAL/SURGICAL/GYN","allowed_amounts":[{"tin":{"type":"ein","value":"580968382"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":484144.74,"providers":[{"billed_charge":359418.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":2575977.31,"providers":[{"billed_charge":857495.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1246619.87,"providers":[{"billed_charge":433200.00,"npi":[1154795581]}]}]}]},{"name":"PSTAY/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"124","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"582453303"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":720257.52,"providers":[{"billed_charge":730518.85,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"262700697"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":162798.26,"providers":[{"billed_charge":296698.00,"npi":[1174865513]}]}]},{"tin":{"type":"ein","value":"711045290"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":351014.72,"providers":[{"billed_charge":330395.00,"npi":[1962435792]}]}]},{"tin":{"type":"ein","value":"262203865"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":324317.21,"providers":[{"billed_charge":502200.00,"npi":[1407021546]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":433650.62,"providers":[{"billed_charge":665184.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":227562.28,"providers":[{"billed_charge":605796.00,"npi":[1467406413]}]}]},{"tin":{"type":"ein","value":"233044978"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":212170.43,"providers":[{"billed_charge":364000.00,"npi":[1093781544]}]}]}]},{"name":"DETOX/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"126","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -DETOXIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"460756663"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":43598.16,"providers":[{"billed_charge":163112.60,"npi":[1427440999]}]}]},{"tin":{"type":"ein","value":"994859635"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":206213.40,"providers":[{"billed_charge":1876800.00,"npi":[1891584645]}]}]},{"tin":{"type":"ein","value":"850667698"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":30595.20,"providers":[{"billed_charge":143649.40,"npi":[1649914813]}]}]},{"tin":{"type":"ein","value":"815105103"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8550.00,"providers":[{"billed_charge":60000.00,"npi":[1033697099]}]}]}]},{"name":"ANES DRG/ASPIR LMBR/SAC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"1938","description":"ANES PERQ IMG NJX DRG/ASPIR PX SPI/SP LMBR/SAC","allowed_amounts":[{"tin":{"type":"ein","value":"820834166"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":327.68,"providers":[{"billed_charge":4000.00,"npi":[1144298761]}]},{"allowed_amount":286.72,"providers":[{"billed_charge":3500.00,"npi":[1952593865]}]}]},{"tin":{"type":"ein","value":"271533256"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":122.88,"providers":[{"billed_charge":2880.00,"npi":[1043398092]}]}]}]},{"name":"INTENSIVE CARE OR ICU","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"200","description":"INTENSIVE CARE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":178430.32,"providers":[{"billed_charge":322674.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":248184.22,"providers":[{"billed_charge":330216.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":344505.48,"providers":[{"billed_charge":529740.00,"npi":[1528056066]}]}]}]},{"name":"POST ICU","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"206","description":"INTENSIVE CARE - POST ICU","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":42244.10,"providers":[{"billed_charge":122250.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":255805.24,"providers":[{"billed_charge":246788.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":41966.54,"providers":[{"billed_charge":123431.00,"npi":[1053824292]}]}]}]},{"name":"DRAIN/INJ JOINT/BURSA W/O US","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"20610","description":"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJ JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIA","allowed_amounts":[{"tin":{"type":"ein","value":"43800503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":297.85,"providers":[{"billed_charge":687.33,"npi":[1558698423]}]}]},{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":323.16,"providers":[{"billed_charge":1200.00,"npi":[1366430233]}]}]}]},{"name":"POST CCU","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"214","description":"CORONARY CARE - POST-CCU","allowed_amounts":[{"tin":{"type":"ein","value":"580968382"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1058886.03,"providers":[{"billed_charge":1054833.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":41182.12,"providers":[{"billed_charge":67931.00,"npi":[1801883780]}]}]}]},{"name":"Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility PPS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"22","description":"Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility PPS","allowed_amounts":[{"tin":{"type":"ein","value":"201871913"},"service_code":["31"],"billing_class":"institutional","payments":[{"allowed_amount":260036.75,"providers":[{"billed_charge":0.00,"npi":[1831175652]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"581911751"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":146.12,"providers":[{"billed_charge":487.00,"npi":[1598784720]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":313.67,"providers":[{"billed_charge":1045.56,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":974.01,"providers":[{"billed_charge":3246.70,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5022.00,"providers":[{"billed_charge":16740.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":356.64,"providers":[{"billed_charge":1271.00,"npi":[1043270564]}]},{"allowed_amount":729.03,"providers":[{"billed_charge":5033.25,"npi":[1043270564]}]},{"allowed_amount":2.35,"providers":[{"billed_charge":10.05,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":435.99,"providers":[{"billed_charge":2009.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2535.90,"providers":[{"billed_charge":8453.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":21.11,"providers":[{"billed_charge":20713.74,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20.40,"providers":[{"billed_charge":10050.50,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9931.87,"providers":[{"billed_charge":29233.24,"npi":[1053824292]}]},{"allowed_amount":51041.27,"providers":[{"billed_charge":164932.62,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1492.74,"providers":[{"billed_charge":4975.80,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":11092.11,"providers":[{"billed_charge":16567.75,"npi":[1881764553]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7.66,"providers":[{"billed_charge":9494.57,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":371.70,"providers":[{"billed_charge":1239.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17491.72,"providers":[{"billed_charge":58325.36,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":721.80,"providers":[{"billed_charge":2406.00,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20608.20,"providers":[{"billed_charge":68694.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":30.70,"providers":[{"billed_charge":102.25,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":409.11,"providers":[{"billed_charge":1596.62,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42.50,"providers":[{"billed_charge":127.00,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11321.30,"providers":[{"billed_charge":40669.12,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":722.61,"providers":[{"billed_charge":2408.70,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"205497506"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31.65,"providers":[{"billed_charge":105.50,"npi":[1821221144]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1734.33,"providers":[{"billed_charge":5500.46,"npi":[1285688234]}]},{"allowed_amount":94.01,"providers":[{"billed_charge":279.25,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"562084959"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":336.72,"providers":[{"billed_charge":1122.25,"npi":[1144247982]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7.73,"providers":[{"billed_charge":25.77,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"741536936"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":791.32,"providers":[{"billed_charge":1914.05,"npi":[1205900370]}]}]},{"tin":{"type":"ein","value":"581685139"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1.88,"providers":[{"billed_charge":6.27,"npi":[1255401519]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":348.13,"providers":[{"billed_charge":1160.40,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23.18,"providers":[{"billed_charge":77.25,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":21.23,"providers":[{"billed_charge":70.77,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2431.95,"providers":[{"billed_charge":8106.50,"npi":[1952340994]}]},{"allowed_amount":6192.58,"providers":[{"billed_charge":20641.95,"npi":[1457396079]}]},{"allowed_amount":1133.55,"providers":[{"billed_charge":3778.50,"npi":[1376574277]}]},{"allowed_amount":2474.55,"providers":[{"billed_charge":8248.50,"npi":[1790715381]}]},{"allowed_amount":11533.80,"providers":[{"billed_charge":38446.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90.31,"providers":[{"billed_charge":1082.67,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2466.15,"providers":[{"billed_charge":138296.12,"npi":[1588640692]}]},{"allowed_amount":600.43,"providers":[{"billed_charge":1531.32,"npi":[1588640692]}]},{"allowed_amount":1323.86,"providers":[{"billed_charge":4412.71,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":158.12,"providers":[{"billed_charge":527.07,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":957.47,"providers":[{"billed_charge":3191.65,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1049.12,"providers":[{"billed_charge":3497.02,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5694.60,"providers":[{"billed_charge":18982.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5371.71,"providers":[{"billed_charge":19369.97,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"204144787"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":109.13,"providers":[{"billed_charge":363.75,"npi":[1619014156]}]}]},{"tin":{"type":"ein","value":"860110232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":111.09,"providers":[{"billed_charge":370.24,"npi":[1780635078]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":942.00,"providers":[{"billed_charge":942.00,"npi":[1700828852]}]},{"allowed_amount":143.40,"providers":[{"billed_charge":478.00,"npi":[1700828852]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42.69,"providers":[{"billed_charge":144.90,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":144.92,"providers":[{"billed_charge":524.42,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1321.38,"providers":[{"billed_charge":8402.29,"npi":[1093716979]}]},{"allowed_amount":938.31,"providers":[{"billed_charge":9493.83,"npi":[1962403865]}]}]},{"tin":{"type":"ein","value":"60646668"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":0.50,"providers":[{"billed_charge":1.68,"npi":[1770696643]}]}]}]},{"name":"DRUGS/INCIDNT RAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"255","description":"PHARMACY - DRUGS INCIDENT TO RADIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":60.00,"providers":[{"billed_charge":3330.00,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1337.81,"providers":[{"billed_charge":1672.27,"npi":[1588640692]}]},{"allowed_amount":1531.71,"providers":[{"billed_charge":5105.68,"npi":[1588640692]}]},{"allowed_amount":353.14,"providers":[{"billed_charge":6680.53,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":990.00,"providers":[{"billed_charge":3300.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":44.09,"providers":[{"billed_charge":1086.21,"npi":[1144203563]}]},{"allowed_amount":22462.20,"providers":[{"billed_charge":74873.17,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":600.00,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":99.00,"providers":[{"billed_charge":330.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31987.80,"providers":[{"billed_charge":108616.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":240.00,"providers":[{"billed_charge":800.00,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2037.00,"providers":[{"billed_charge":7750.00,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1344.00,"providers":[{"billed_charge":4954.00,"npi":[1952340994]}]},{"allowed_amount":6600.00,"providers":[{"billed_charge":22000.00,"npi":[1225050396]}]},{"allowed_amount":314.40,"providers":[{"billed_charge":1048.00,"npi":[1790715381]}]},{"allowed_amount":5946.90,"providers":[{"billed_charge":19823.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1968.17,"providers":[{"billed_charge":13759.44,"npi":[1962403865]}]},{"allowed_amount":2112.06,"providers":[{"billed_charge":14449.62,"npi":[1093716979]}]}]}]},{"name":"IV SOLUTIONS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"258","description":"PHARMACY - IV SOLUTIONS","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1068.18,"providers":[{"billed_charge":3560.57,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":96.66,"providers":[{"billed_charge":322.20,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7506.00,"providers":[{"billed_charge":25020.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":15.21,"providers":[{"billed_charge":65.00,"npi":[1043270564]}]},{"allowed_amount":43.29,"providers":[{"billed_charge":24941.05,"npi":[1043270564]}]},{"allowed_amount":153.32,"providers":[{"billed_charge":524.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3411.90,"providers":[{"billed_charge":11373.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":6470.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5965.80,"providers":[{"billed_charge":19886.00,"npi":[1225050396]}]},{"allowed_amount":2246.40,"providers":[{"billed_charge":7488.00,"npi":[1790715381]}]},{"allowed_amount":2037.45,"providers":[{"billed_charge":6999.50,"npi":[1952340994]}]},{"allowed_amount":2056.35,"providers":[{"billed_charge":6854.50,"npi":[1457396079]}]},{"allowed_amount":496.35,"providers":[{"billed_charge":1654.50,"npi":[1376574277]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":19248.16,"providers":[{"billed_charge":61404.90,"npi":[1053824292]}]},{"allowed_amount":14651.86,"providers":[{"billed_charge":43140.10,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":338.31,"providers":[{"billed_charge":1127.70,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":436.44,"providers":[{"billed_charge":1454.80,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31.50,"providers":[{"billed_charge":105.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1714.77,"providers":[{"billed_charge":5715.85,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90.60,"providers":[{"billed_charge":7902.53,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":655.20,"providers":[{"billed_charge":2184.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":29985.60,"providers":[{"billed_charge":100502.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":437.89,"providers":[{"billed_charge":1459.43,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":362.38,"providers":[{"billed_charge":1711.05,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3094.12,"providers":[{"billed_charge":12325.60,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":81.75,"providers":[{"billed_charge":272.50,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":48.33,"providers":[{"billed_charge":161.10,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1520.97,"providers":[{"billed_charge":5069.88,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31.50,"providers":[{"billed_charge":315.00,"npi":[1093716979]}]},{"allowed_amount":21.00,"providers":[{"billed_charge":175.00,"npi":[1962403865]}]}]}]},{"name":"DRUGS/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"259","description":"PHARMACY - OTHER PHARMACY","allowed_amounts":[{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":222.64,"providers":[{"billed_charge":742.11,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":33.58,"providers":[{"billed_charge":111.93,"npi":[1154386431]}]}]}]},{"name":"IV THERAPY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"260","description":"IV THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1771.73,"providers":[{"billed_charge":3782.00,"npi":[1649726738]}]},{"allowed_amount":887.62,"providers":[{"billed_charge":3295.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":32486.64,"providers":[{"billed_charge":99877.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":81224.95,"providers":[{"billed_charge":271774.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":8113.13,"providers":[{"billed_charge":62863.00,"npi":[1992799050]}]},{"allowed_amount":4012.67,"providers":[{"billed_charge":42781.00,"npi":[1992799050]}]},{"allowed_amount":1419.25,"providers":[{"billed_charge":15600.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":41646.64,"providers":[{"billed_charge":139852.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9601.62,"providers":[{"billed_charge":30315.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2931.17,"providers":[{"billed_charge":7794.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":33.69,"providers":[{"billed_charge":89.25,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1789.60,"providers":[{"billed_charge":1610.55,"npi":[1720189517]}]},{"allowed_amount":3821.62,"providers":[{"billed_charge":9243.25,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"592142859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":581.69,"providers":[{"billed_charge":3279.08,"npi":[1821186313]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":124695.88,"providers":[{"billed_charge":365977.00,"npi":[1053824292]}]},{"allowed_amount":37637.32,"providers":[{"billed_charge":113538.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3427.08,"providers":[{"billed_charge":9575.76,"npi":[1437186111]}]},{"allowed_amount":23157.12,"providers":[{"billed_charge":80840.52,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":205.29,"providers":[{"billed_charge":335.00,"npi":[1871556621]}]},{"allowed_amount":2453.84,"providers":[{"billed_charge":12189.00,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":290916.98,"providers":[{"billed_charge":697590.00,"npi":[1144203563]}]},{"allowed_amount":336.00,"providers":[{"billed_charge":420.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"590973502"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1979.94,"providers":[{"billed_charge":3213.42,"npi":[1063426823]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":223928.84,"providers":[{"billed_charge":747789.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13237.28,"providers":[{"billed_charge":43438.27,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2776.96,"providers":[{"billed_charge":8292.50,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3178.21,"providers":[{"billed_charge":10701.17,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23781.90,"providers":[{"billed_charge":77099.31,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"510141601"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":629.91,"providers":[{"billed_charge":982.00,"npi":[1043311715]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8795.35,"providers":[{"billed_charge":27421.41,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":683.17,"providers":[{"billed_charge":1328.00,"npi":[1306938071]}]},{"allowed_amount":11030.54,"providers":[{"billed_charge":27393.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"300999841"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":215.25,"providers":[{"billed_charge":954.26,"npi":[1306355680]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":970.80,"providers":[{"billed_charge":2285.11,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14640.19,"providers":[{"billed_charge":49610.00,"npi":[1952340994]}]},{"allowed_amount":4649.44,"providers":[{"billed_charge":13187.00,"npi":[1790715381]}]},{"allowed_amount":2044.10,"providers":[{"billed_charge":6775.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4304.22,"providers":[{"billed_charge":14950.12,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10667.23,"providers":[{"billed_charge":50019.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":53601.66,"providers":[{"billed_charge":160909.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19721.37,"providers":[{"billed_charge":46876.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"621736983"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":564.48,"providers":[{"billed_charge":3490.25,"npi":[1598719643]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16016.79,"providers":[{"billed_charge":42717.34,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581734026"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1247.60,"providers":[{"billed_charge":6822.00,"npi":[1659376630]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9242.15,"providers":[{"billed_charge":22168.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":158683.06,"providers":[{"billed_charge":682427.00,"npi":[1528056066]}]},{"allowed_amount":200.68,"providers":[{"billed_charge":644.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20750.37,"providers":[{"billed_charge":54010.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":58623.04,"providers":[{"billed_charge":199949.67,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":39778.12,"providers":[{"billed_charge":126170.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3307.59,"providers":[{"billed_charge":12599.64,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":43850.53,"providers":[{"billed_charge":111222.00,"npi":[1962403865]}]},{"allowed_amount":40755.31,"providers":[{"billed_charge":109936.00,"npi":[1093716979]}]}]}]},{"name":"MED-SUR SUPPLIES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"270","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":699.13,"providers":[{"billed_charge":2330.42,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1.11,"providers":[{"billed_charge":789.09,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1246.17,"providers":[{"billed_charge":4153.90,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":5263.78,"providers":[{"billed_charge":7862.30,"npi":[1881764553]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1095.20,"providers":[{"billed_charge":39627.62,"npi":[1588640692]}]},{"allowed_amount":59.70,"providers":[{"billed_charge":199.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":556.41,"providers":[{"billed_charge":1854.70,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5194.27,"providers":[{"billed_charge":17314.23,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":882.54,"providers":[{"billed_charge":2941.79,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":702.00,"providers":[{"billed_charge":2340.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13.65,"providers":[{"billed_charge":40.74,"npi":[1811962756]}]},{"allowed_amount":202.98,"providers":[{"billed_charge":606.27,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":288.22,"providers":[{"billed_charge":960.77,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90.86,"providers":[{"billed_charge":302.90,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":679.23,"providers":[{"billed_charge":2264.10,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"205497506"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":232.77,"providers":[{"billed_charge":775.90,"npi":[1821221144]}]}]}]},{"name":"NON-STER SUPPLY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"271","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON-STERILE SUPPLY","allowed_amounts":[{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11802.67,"providers":[{"billed_charge":39499.64,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":160.76,"providers":[{"billed_charge":560.85,"npi":[1154795581]}]}]}]},{"name":"STERILE SUPPLY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"272","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY","allowed_amounts":[{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":401.55,"providers":[{"billed_charge":1338.52,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":34358.85,"providers":[{"billed_charge":114529.50,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10.59,"providers":[{"billed_charge":35.30,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25206.91,"providers":[{"billed_charge":84179.57,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":703.88,"providers":[{"billed_charge":2421.16,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2330.93,"providers":[{"billed_charge":8820.19,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":148.75,"providers":[{"billed_charge":444.19,"npi":[1811962756]}]},{"allowed_amount":126.82,"providers":[{"billed_charge":378.63,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":75.18,"providers":[{"billed_charge":267.05,"npi":[1043270564]}]},{"allowed_amount":24.39,"providers":[{"billed_charge":104.23,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":27.53,"providers":[{"billed_charge":4616.43,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":39529.40,"providers":[{"billed_charge":116262.75,"npi":[1053824292]}]},{"allowed_amount":145423.35,"providers":[{"billed_charge":465782.75,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":49.32,"providers":[{"billed_charge":164.40,"npi":[1649248626]}]}]}]},{"name":"SUPPLY/IMPLANTS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"278","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANTS","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":91.13,"providers":[{"billed_charge":303.77,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":416.34,"providers":[{"billed_charge":1387.80,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2233.55,"providers":[{"billed_charge":7445.18,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2108.10,"providers":[{"billed_charge":6200.25,"npi":[1053824292]}]},{"allowed_amount":41848.01,"providers":[{"billed_charge":129822.25,"npi":[1053824292]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":214.84,"providers":[{"billed_charge":213.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7505.17,"providers":[{"billed_charge":22726.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":30839.94,"providers":[{"billed_charge":114680.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"581953215"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":65943.44,"providers":[{"billed_charge":44400.00,"npi":[1457396079]}]},{"allowed_amount":8051.37,"providers":[{"billed_charge":38060.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":776.57,"providers":[{"billed_charge":80366.70,"npi":[1992799050]}]},{"allowed_amount":725.87,"providers":[{"billed_charge":36612.40,"npi":[1992799050]}]},{"allowed_amount":3368.48,"providers":[{"billed_charge":85376.20,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"586025016"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":98.00,"providers":[{"billed_charge":679.48,"npi":[1326079260]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":58.39,"providers":[{"billed_charge":19309.87,"npi":[1720189517]}]},{"allowed_amount":2679.02,"providers":[{"billed_charge":10396.56,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":6196.16,"providers":[{"billed_charge":18224.00,"npi":[1053824292]}]},{"allowed_amount":21258.50,"providers":[{"billed_charge":63245.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"953561198"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":910.77,"providers":[{"billed_charge":2040.00,"npi":[1457382483]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31050.96,"providers":[{"billed_charge":116021.00,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26450.79,"providers":[{"billed_charge":96033.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":38.40,"providers":[{"billed_charge":2529.00,"npi":[1144203563]}]},{"allowed_amount":47503.61,"providers":[{"billed_charge":135461.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15648.57,"providers":[{"billed_charge":60992.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"810851756"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3052.86,"providers":[{"billed_charge":10840.00,"npi":[1750312997]}]}]},{"tin":{"type":"ein","value":"636005396"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":40.53,"providers":[{"billed_charge":231.00,"npi":[1154435824]}]},{"allowed_amount":275.86,"providers":[{"billed_charge":3699.44,"npi":[1154435824]}]}]},{"tin":{"type":"ein","value":"580625140"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7.87,"providers":[{"billed_charge":79.77,"npi":[1740272095]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1242.07,"providers":[{"billed_charge":5062.84,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"934580630"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":862.59,"providers":[{"billed_charge":2963.00,"npi":[1205605409]}]}]},{"tin":{"type":"ein","value":"560585243"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":323.26,"providers":[{"billed_charge":766.51,"npi":[1043218944]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":318.92,"providers":[{"billed_charge":630.00,"npi":[1780235002]}]},{"allowed_amount":282.98,"providers":[{"billed_charge":964.00,"npi":[1154386431]}]}]},{"tin":{"type":"ein","value":"720502505"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3460.00,"providers":[{"billed_charge":5032.00,"npi":[1811973100]}]},{"allowed_amount":1870.46,"providers":[{"billed_charge":5633.00,"npi":[1811973100]}]}]},{"tin":{"type":"ein","value":"640881013"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":369.33,"providers":[{"billed_charge":2104.00,"npi":[1710909585]}]}]},{"tin":{"type":"ein","value":"311626179"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3476.03,"providers":[{"billed_charge":5837.50,"npi":[1538164090]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":256.10,"providers":[{"billed_charge":300.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"741536936"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":293.74,"providers":[{"billed_charge":31359.00,"npi":[1205900370]}]},{"allowed_amount":109.00,"providers":[{"billed_charge":10875.00,"npi":[1205900370]}]}]},{"tin":{"type":"ein","value":"650729921"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18.22,"providers":[{"billed_charge":1640.00,"npi":[1952311243]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":377.77,"providers":[{"billed_charge":1240.25,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"352635546"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":118.61,"providers":[{"billed_charge":615.08,"npi":[1942784715]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":36778.76,"providers":[{"billed_charge":171836.00,"npi":[1225050396]}]},{"allowed_amount":46106.25,"providers":[{"billed_charge":198833.00,"npi":[1457396079]}]},{"allowed_amount":1153.05,"providers":[{"billed_charge":4309.00,"npi":[1952340994]}]},{"allowed_amount":3494.90,"providers":[{"billed_charge":9753.00,"npi":[1457396079]}]},{"allowed_amount":8288.14,"providers":[{"billed_charge":36342.00,"npi":[1376574277]}]}]},{"tin":{"type":"ein","value":"364827272"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":559.62,"providers":[{"billed_charge":2386.79,"npi":[1740724780]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5048.53,"providers":[{"billed_charge":14178.00,"npi":[1588640692]}]},{"allowed_amount":10843.85,"providers":[{"billed_charge":645875.00,"npi":[1588640692]}]},{"allowed_amount":14438.40,"providers":[{"billed_charge":18087.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13993.41,"providers":[{"billed_charge":42505.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"611334601"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":279.76,"providers":[{"billed_charge":1584.00,"npi":[1437150984]}]},{"allowed_amount":3305.00,"providers":[{"billed_charge":3305.00,"npi":[1437150984]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1149.01,"providers":[{"billed_charge":3548.03,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":799.12,"providers":[{"billed_charge":2120.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581734026"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3268.42,"providers":[{"billed_charge":9512.00,"npi":[1659376630]}]}]},{"tin":{"type":"ein","value":"582223937"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16.97,"providers":[{"billed_charge":29.00,"npi":[1205843174]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":57.81,"providers":[{"billed_charge":393.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":19770.89,"providers":[{"billed_charge":59516.50,"npi":[1962461681]}]},{"allowed_amount":290.67,"providers":[{"billed_charge":1717.38,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"646001587"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":94.52,"providers":[{"billed_charge":215.38,"npi":[1225041809]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8434.68,"providers":[{"billed_charge":25219.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"60646704"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":602.24,"providers":[{"billed_charge":1263.22,"npi":[1700092459]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":421.20,"providers":[{"billed_charge":1473.45,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"576000934"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1892.00,"providers":[{"billed_charge":3783.00,"npi":[1609807122]}]}]},{"tin":{"type":"ein","value":"581911751"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2810.72,"providers":[{"billed_charge":6465.38,"npi":[1598784720]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3614.70,"providers":[{"billed_charge":17265.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"581020324"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":538.98,"providers":[{"billed_charge":1320.39,"npi":[1386670834]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1447.76,"providers":[{"billed_charge":5523.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.84,"providers":[{"billed_charge":850.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"813334196"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":165.16,"providers":[{"billed_charge":4044.00,"npi":[1013499383]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":101.47,"providers":[{"billed_charge":1566.75,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2484.66,"providers":[{"billed_charge":9901.10,"npi":[1437186111]}]},{"allowed_amount":6809.35,"providers":[{"billed_charge":13465.43,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":46.00,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"650543088"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3247.53,"providers":[{"billed_charge":9466.00,"npi":[1760419527]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":128.39,"providers":[{"billed_charge":643.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"586011876"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":565.91,"providers":[{"billed_charge":969.00,"npi":[1770578999]}]}]},{"tin":{"type":"ein","value":"201729674"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":105.61,"providers":[{"billed_charge":135.00,"npi":[1053360651]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9422.52,"providers":[{"billed_charge":32335.70,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2.83,"providers":[{"billed_charge":8.45,"npi":[1811962756]}]},{"allowed_amount":95.94,"providers":[{"billed_charge":286.50,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31.20,"providers":[{"billed_charge":89.30,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20418.10,"providers":[{"billed_charge":75197.00,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"205497506"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11050.66,"providers":[{"billed_charge":49170.34,"npi":[1821221144]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":205.96,"providers":[{"billed_charge":1232.82,"npi":[1235129214]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1434.44,"providers":[{"billed_charge":5215.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"994785298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":65.78,"providers":[{"billed_charge":16463.25,"npi":[1639992514]}]}]},{"tin":{"type":"ein","value":"582144788"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":372.31,"providers":[{"billed_charge":1474.00,"npi":[1437135902]}]},{"allowed_amount":931.64,"providers":[{"billed_charge":4827.00,"npi":[1437135902]}]}]},{"tin":{"type":"ein","value":"581685139"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4.86,"providers":[{"billed_charge":44.65,"npi":[1255401519]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":579.45,"providers":[{"billed_charge":3085.80,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"570359174"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":68.07,"providers":[{"billed_charge":279.00,"npi":[1417919531]}]},{"allowed_amount":1573.79,"providers":[{"billed_charge":3720.00,"npi":[1417919531]}]}]},{"tin":{"type":"ein","value":"582026750"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":197.93,"providers":[{"billed_charge":880.00,"npi":[1649247974]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":144.92,"providers":[{"billed_charge":714.40,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"711045290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12.77,"providers":[{"billed_charge":24.00,"npi":[1962435792]}]}]},{"tin":{"type":"ein","value":"886000436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2571.06,"providers":[{"billed_charge":7658.00,"npi":[1548393127]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.00,"providers":[{"billed_charge":36.00,"npi":[1528056066]}]},{"allowed_amount":101956.29,"providers":[{"billed_charge":238810.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580607088"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1316.52,"providers":[{"billed_charge":4140.00,"npi":[1912099094]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":27.75,"providers":[{"billed_charge":40.00,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3260.39,"providers":[{"billed_charge":18780.00,"npi":[1962403865]}]},{"allowed_amount":3209.33,"providers":[{"billed_charge":16069.00,"npi":[1093716979]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"636001820"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":76.95,"providers":[{"billed_charge":173.00,"npi":[1043262488]}]}]},{"tin":{"type":"ein","value":"596012065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1372.57,"providers":[{"billed_charge":2901.80,"npi":[1265460232]}]},{"allowed_amount":3203.19,"providers":[{"billed_charge":6772.05,"npi":[1285662239]}]}]},{"tin":{"type":"ein","value":"811723202"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":142.49,"providers":[{"billed_charge":4683.00,"npi":[1649726738]}]},{"allowed_amount":1214.18,"providers":[{"billed_charge":10414.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26449.87,"providers":[{"billed_charge":73235.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"340714456"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":312.86,"providers":[{"billed_charge":596.00,"npi":[1790837235]}]}]},{"tin":{"type":"ein","value":"581953215"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":2553.57,"providers":[{"billed_charge":5007.00,"npi":[1457396079]}]},{"allowed_amount":1268.37,"providers":[{"billed_charge":7284.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":2002.98,"providers":[{"billed_charge":214892.95,"npi":[1992799050]}]},{"allowed_amount":8081.75,"providers":[{"billed_charge":514485.83,"npi":[1992799050]}]},{"allowed_amount":2780.78,"providers":[{"billed_charge":634633.36,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"586025016"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":859.51,"providers":[{"billed_charge":3246.17,"npi":[1326079260]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6670.65,"providers":[{"billed_charge":26731.98,"npi":[1720189517]}]},{"allowed_amount":131.63,"providers":[{"billed_charge":28825.41,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":216.58,"providers":[{"billed_charge":637.00,"npi":[1053824292]}]},{"allowed_amount":197344.99,"providers":[{"billed_charge":582167.70,"npi":[1053824292]}]},{"allowed_amount":186551.16,"providers":[{"billed_charge":596027.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582155150"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1157.35,"providers":[{"billed_charge":3729.16,"npi":[1760498588]}]}]},{"tin":{"type":"ein","value":"852556972"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":759.66,"providers":[{"billed_charge":2701.28,"npi":[1790376564]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":336080.80,"providers":[{"billed_charge":704141.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"591113901"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8.72,"providers":[{"billed_charge":4420.83,"npi":[1053321919]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":264935.25,"providers":[{"billed_charge":883790.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"560543246"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":412.40,"providers":[{"billed_charge":838.00,"npi":[1427075027]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13398.29,"providers":[{"billed_charge":57824.79,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"581928247"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2843.33,"providers":[{"billed_charge":11148.00,"npi":[1992789721]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4134.00,"providers":[{"billed_charge":15033.00,"npi":[1154386431]}]},{"allowed_amount":1230.36,"providers":[{"billed_charge":2210.00,"npi":[1154386431]}]},{"allowed_amount":1580.66,"providers":[{"billed_charge":3368.00,"npi":[1780235002]}]}]},{"tin":{"type":"ein","value":"720502505"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":144.23,"providers":[{"billed_charge":279.00,"npi":[1811973100]}]}]},{"tin":{"type":"ein","value":"592650456"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":46.55,"providers":[{"billed_charge":11174.00,"npi":[1144228446]}]}]},{"tin":{"type":"ein","value":"475348597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":549.51,"providers":[{"billed_charge":939.00,"npi":[1912428301]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1822.00,"providers":[{"billed_charge":2335.00,"npi":[1558365890]}]},{"allowed_amount":1628.37,"providers":[{"billed_charge":2792.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":372.84,"providers":[{"billed_charge":4326.00,"npi":[1023057775]}]},{"allowed_amount":8373.05,"providers":[{"billed_charge":32685.00,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"561844262"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":865.45,"providers":[{"billed_charge":2032.00,"npi":[1801831102]}]}]},{"tin":{"type":"ein","value":"453957368"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3534.04,"providers":[{"billed_charge":16808.00,"npi":[1073927117]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":135.37,"providers":[{"billed_charge":50400.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"620528340"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":213.75,"providers":[{"billed_charge":360.00,"npi":[1942294814]}]}]},{"tin":{"type":"ein","value":"300999841"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3036.29,"providers":[{"billed_charge":10791.62,"npi":[1306355680]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3163.82,"providers":[{"billed_charge":10928.49,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":27888.62,"providers":[{"billed_charge":122436.00,"npi":[1952340994]}]},{"allowed_amount":1533.28,"providers":[{"billed_charge":2798.00,"npi":[1457396079]}]},{"allowed_amount":33329.33,"providers":[{"billed_charge":125026.00,"npi":[1457396079]}]},{"allowed_amount":21439.49,"providers":[{"billed_charge":82443.00,"npi":[1225050396]}]},{"allowed_amount":17052.33,"providers":[{"billed_charge":71105.00,"npi":[1790715381]}]},{"allowed_amount":2352.50,"providers":[{"billed_charge":9108.00,"npi":[1376574277]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":96.42,"providers":[{"billed_charge":46778.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"581581103"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":96.02,"providers":[{"billed_charge":503.98,"npi":[1588665566]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45558.56,"providers":[{"billed_charge":128413.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3429.60,"providers":[{"billed_charge":4529.00,"npi":[1588640692]}]},{"allowed_amount":12425.30,"providers":[{"billed_charge":326989.00,"npi":[1588640692]}]},{"allowed_amount":23348.56,"providers":[{"billed_charge":48138.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"621736983"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2436.29,"providers":[{"billed_charge":13155.92,"npi":[1598719643]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25644.59,"providers":[{"billed_charge":85517.33,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8828.76,"providers":[{"billed_charge":18221.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":49888.12,"providers":[{"billed_charge":226323.36,"npi":[1962461681]}]},{"allowed_amount":887.56,"providers":[{"billed_charge":47951.35,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":45.58,"providers":[{"billed_charge":80316.00,"npi":[1679664395]}]},{"allowed_amount":22.39,"providers":[{"billed_charge":3324.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":32611.92,"providers":[{"billed_charge":90374.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9704.53,"providers":[{"billed_charge":41920.30,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"560530233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":207.97,"providers":[{"billed_charge":216.00,"npi":[1427030774]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":64903.59,"providers":[{"billed_charge":341312.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":428.56,"providers":[{"billed_charge":1861.00,"npi":[1043270564]}]},{"allowed_amount":14.04,"providers":[{"billed_charge":60.00,"npi":[1043270564]}]},{"allowed_amount":950.21,"providers":[{"billed_charge":72450.00,"npi":[1043270564]}]},{"allowed_amount":15077.22,"providers":[{"billed_charge":57464.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18583.69,"providers":[{"billed_charge":57641.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":46902.90,"providers":[{"billed_charge":142994.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":8.81,"providers":[{"billed_charge":54.25,"npi":[1841394418]}]},{"allowed_amount":426.39,"providers":[{"billed_charge":3096.00,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"592142859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":28.75,"providers":[{"billed_charge":15402.57,"npi":[1821186313]}]}]},{"tin":{"type":"ein","value":"824194264"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":137.44,"providers":[{"billed_charge":769.50,"npi":[1720589328]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":20989.67,"providers":[{"billed_charge":137187.52,"npi":[1437186111]}]},{"allowed_amount":1018.99,"providers":[{"billed_charge":150890.32,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13.39,"providers":[{"billed_charge":5722.00,"npi":[1871556621]}]},{"allowed_amount":78.23,"providers":[{"billed_charge":569.00,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19002.24,"providers":[{"billed_charge":21966.80,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"590973502"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10.41,"providers":[{"billed_charge":10629.75,"npi":[1063426823]}]}]},{"tin":{"type":"ein","value":"310537504"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":100.22,"providers":[{"billed_charge":403.00,"npi":[1073688354]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2499.31,"providers":[{"billed_charge":8067.84,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"590714831"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.67,"providers":[{"billed_charge":6147.00,"npi":[1891782470]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":968.35,"providers":[{"billed_charge":2891.50,"npi":[1811962756]}]},{"allowed_amount":1891.93,"providers":[{"billed_charge":5743.00,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4872.68,"providers":[{"billed_charge":16122.39,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":207390.21,"providers":[{"billed_charge":631432.62,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"814223395"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":60.01,"providers":[{"billed_charge":498.00,"npi":[1922530468]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12604.87,"providers":[{"billed_charge":66093.00,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"562084959"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":386.33,"providers":[{"billed_charge":890.00,"npi":[1144247982]}]}]},{"tin":{"type":"ein","value":"874714839"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":723.43,"providers":[{"billed_charge":1457.00,"npi":[1144096553]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":914.22,"providers":[{"billed_charge":2308.00,"npi":[1366436123]}]}]},{"tin":{"type":"ein","value":"451834769"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1077.39,"providers":[{"billed_charge":4293.00,"npi":[1144227539]}]}]},{"tin":{"type":"ein","value":"581685139"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":485.16,"providers":[{"billed_charge":1665.00,"npi":[1255401519]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13564.32,"providers":[{"billed_charge":72709.01,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"161165049"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":463.77,"providers":[{"billed_charge":2604.00,"npi":[1518998699]}]}]},{"tin":{"type":"ein","value":"340714585"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":720.70,"providers":[{"billed_charge":1312.00,"npi":[1679525919]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5861.20,"providers":[{"billed_charge":25170.69,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"711045290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":486.43,"providers":[{"billed_charge":830.28,"npi":[1962435792]}]}]},{"tin":{"type":"ein","value":"592447554"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5600.64,"providers":[{"billed_charge":11668.00,"npi":[1417952748]}]},{"allowed_amount":1007.04,"providers":[{"billed_charge":2098.00,"npi":[1417952748]}]}]},{"tin":{"type":"ein","value":"560928089"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":220.65,"providers":[{"billed_charge":1439.00,"npi":[1447200233]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11.74,"providers":[{"billed_charge":411.00,"npi":[1528056066]}]},{"allowed_amount":277681.47,"providers":[{"billed_charge":645836.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"581162801"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":177.43,"providers":[{"billed_charge":496.01,"npi":[1912951963]}]},{"allowed_amount":1338.06,"providers":[{"billed_charge":3935.47,"npi":[1912951963]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1828.00,"providers":[{"billed_charge":1828.00,"npi":[1700828852]}]},{"allowed_amount":795.49,"providers":[{"billed_charge":2008.00,"npi":[1700828852]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1024.64,"providers":[{"billed_charge":19679.50,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":27718.38,"providers":[{"billed_charge":143595.00,"npi":[1962403865]}]},{"allowed_amount":31910.67,"providers":[{"billed_charge":136099.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"250965480"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10.98,"providers":[{"billed_charge":134.00,"npi":[1821007881]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":257.49,"providers":[{"billed_charge":2587.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":33.99,"providers":[{"billed_charge":53.00,"npi":[1023057775]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":185.57,"providers":[{"billed_charge":559.00,"npi":[1043270564]}]},{"allowed_amount":173.49,"providers":[{"billed_charge":3567.00,"npi":[1043270564]}]},{"allowed_amount":56.63,"providers":[{"billed_charge":242.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":1595.34,"providers":[{"billed_charge":49429.59,"npi":[1992799050]}]},{"allowed_amount":3718.73,"providers":[{"billed_charge":165909.45,"npi":[1992799050]}]},{"allowed_amount":1129.92,"providers":[{"billed_charge":101432.58,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":628.55,"providers":[{"billed_charge":967.00,"npi":[1457396079]}]},{"allowed_amount":193.93,"providers":[{"billed_charge":512.00,"npi":[1457396079]}]},{"allowed_amount":269.89,"providers":[{"billed_charge":1320.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":103.28,"providers":[{"billed_charge":742.80,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":29253.12,"providers":[{"billed_charge":95558.00,"npi":[1053824292]}]},{"allowed_amount":14706.70,"providers":[{"billed_charge":43255.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4375.96,"providers":[{"billed_charge":12445.00,"npi":[1588640692]}]},{"allowed_amount":4017.25,"providers":[{"billed_charge":35909.00,"npi":[1588640692]}]},{"allowed_amount":2196.80,"providers":[{"billed_charge":2746.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":9104.62,"providers":[{"billed_charge":39127.86,"npi":[1437186111]}]},{"allowed_amount":15.74,"providers":[{"billed_charge":2598.94,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14548.78,"providers":[{"billed_charge":39888.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":94.46,"providers":[{"billed_charge":213.90,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3342.94,"providers":[{"billed_charge":10743.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":81.07,"providers":[{"billed_charge":399.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3781.11,"providers":[{"billed_charge":10269.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1824.71,"providers":[{"billed_charge":42825.60,"npi":[1962461681]}]},{"allowed_amount":659.96,"providers":[{"billed_charge":3123.43,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5867.87,"providers":[{"billed_charge":25360.40,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":234.85,"providers":[{"billed_charge":1897.00,"npi":[1962403865]}]},{"allowed_amount":328.37,"providers":[{"billed_charge":1541.00,"npi":[1093716979]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":27.82,"providers":[{"billed_charge":593.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":921.02,"providers":[{"billed_charge":2663.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13029.23,"providers":[{"billed_charge":63450.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"581953215"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":868.53,"providers":[{"billed_charge":1703.00,"npi":[1457396079]}]},{"allowed_amount":156.57,"providers":[{"billed_charge":2139.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3675.60,"providers":[{"billed_charge":14035.00,"npi":[1043270564]}]},{"allowed_amount":572.45,"providers":[{"billed_charge":2748.00,"npi":[1043270564]}]},{"allowed_amount":98.59,"providers":[{"billed_charge":9560.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2636.93,"providers":[{"billed_charge":8065.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":561.37,"providers":[{"billed_charge":156266.00,"npi":[1992799050]}]},{"allowed_amount":648.34,"providers":[{"billed_charge":103658.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8275.82,"providers":[{"billed_charge":25307.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":39.03,"providers":[{"billed_charge":275.16,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":66484.94,"providers":[{"billed_charge":196033.00,"npi":[1053824292]}]},{"allowed_amount":67842.92,"providers":[{"billed_charge":217839.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1677.78,"providers":[{"billed_charge":20781.19,"npi":[1437186111]}]},{"allowed_amount":268.56,"providers":[{"billed_charge":29038.66,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":13.78,"providers":[{"billed_charge":257.00,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":65362.95,"providers":[{"billed_charge":128555.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3152.22,"providers":[{"billed_charge":4310.50,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":44890.62,"providers":[{"billed_charge":153476.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":669.21,"providers":[{"billed_charge":1651.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3036.85,"providers":[{"billed_charge":12841.81,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":155.70,"providers":[{"billed_charge":465.00,"npi":[1811962756]}]},{"allowed_amount":704.44,"providers":[{"billed_charge":2103.00,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":623.20,"providers":[{"billed_charge":2190.50,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42327.70,"providers":[{"billed_charge":124270.03,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"581928247"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":112.83,"providers":[{"billed_charge":588.00,"npi":[1992789721]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2591.82,"providers":[{"billed_charge":12246.00,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":93.48,"providers":[{"billed_charge":144.00,"npi":[1780235002]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1171.41,"providers":[{"billed_charge":11806.30,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":839.75,"providers":[{"billed_charge":6403.00,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"453957368"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":203.18,"providers":[{"billed_charge":2062.00,"npi":[1073927117]}]}]},{"tin":{"type":"ein","value":"300999841"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":230.14,"providers":[{"billed_charge":954.32,"npi":[1306355680]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":557.51,"providers":[{"billed_charge":1775.12,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":389.63,"providers":[{"billed_charge":1148.00,"npi":[1457396079]}]},{"allowed_amount":11305.16,"providers":[{"billed_charge":59328.00,"npi":[1457396079]}]},{"allowed_amount":2209.30,"providers":[{"billed_charge":10824.00,"npi":[1790715381]}]},{"allowed_amount":5326.44,"providers":[{"billed_charge":27196.00,"npi":[1952340994]}]},{"allowed_amount":933.51,"providers":[{"billed_charge":5205.00,"npi":[1376574277]}]},{"allowed_amount":8973.52,"providers":[{"billed_charge":47713.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":999.11,"providers":[{"billed_charge":6545.52,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1014.40,"providers":[{"billed_charge":1381.00,"npi":[1588640692]}]},{"allowed_amount":5294.69,"providers":[{"billed_charge":10476.00,"npi":[1588640692]}]},{"allowed_amount":2562.20,"providers":[{"billed_charge":123656.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1604.82,"providers":[{"billed_charge":5519.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"711045290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":62.16,"providers":[{"billed_charge":62.16,"npi":[1962435792]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4418.63,"providers":[{"billed_charge":15460.46,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1729.40,"providers":[{"billed_charge":3441.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":100717.03,"providers":[{"billed_charge":329117.00,"npi":[1528056066]}]},{"allowed_amount":8.63,"providers":[{"billed_charge":296.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":10087.09,"providers":[{"billed_charge":44489.86,"npi":[1962461681]}]},{"allowed_amount":96.21,"providers":[{"billed_charge":7156.25,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":25.56,"providers":[{"billed_charge":846.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":640.91,"providers":[{"billed_charge":2404.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1519.45,"providers":[{"billed_charge":6874.69,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":73.44,"providers":[{"billed_charge":1851.00,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5214.86,"providers":[{"billed_charge":25905.00,"npi":[1962403865]}]},{"allowed_amount":6120.49,"providers":[{"billed_charge":24995.00,"npi":[1093716979]}]}]}]},{"name":"LAB/BACT-MIRCO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"306","description":"LABORATORY - BACTERIOLOGY & MICROBIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7400.22,"providers":[{"billed_charge":12535.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16227.42,"providers":[{"billed_charge":47393.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"581953215"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":10702.86,"providers":[{"billed_charge":27065.00,"npi":[1457396079]}]},{"allowed_amount":1080.18,"providers":[{"billed_charge":2118.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":2360.91,"providers":[{"billed_charge":8466.00,"npi":[1043270564]}]},{"allowed_amount":652.68,"providers":[{"billed_charge":2785.00,"npi":[1043270564]}]},{"allowed_amount":577.14,"providers":[{"billed_charge":2464.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":998.41,"providers":[{"billed_charge":125114.00,"npi":[1992799050]}]},{"allowed_amount":6391.95,"providers":[{"billed_charge":275655.30,"npi":[1992799050]}]},{"allowed_amount":9091.41,"providers":[{"billed_charge":170073.70,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7944.11,"providers":[{"billed_charge":19981.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":949.33,"providers":[{"billed_charge":2628.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"592142859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":350.87,"providers":[{"billed_charge":3764.08,"npi":[1821186313]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":249.14,"providers":[{"billed_charge":1291.47,"npi":[1720189517]}]},{"allowed_amount":72.41,"providers":[{"billed_charge":1189.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":502.86,"providers":[{"billed_charge":1479.00,"npi":[1053824292]}]},{"allowed_amount":77088.36,"providers":[{"billed_charge":226821.00,"npi":[1053824292]}]},{"allowed_amount":34019.04,"providers":[{"billed_charge":108756.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"852556972"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":508.52,"providers":[{"billed_charge":1810.00,"npi":[1790376564]}]},{"allowed_amount":143.75,"providers":[{"billed_charge":422.81,"npi":[1790376564]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5492.50,"providers":[{"billed_charge":38049.52,"npi":[1437186111]}]},{"allowed_amount":11778.25,"providers":[{"billed_charge":51459.96,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":89742.05,"providers":[{"billed_charge":194275.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3174.12,"providers":[{"billed_charge":5846.00,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":38964.41,"providers":[{"billed_charge":114195.00,"npi":[1427055821]}]},{"allowed_amount":32.70,"providers":[{"billed_charge":1024.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":996.53,"providers":[{"billed_charge":10512.52,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18271.19,"providers":[{"billed_charge":45112.11,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":795.61,"providers":[{"billed_charge":3210.75,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":136.82,"providers":[{"billed_charge":949.68,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3401.73,"providers":[{"billed_charge":29674.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":321.32,"providers":[{"billed_charge":1691.50,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3037.78,"providers":[{"billed_charge":13196.00,"npi":[1225050396]}]},{"allowed_amount":2955.47,"providers":[{"billed_charge":13632.00,"npi":[1952340994]}]},{"allowed_amount":368.58,"providers":[{"billed_charge":1096.00,"npi":[1457396079]}]},{"allowed_amount":1636.99,"providers":[{"billed_charge":7759.00,"npi":[1790715381]}]},{"allowed_amount":5531.41,"providers":[{"billed_charge":28074.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":127.14,"providers":[{"billed_charge":551.00,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1711.55,"providers":[{"billed_charge":6646.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1014.40,"providers":[{"billed_charge":1268.00,"npi":[1588640692]}]},{"allowed_amount":1460.90,"providers":[{"billed_charge":50348.00,"npi":[1588640692]}]},{"allowed_amount":4766.47,"providers":[{"billed_charge":10299.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12376.10,"providers":[{"billed_charge":20785.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5488.50,"providers":[{"billed_charge":35276.15,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":49633.13,"providers":[{"billed_charge":94161.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":184.00,"providers":[{"billed_charge":184.00,"npi":[1679664395]}]},{"allowed_amount":10963.27,"providers":[{"billed_charge":17952.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6586.15,"providers":[{"billed_charge":32922.80,"npi":[1962461681]}]},{"allowed_amount":154.22,"providers":[{"billed_charge":19131.95,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10900.04,"providers":[{"billed_charge":15675.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":386.08,"providers":[{"billed_charge":3467.00,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":190.77,"providers":[{"billed_charge":1348.05,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12029.64,"providers":[{"billed_charge":21571.00,"npi":[1962403865]}]},{"allowed_amount":14186.89,"providers":[{"billed_charge":23189.00,"npi":[1093716979]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3326.86,"providers":[{"billed_charge":13115.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2626.79,"providers":[{"billed_charge":13331.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":306.54,"providers":[{"billed_charge":37774.10,"npi":[1992799050]}]},{"allowed_amount":134.23,"providers":[{"billed_charge":39524.40,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":34.16,"providers":[{"billed_charge":146.00,"npi":[1043270564]}]},{"allowed_amount":69.41,"providers":[{"billed_charge":296.00,"npi":[1043270564]}]},{"allowed_amount":331.05,"providers":[{"billed_charge":1215.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1113.51,"providers":[{"billed_charge":3719.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":48.25,"providers":[{"billed_charge":528.00,"npi":[1720189517]}]},{"allowed_amount":20.83,"providers":[{"billed_charge":2718.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9811.76,"providers":[{"billed_charge":29064.00,"npi":[1053824292]}]},{"allowed_amount":2265.76,"providers":[{"billed_charge":6862.00,"npi":[1053824292]}]},{"allowed_amount":22.44,"providers":[{"billed_charge":66.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":118.40,"providers":[{"billed_charge":5400.60,"npi":[1437186111]}]},{"allowed_amount":6.62,"providers":[{"billed_charge":13076.75,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":39435.66,"providers":[{"billed_charge":46575.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":552.54,"providers":[{"billed_charge":1321.35,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9352.41,"providers":[{"billed_charge":33988.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":168.19,"providers":[{"billed_charge":420.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":350.07,"providers":[{"billed_charge":1627.35,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":46.25,"providers":[{"billed_charge":138.00,"npi":[1811962756]}]},{"allowed_amount":151.99,"providers":[{"billed_charge":453.50,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18504.73,"providers":[{"billed_charge":41992.41,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":269.69,"providers":[{"billed_charge":1491.75,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":476.01,"providers":[{"billed_charge":786.00,"npi":[1790715381]}]},{"allowed_amount":1341.71,"providers":[{"billed_charge":2393.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":92.00,"providers":[{"billed_charge":421.80,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1848.76,"providers":[{"billed_charge":2360.00,"npi":[1588640692]}]},{"allowed_amount":130.50,"providers":[{"billed_charge":1814.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6928.06,"providers":[{"billed_charge":26956.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2375.12,"providers":[{"billed_charge":6882.75,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":293.61,"providers":[{"billed_charge":389.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":32506.50,"providers":[{"billed_charge":99960.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3880.78,"providers":[{"billed_charge":16922.35,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3902.24,"providers":[{"billed_charge":14754.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":157.49,"providers":[{"billed_charge":2553.00,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2357.73,"providers":[{"billed_charge":6205.00,"npi":[1093716979]}]},{"allowed_amount":986.56,"providers":[{"billed_charge":5274.00,"npi":[1962403865]}]}]}]},{"name":"LAB/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"309","description":"LABORATORY - OTHER LABORATORY","allowed_amounts":[{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":966.40,"providers":[{"billed_charge":5006.15,"npi":[1588640692]}]},{"allowed_amount":331.80,"providers":[{"billed_charge":1530.00,"npi":[1588640692]}]},{"allowed_amount":1333.60,"providers":[{"billed_charge":1667.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4523.64,"providers":[{"billed_charge":18045.00,"npi":[1144203563]}]}]}]},{"name":"PATHOLOGY LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"310","description":"LABORATORY PATHOLOGICAL - GENERAL CLASSIFIATION","allowed_amounts":[{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1015.62,"providers":[{"billed_charge":4669.00,"npi":[1952340994]}]},{"allowed_amount":5434.71,"providers":[{"billed_charge":24669.00,"npi":[1457396079]}]},{"allowed_amount":8271.90,"providers":[{"billed_charge":12726.00,"npi":[1457396079]}]},{"allowed_amount":1687.81,"providers":[{"billed_charge":8474.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2258.96,"providers":[{"billed_charge":6644.00,"npi":[1053824292]}]},{"allowed_amount":987.36,"providers":[{"billed_charge":2904.00,"npi":[1053824292]}]}]}]},{"name":"PATHOL/CYTOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"311","description":"LABORATORY PATHOLOGICAL - CYTOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":358.28,"providers":[{"billed_charge":909.00,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":110.28,"providers":[{"billed_charge":9894.00,"npi":[1992799050]}]}]}]},{"name":"PATHOL/HYSTOL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"312","description":"LABORATORY PATHOLOGICAL - HISTOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":415.20,"providers":[{"billed_charge":36243.60,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1403.41,"providers":[{"billed_charge":2536.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":892.70,"providers":[{"billed_charge":3224.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":637.74,"providers":[{"billed_charge":1518.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1751.27,"providers":[{"billed_charge":114749.00,"npi":[1992799050]}]}]}]},{"name":"DX X-RAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"320","description":"RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3787.05,"providers":[{"billed_charge":10861.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5567.95,"providers":[{"billed_charge":14277.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20603.13,"providers":[{"billed_charge":73984.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":551.53,"providers":[{"billed_charge":1829.00,"npi":[1043270564]}]},{"allowed_amount":197.02,"providers":[{"billed_charge":842.00,"npi":[1043270564]}]},{"allowed_amount":175.03,"providers":[{"billed_charge":748.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13512.92,"providers":[{"billed_charge":219858.42,"npi":[1992799050]}]},{"allowed_amount":960.42,"providers":[{"billed_charge":185544.76,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3103.79,"providers":[{"billed_charge":17083.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1249.14,"providers":[{"billed_charge":3513.00,"npi":[1376574277]}]},{"allowed_amount":31799.64,"providers":[{"billed_charge":88863.00,"npi":[1457396079]}]},{"allowed_amount":7827.66,"providers":[{"billed_charge":21010.00,"npi":[1952340994]}]},{"allowed_amount":22443.64,"providers":[{"billed_charge":62355.00,"npi":[1225050396]}]},{"allowed_amount":1114.93,"providers":[{"billed_charge":3499.00,"npi":[1790715381]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":91.96,"providers":[{"billed_charge":10061.35,"npi":[1720189517]}]},{"allowed_amount":8264.16,"providers":[{"billed_charge":19015.10,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":121.32,"providers":[{"billed_charge":1241.00,"npi":[1053824292]}]},{"allowed_amount":29885.89,"providers":[{"billed_charge":88452.00,"npi":[1053824292]}]},{"allowed_amount":161464.69,"providers":[{"billed_charge":475119.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5836.11,"providers":[{"billed_charge":14930.00,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10257.64,"providers":[{"billed_charge":28356.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3904.42,"providers":[{"billed_charge":30480.80,"npi":[1437186111]}]},{"allowed_amount":126.32,"providers":[{"billed_charge":16440.90,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6137.83,"providers":[{"billed_charge":15262.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":356.01,"providers":[{"billed_charge":402.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":103273.50,"providers":[{"billed_charge":122247.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25700.60,"providers":[{"billed_charge":104085.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2120.92,"providers":[{"billed_charge":6376.50,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":58766.85,"providers":[{"billed_charge":170464.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1036.29,"providers":[{"billed_charge":6256.50,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11816.29,"providers":[{"billed_charge":42873.95,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":66621.13,"providers":[{"billed_charge":151919.83,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2808.95,"providers":[{"billed_charge":6808.00,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5839.04,"providers":[{"billed_charge":17099.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13402.03,"providers":[{"billed_charge":23426.00,"npi":[1093716979]}]},{"allowed_amount":7483.74,"providers":[{"billed_charge":21119.00,"npi":[1962403865]}]},{"allowed_amount":560.70,"providers":[{"billed_charge":1412.00,"npi":[1962403865]}]}]}]},{"name":"DX X-RAY/CHEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"324","description":"RADIOLOGY - DIAGNOSTIC - CHEST X-RAY","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7308.12,"providers":[{"billed_charge":18430.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9739.41,"providers":[{"billed_charge":53243.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":1334.37,"providers":[{"billed_charge":17000.00,"npi":[1992799050]}]},{"allowed_amount":70.23,"providers":[{"billed_charge":787.00,"npi":[1992799050]}]},{"allowed_amount":12391.60,"providers":[{"billed_charge":148792.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1906.45,"providers":[{"billed_charge":9750.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1158.82,"providers":[{"billed_charge":7086.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":808.88,"providers":[{"billed_charge":5132.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1454.22,"providers":[{"billed_charge":5274.00,"npi":[1720189517]}]},{"allowed_amount":4091.34,"providers":[{"billed_charge":14364.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":24784.38,"providers":[{"billed_charge":80898.00,"npi":[1053824292]}]},{"allowed_amount":87575.71,"providers":[{"billed_charge":257736.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":346.64,"providers":[{"billed_charge":1032.00,"npi":[1437186111]}]},{"allowed_amount":2010.48,"providers":[{"billed_charge":5985.60,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":89039.94,"providers":[{"billed_charge":90753.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":562.72,"providers":[{"billed_charge":882.00,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20202.78,"providers":[{"billed_charge":117936.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1575.95,"providers":[{"billed_charge":3508.80,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47558.78,"providers":[{"billed_charge":98002.40,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"741536936"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":249.70,"providers":[{"billed_charge":616.00,"npi":[1205900370]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":310.33,"providers":[{"billed_charge":1415.74,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2316.92,"providers":[{"billed_charge":6051.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3885.00,"providers":[{"billed_charge":3885.00,"npi":[1588640692]}]},{"allowed_amount":296.80,"providers":[{"billed_charge":371.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17128.49,"providers":[{"billed_charge":43789.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3589.50,"providers":[{"billed_charge":7017.60,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47420.66,"providers":[{"billed_charge":124743.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4708.82,"providers":[{"billed_charge":6098.00,"npi":[1679664395]}]},{"allowed_amount":371.46,"providers":[{"billed_charge":462.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1122.40,"providers":[{"billed_charge":4128.00,"npi":[1962461681]}]},{"allowed_amount":12733.00,"providers":[{"billed_charge":28070.40,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7269.30,"providers":[{"billed_charge":19318.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":789.12,"providers":[{"billed_charge":1548.00,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11480.52,"providers":[{"billed_charge":12237.00,"npi":[1093716979]}]},{"allowed_amount":15864.32,"providers":[{"billed_charge":17717.00,"npi":[1962403865]}]}]}]},{"name":"RADIATION RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"RADIOLOGY--THERAPEUTIC - RADIATION THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5300.24,"providers":[{"billed_charge":14433.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2622.46,"providers":[{"billed_charge":20578.75,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":22432.04,"providers":[{"billed_charge":428798.00,"npi":[1992799050]}]}]}]},{"name":"CHEMOTHERP-IV","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"335","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--IV","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5537.76,"providers":[{"billed_charge":30138.15,"npi":[1992799050]}]}]}]},{"name":"CT SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"350","description":"CT SCAN - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":44381.18,"providers":[{"billed_charge":117765.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12458.48,"providers":[{"billed_charge":15624.00,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":34105.15,"providers":[{"billed_charge":98413.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":21030.67,"providers":[{"billed_charge":48034.00,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":24123.68,"providers":[{"billed_charge":70952.00,"npi":[1053824292]}]},{"allowed_amount":10196.26,"providers":[{"billed_charge":29989.00,"npi":[1053824292]}]},{"allowed_amount":4223.48,"providers":[{"billed_charge":12422.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":60318.26,"providers":[{"billed_charge":164764.00,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":860.35,"providers":[{"billed_charge":9342.00,"npi":[1578620449]}]}]}]},{"name":"CT SCAN/HEAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"351","description":"CT SCAN - HEAD SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20042.34,"providers":[{"billed_charge":55982.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":52311.07,"providers":[{"billed_charge":106490.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":15114.44,"providers":[{"billed_charge":467311.00,"npi":[1992799050]}]},{"allowed_amount":1845.24,"providers":[{"billed_charge":75236.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1464.40,"providers":[{"billed_charge":5368.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":8696.82,"providers":[{"billed_charge":27868.00,"npi":[1952340994]}]},{"allowed_amount":31530.83,"providers":[{"billed_charge":93892.00,"npi":[1457396079]}]},{"allowed_amount":718.89,"providers":[{"billed_charge":3928.00,"npi":[1457396079]}]},{"allowed_amount":30946.40,"providers":[{"billed_charge":97038.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3608.12,"providers":[{"billed_charge":23816.50,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":44895.98,"providers":[{"billed_charge":133951.00,"npi":[1053824292]}]},{"allowed_amount":114108.72,"providers":[{"billed_charge":335562.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":256.18,"providers":[{"billed_charge":4992.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1018.50,"providers":[{"billed_charge":14436.96,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5466.97,"providers":[{"billed_charge":13542.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":224.30,"providers":[{"billed_charge":1031.00,"npi":[1144203563]}]},{"allowed_amount":156850.90,"providers":[{"billed_charge":165702.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":156668.97,"providers":[{"billed_charge":319322.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":96994.31,"providers":[{"billed_charge":190149.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2938.55,"providers":[{"billed_charge":11807.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24873.01,"providers":[{"billed_charge":84294.96,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":94125.56,"providers":[{"billed_charge":195615.84,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":29653.58,"providers":[{"billed_charge":43546.00,"npi":[1093716979]}]},{"allowed_amount":29347.39,"providers":[{"billed_charge":58066.00,"npi":[1962403865]}]}]}]},{"name":"CT SCAN/BODY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"CT SCAN - BODY SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47380.79,"providers":[{"billed_charge":139813.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1387.47,"providers":[{"billed_charge":12739.95,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90666.28,"providers":[{"billed_charge":276063.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":19636.97,"providers":[{"billed_charge":1350693.00,"npi":[1992799050]}]},{"allowed_amount":5580.45,"providers":[{"billed_charge":226847.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":15857.75,"providers":[{"billed_charge":71298.00,"npi":[1043270564]}]},{"allowed_amount":6223.34,"providers":[{"billed_charge":26498.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":36816.22,"providers":[{"billed_charge":81869.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":122866.12,"providers":[{"billed_charge":383666.00,"npi":[1225050396]}]},{"allowed_amount":718.89,"providers":[{"billed_charge":2707.00,"npi":[1952340994]}]},{"allowed_amount":4313.34,"providers":[{"billed_charge":40903.00,"npi":[1457396079]}]},{"allowed_amount":130215.10,"providers":[{"billed_charge":370508.00,"npi":[1457396079]}]},{"allowed_amount":32105.92,"providers":[{"billed_charge":94026.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":12812.35,"providers":[{"billed_charge":105206.00,"npi":[1720189517]}]},{"allowed_amount":948.01,"providers":[{"billed_charge":8388.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":291079.05,"providers":[{"billed_charge":853735.00,"npi":[1053824292]}]},{"allowed_amount":108207.38,"providers":[{"billed_charge":347586.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":112562.23,"providers":[{"billed_charge":354047.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":30363.33,"providers":[{"billed_charge":33837.00,"npi":[1588640692]}]},{"allowed_amount":375.49,"providers":[{"billed_charge":1782.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11956.79,"providers":[{"billed_charge":144704.75,"npi":[1437186111]}]},{"allowed_amount":8664.47,"providers":[{"billed_charge":100374.20,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1525.58,"providers":[{"billed_charge":6250.00,"npi":[1144203563]}]},{"allowed_amount":459835.86,"providers":[{"billed_charge":578412.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":396.17,"providers":[{"billed_charge":8467.00,"npi":[1427055821]}]},{"allowed_amount":305680.13,"providers":[{"billed_charge":759436.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24635.74,"providers":[{"billed_charge":74789.25,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":16627.58,"providers":[{"billed_charge":47099.60,"npi":[1528027240]}]},{"allowed_amount":432.90,"providers":[{"billed_charge":6136.20,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399377.86,"providers":[{"billed_charge":669361.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":117134.25,"providers":[{"billed_charge":369598.30,"npi":[1962461681]}]},{"allowed_amount":6634.06,"providers":[{"billed_charge":85573.05,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":211.60,"providers":[{"billed_charge":5330.33,"npi":[1154795581]}]},{"allowed_amount":192903.42,"providers":[{"billed_charge":419995.09,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6188.59,"providers":[{"billed_charge":43170.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":74654.26,"providers":[{"billed_charge":232326.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47263.24,"providers":[{"billed_charge":99820.00,"npi":[1093716979]}]},{"allowed_amount":46136.55,"providers":[{"billed_charge":112631.00,"npi":[1962403865]}]}]}]},{"name":"OR SERVICES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"360","description":"OPERATING ROOM SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":29294.29,"providers":[{"billed_charge":63299.60,"npi":[1437186111]}]},{"allowed_amount":298576.10,"providers":[{"billed_charge":601849.83,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":51367.19,"providers":[{"billed_charge":170594.25,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":28886.30,"providers":[{"billed_charge":110253.25,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":144562.85,"providers":[{"billed_charge":3168479.35,"npi":[1992799050]}]},{"allowed_amount":5698.06,"providers":[{"billed_charge":12666.81,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":51304.20,"providers":[{"billed_charge":219187.65,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":32896.70,"providers":[{"billed_charge":96755.00,"npi":[1053824292]}]},{"allowed_amount":173474.34,"providers":[{"billed_charge":603702.00,"npi":[1053824292]}]},{"allowed_amount":9506.69,"providers":[{"billed_charge":44441.00,"npi":[1053824292]}]}]}]},{"name":"OR/MINOR","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"361","description":"OPERATING ROOM SERVICES - MINOR SURGERY","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":845.94,"providers":[{"billed_charge":1294.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":201.09,"providers":[{"billed_charge":666.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","19"],"billing_class":"institutional","payments":[{"allowed_amount":83248.37,"providers":[{"billed_charge":646926.00,"npi":[1992799050]}]},{"allowed_amount":393.95,"providers":[{"billed_charge":5237.00,"npi":[1992799050]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5551.00,"providers":[{"billed_charge":21960.00,"npi":[1942526447]}]}]},{"tin":{"type":"ein","value":"453765471"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":49.62,"providers":[{"billed_charge":150.00,"npi":[1831776764]}]}]},{"tin":{"type":"ein","value":"621647259"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":268.25,"providers":[{"billed_charge":735.00,"npi":[1861473472]}]}]},{"tin":{"type":"ein","value":"834587658"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":86.97,"providers":[{"billed_charge":105.00,"npi":[1780679365]}]}]},{"tin":{"type":"ein","value":"331166863"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":264.00,"providers":[{"billed_charge":264.00,"npi":[1790707925]}]}]},{"tin":{"type":"ein","value":"992262156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":45.50,"providers":[{"billed_charge":200.00,"npi":[1457400251]}]}]},{"tin":{"type":"ein","value":"586002491"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":40.00,"providers":[{"billed_charge":40.00,"npi":[1801025424]}]}]},{"tin":{"type":"ein","value":"582477056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":57.90,"providers":[{"billed_charge":150.00,"npi":[1053383406]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":881.73,"providers":[{"billed_charge":2425.00,"npi":[1225021678]}]}]},{"tin":{"type":"ein","value":"582041471"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":87.88,"providers":[{"billed_charge":280.00,"npi":[1598949166]}]}]},{"tin":{"type":"ein","value":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":248.04,"providers":[{"billed_charge":1140.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"463285783"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":219.92,"providers":[{"billed_charge":320.00,"npi":[1770909236]}]}]},{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13.65,"providers":[{"billed_charge":30.00,"npi":[1093789075]}]},{"allowed_amount":309.40,"providers":[{"billed_charge":680.00,"npi":[1598051724]}]}]},{"tin":{"type":"ein","value":"582545719"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":324.00,"providers":[{"billed_charge":324.00,"npi":[1063515815]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":109.20,"providers":[{"billed_charge":480.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"30417049"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":123.49,"providers":[{"billed_charge":144.00,"npi":[1336424522]}]},{"allowed_amount":27.36,"providers":[{"billed_charge":32.00,"npi":[1770175309]}]},{"allowed_amount":14.05,"providers":[{"billed_charge":16.00,"npi":[1568910461]}]},{"allowed_amount":208.00,"providers":[{"billed_charge":208.00,"npi":[1346225919]}]},{"allowed_amount":336.00,"providers":[{"billed_charge":336.00,"npi":[1336132679]}]}]},{"tin":{"type":"ein","value":"824681345"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":144.00,"providers":[{"billed_charge":144.00,"npi":[1649831314]}]}]},{"tin":{"type":"ein","value":"205870972"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":555.10,"providers":[{"billed_charge":2684.00,"npi":[1285325282]}]}]},{"tin":{"type":"ein","value":"453766969"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":484.62,"providers":[{"billed_charge":633.76,"npi":[1053536177]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1610.00,"providers":[{"billed_charge":1610.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":208.44,"providers":[{"billed_charge":1134.00,"npi":[1851010466]}]},{"allowed_amount":65.62,"providers":[{"billed_charge":357.00,"npi":[1073175923]}]},{"allowed_amount":40.95,"providers":[{"billed_charge":189.00,"npi":[1184964025]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1752.94,"providers":[{"billed_charge":3724.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["17","81"],"billing_class":"professional","payments":[{"allowed_amount":8.18,"providers":[{"billed_charge":40.73,"npi":[1234567893]}]},{"allowed_amount":3832.32,"providers":[{"billed_charge":41805.20,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":238.56,"providers":[{"billed_charge":378.00,"npi":[1073254363]}]},{"allowed_amount":363.52,"providers":[{"billed_charge":576.00,"npi":[1295969228]}]},{"allowed_amount":454.40,"providers":[{"billed_charge":720.00,"npi":[1912167578]}]}]}]},{"name":"ANESTHESIA","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"370","description":"ANESTHESIA - GENERAL CLASSIFICATIION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3075.00,"providers":[{"billed_charge":10250.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":30636.60,"providers":[{"billed_charge":102122.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7411.32,"providers":[{"billed_charge":24821.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":875.84,"providers":[{"billed_charge":2919.46,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":122201.24,"providers":[{"billed_charge":387222.00,"npi":[1053824292]}]},{"allowed_amount":20896.40,"providers":[{"billed_charge":61460.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":64430.10,"providers":[{"billed_charge":96236.00,"npi":[1881764553]}]}]}]},{"name":"BLOOD/STOR-PROC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"390","description":"BLOOD STORAGE AND PROCESSING - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1497.90,"providers":[{"billed_charge":4993.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581953215"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":12223.17,"providers":[{"billed_charge":65098.00,"npi":[1457396079]}]},{"allowed_amount":60480.90,"providers":[{"billed_charge":120256.00,"npi":[1457396079]}]}]}]},{"name":"BLOOD/ADMIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"391","description":"BLOOD STORAGE AND PROCESSING - BLOOD ADMINISTRATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2818.36,"providers":[{"billed_charge":6736.00,"npi":[1144203563]}]}]}]},{"name":"MAMMOGRAPHY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"401","description":"OTHER IMAGING SERVICES - MAMMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2248.31,"providers":[{"billed_charge":16781.15,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","19"],"billing_class":"institutional","payments":[{"allowed_amount":25.98,"providers":[{"billed_charge":156.00,"npi":[1992799050]}]},{"allowed_amount":3404.26,"providers":[{"billed_charge":30521.00,"npi":[1992799050]}]}]}]},{"name":"ULTRASOUND","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"402","description":"OTHER IMAGING SERVICES - ULTRASOUND","allowed_amounts":[{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2927.91,"providers":[{"billed_charge":15756.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":9795.96,"providers":[{"billed_charge":212754.80,"npi":[1992799050]}]},{"allowed_amount":2078.09,"providers":[{"billed_charge":53291.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1749.31,"providers":[{"billed_charge":5744.00,"npi":[1952340994]}]},{"allowed_amount":6244.47,"providers":[{"billed_charge":18360.00,"npi":[1457396079]}]},{"allowed_amount":2461.00,"providers":[{"billed_charge":5001.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7327.00,"providers":[{"billed_charge":21550.00,"npi":[1053824292]}]},{"allowed_amount":18441.94,"providers":[{"billed_charge":54241.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":531.33,"providers":[{"billed_charge":949.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":406.40,"providers":[{"billed_charge":6397.00,"npi":[1588640692]}]},{"allowed_amount":3658.06,"providers":[{"billed_charge":11175.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4757.01,"providers":[{"billed_charge":47526.63,"npi":[1437186111]}]},{"allowed_amount":2516.27,"providers":[{"billed_charge":27647.40,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1280.81,"providers":[{"billed_charge":2892.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42117.10,"providers":[{"billed_charge":122886.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":37123.80,"providers":[{"billed_charge":132306.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":36179.79,"providers":[{"billed_charge":93668.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":190.44,"providers":[{"billed_charge":14664.10,"npi":[1962461681]}]},{"allowed_amount":8879.96,"providers":[{"billed_charge":43642.90,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12903.76,"providers":[{"billed_charge":29921.25,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2519.96,"providers":[{"billed_charge":11320.00,"npi":[1093716979]}]},{"allowed_amount":1204.32,"providers":[{"billed_charge":5014.00,"npi":[1962403865]}]}]}]},{"name":"SCRN MAMMOGRAPHY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"403","description":"OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5957.14,"providers":[{"billed_charge":32730.00,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","19"],"billing_class":"institutional","payments":[{"allowed_amount":153.12,"providers":[{"billed_charge":860.00,"npi":[1992799050]}]},{"allowed_amount":9828.42,"providers":[{"billed_charge":56190.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2208.53,"providers":[{"billed_charge":9321.00,"npi":[1720189517]}]}]}]},{"name":"PET SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"404","description":"POSITION EMISSION TOMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3268.27,"providers":[{"billed_charge":9367.00,"npi":[1144203563]}]}]}]},{"name":"RESPIRATORY SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"410","description":"RESPIRATORY SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1849.07,"providers":[{"billed_charge":3000.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14346.14,"providers":[{"billed_charge":25564.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8538.91,"providers":[{"billed_charge":36735.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1429.69,"providers":[{"billed_charge":3235.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5584.32,"providers":[{"billed_charge":30407.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":789.20,"providers":[{"billed_charge":3095.68,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["19"],"billing_class":"institutional","payments":[{"allowed_amount":162.23,"providers":[{"billed_charge":659.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":315.68,"providers":[{"billed_charge":1470.00,"npi":[1225050396]}]},{"allowed_amount":194.47,"providers":[{"billed_charge":735.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":157.84,"providers":[{"billed_charge":1232.00,"npi":[1962403865]}]},{"allowed_amount":631.36,"providers":[{"billed_charge":2772.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3530.56,"providers":[{"billed_charge":10384.00,"npi":[1053824292]}]},{"allowed_amount":8495.92,"providers":[{"billed_charge":103214.00,"npi":[1053824292]}]}]}]},{"name":"INHALATION SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"412","description":"RESPIRATORY SERVICES - INHALATION SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4916.18,"providers":[{"billed_charge":14737.15,"npi":[1154795581]}]}]}]},{"name":"PHYSICAL THERP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"420","description":"PHYSICAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":15022.40,"providers":[{"billed_charge":91767.70,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":41.74,"providers":[{"billed_charge":365.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":246.69,"providers":[{"billed_charge":1212.00,"npi":[1427055821]}]},{"allowed_amount":50.15,"providers":[{"billed_charge":215.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":50.81,"providers":[{"billed_charge":502.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":83.10,"providers":[{"billed_charge":4689.00,"npi":[1992799050]}]},{"allowed_amount":5496.04,"providers":[{"billed_charge":138011.30,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7843.32,"providers":[{"billed_charge":15203.25,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12706.78,"providers":[{"billed_charge":43354.00,"npi":[1053824292]}]},{"allowed_amount":863.26,"providers":[{"billed_charge":2582.00,"npi":[1053824292]}]}]}]},{"name":"PHYS THERP/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"424","description":"PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":734.00,"providers":[{"billed_charge":2351.74,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":772.60,"providers":[{"billed_charge":1731.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":224.62,"providers":[{"billed_charge":484.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":561.23,"providers":[{"billed_charge":1970.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2106.81,"providers":[{"billed_charge":19992.00,"npi":[1992799050]}]},{"allowed_amount":390.15,"providers":[{"billed_charge":3647.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":211.74,"providers":[{"billed_charge":417.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":423.43,"providers":[{"billed_charge":1430.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":357.00,"providers":[{"billed_charge":1050.00,"npi":[1053824292]}]},{"allowed_amount":4019.41,"providers":[{"billed_charge":12444.00,"npi":[1053824292]}]},{"allowed_amount":18854.19,"providers":[{"billed_charge":58297.00,"npi":[1053824292]}]}]}]},{"name":"OCCUPATION THER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"430","description":"OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"582179986"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1031.51,"providers":[{"billed_charge":5324.55,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":98.38,"providers":[{"billed_charge":816.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1298.24,"providers":[{"billed_charge":17712.00,"npi":[1992799050]}]},{"allowed_amount":124.52,"providers":[{"billed_charge":3329.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":65.79,"providers":[{"billed_charge":215.00,"npi":[1053824292]}]},{"allowed_amount":4425.76,"providers":[{"billed_charge":14157.00,"npi":[1053824292]}]}]}]},{"name":"EGD BIOPSY SINGLE/MULTIPLE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"43239","description":"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE","allowed_amounts":[{"tin":{"type":"ein","value":"262988454"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1680.68,"providers":[{"billed_charge":7440.00,"npi":[1376745356]}]}]},{"tin":{"type":"ein","value":"582471834"},"service_code":["22","24","21"],"billing_class":"professional","payments":[{"allowed_amount":166.95,"providers":[{"billed_charge":1000.00,"npi":[1043203011]}]},{"allowed_amount":1975.83,"providers":[{"billed_charge":11350.00,"npi":[1043203011]}]},{"allowed_amount":241.23,"providers":[{"billed_charge":2000.00,"npi":[1043203011]}]}]}]},{"name":"OCCUP THERP/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"434","description":"OCCUPATIONAL THERAPY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":838.43,"providers":[{"billed_charge":1593.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":105.79,"providers":[{"billed_charge":542.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":172.56,"providers":[{"billed_charge":1098.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":68.19,"providers":[{"billed_charge":726.00,"npi":[1992799050]}]},{"allowed_amount":454.62,"providers":[{"billed_charge":4458.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":219.49,"providers":[{"billed_charge":715.00,"npi":[1225050396]}]},{"allowed_amount":464.75,"providers":[{"billed_charge":715.00,"npi":[1457396079]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12825.48,"providers":[{"billed_charge":37722.00,"npi":[1053824292]}]},{"allowed_amount":3876.61,"providers":[{"billed_charge":12444.00,"npi":[1053824292]}]}]}]},{"name":"SPEECH PATH/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"444","description":"SPEECH-LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":217.81,"providers":[{"billed_charge":254.00,"npi":[1427055821]}]}]}]},{"name":"EMERG ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"636001820"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":847.85,"providers":[{"billed_charge":2655.00,"npi":[1043262488]}]}]},{"tin":{"type":"ein","value":"650232993"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3744.00,"providers":[{"billed_charge":7800.00,"npi":[1578547865]}]}]},{"tin":{"type":"ein","value":"811723202"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4874.48,"providers":[{"billed_charge":4592.00,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":114101.61,"providers":[{"billed_charge":356249.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":101409.19,"providers":[{"billed_charge":270231.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":382409.45,"providers":[{"billed_charge":3557735.10,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"586025016"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2667.97,"providers":[{"billed_charge":9057.56,"npi":[1326079260]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":182703.46,"providers":[{"billed_charge":420688.02,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":217889.68,"providers":[{"billed_charge":651970.00,"npi":[1053824292]}]},{"allowed_amount":1698424.49,"providers":[{"billed_charge":5016371.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":103688.06,"providers":[{"billed_charge":235915.00,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"852556972"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1386.45,"providers":[{"billed_charge":4077.79,"npi":[1790376564]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":82175.05,"providers":[{"billed_charge":186174.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"650460321"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":758.78,"providers":[{"billed_charge":5145.13,"npi":[1104897859]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1820093.20,"providers":[{"billed_charge":3347050.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":407395.75,"providers":[{"billed_charge":2211795.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"810851756"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6708.63,"providers":[{"billed_charge":12923.00,"npi":[1750312997]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":65219.30,"providers":[{"billed_charge":200621.65,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"581928247"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6543.14,"providers":[{"billed_charge":21991.00,"npi":[1992789721]}]}]},{"tin":{"type":"ein","value":"934580630"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5163.26,"providers":[{"billed_charge":11507.00,"npi":[1205605409]}]}]},{"tin":{"type":"ein","value":"741152597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":394.89,"providers":[{"billed_charge":2021.25,"npi":[1982666111]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9020.92,"providers":[{"billed_charge":18972.00,"npi":[1154386431]}]},{"allowed_amount":1128.34,"providers":[{"billed_charge":7290.00,"npi":[1154386431]}]},{"allowed_amount":401.52,"providers":[{"billed_charge":638.00,"npi":[1073685483]}]},{"allowed_amount":14609.91,"providers":[{"billed_charge":28128.00,"npi":[1780235002]}]}]},{"tin":{"type":"ein","value":"311626179"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":672.65,"providers":[{"billed_charge":999.00,"npi":[1538164090]}]}]},{"tin":{"type":"ein","value":"741536936"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":34752.89,"providers":[{"billed_charge":48030.02,"npi":[1205900370]}]}]},{"tin":{"type":"ein","value":"561844262"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10782.41,"providers":[{"billed_charge":11771.00,"npi":[1801831102]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14949.42,"providers":[{"billed_charge":39604.00,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":84757.93,"providers":[{"billed_charge":187138.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"453957368"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12725.73,"providers":[{"billed_charge":41967.00,"npi":[1073927117]}]}]},{"tin":{"type":"ein","value":"300999841"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2565.24,"providers":[{"billed_charge":7737.40,"npi":[1306355680]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7375.36,"providers":[{"billed_charge":20666.80,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":58512.93,"providers":[{"billed_charge":152602.00,"npi":[1790715381]}]},{"allowed_amount":353075.65,"providers":[{"billed_charge":966744.00,"npi":[1457396079]}]},{"allowed_amount":51177.96,"providers":[{"billed_charge":143461.00,"npi":[1376574277]}]},{"allowed_amount":277416.61,"providers":[{"billed_charge":755941.00,"npi":[1225050396]}]},{"allowed_amount":105091.16,"providers":[{"billed_charge":284631.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"582513901"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":266.68,"providers":[{"billed_charge":464.60,"npi":[1326028978]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":91176.95,"providers":[{"billed_charge":266944.00,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":264507.89,"providers":[{"billed_charge":789058.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":115222.78,"providers":[{"billed_charge":216291.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":106711.41,"providers":[{"billed_charge":300333.10,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581734026"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":397.66,"providers":[{"billed_charge":2226.00,"npi":[1659376630]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":38929.79,"providers":[{"billed_charge":71125.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"582223937"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9606.63,"providers":[{"billed_charge":16421.50,"npi":[1205843174]}]}]},{"tin":{"type":"ein","value":"741180155"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":927.28,"providers":[{"billed_charge":4752.00,"npi":[1548387418]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":273383.99,"providers":[{"billed_charge":851991.15,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":221317.08,"providers":[{"billed_charge":343359.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":149391.27,"providers":[{"billed_charge":518402.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":39077.58,"providers":[{"billed_charge":131786.16,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1564.33,"providers":[{"billed_charge":9192.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"581911751"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8180.41,"providers":[{"billed_charge":21767.55,"npi":[1598784720]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":249558.22,"providers":[{"billed_charge":1172232.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":68648.88,"providers":[{"billed_charge":297050.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":60240.17,"providers":[{"billed_charge":378173.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23741.52,"providers":[{"billed_charge":143252.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"592142859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":27298.21,"providers":[{"billed_charge":136793.55,"npi":[1821186313]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12642.75,"providers":[{"billed_charge":40699.00,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":149290.50,"providers":[{"billed_charge":448770.70,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":55650.74,"providers":[{"billed_charge":88477.35,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"590973502"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1132.69,"providers":[{"billed_charge":2233.14,"npi":[1063426823]}]}]},{"tin":{"type":"ein","value":"591726273"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10568.44,"providers":[{"billed_charge":21958.00,"npi":[1184709057]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8145.84,"providers":[{"billed_charge":26410.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"590714831"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7048.18,"providers":[{"billed_charge":12394.00,"npi":[1891782470]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14239.73,"providers":[{"billed_charge":45542.20,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"814223395"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1476.10,"providers":[{"billed_charge":11465.75,"npi":[1922530468]}]},{"allowed_amount":2005.75,"providers":[{"billed_charge":5899.25,"npi":[1922530468]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1029708.48,"providers":[{"billed_charge":3034040.05,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8167.90,"providers":[{"billed_charge":24390.50,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":114136.01,"providers":[{"billed_charge":265171.00,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"205497506"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24108.83,"providers":[{"billed_charge":92810.00,"npi":[1821221144]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":19433.39,"providers":[{"billed_charge":60233.50,"npi":[1285688234]}]},{"allowed_amount":1417.97,"providers":[{"billed_charge":4170.50,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"562084959"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3378.36,"providers":[{"billed_charge":4516.00,"npi":[1144247982]}]}]},{"tin":{"type":"ein","value":"874714839"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5712.77,"providers":[{"billed_charge":17049.00,"npi":[1144096553]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1482.48,"providers":[{"billed_charge":5428.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"994785298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11529.72,"providers":[{"billed_charge":49667.64,"npi":[1639992514]}]}]},{"tin":{"type":"ein","value":"582144788"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":35.77,"providers":[{"billed_charge":133.00,"npi":[1437135902]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":35416.61,"providers":[{"billed_charge":104227.35,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"570359174"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16772.04,"providers":[{"billed_charge":23143.00,"npi":[1417919531]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23095.22,"providers":[{"billed_charge":60836.90,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"711045290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1194.29,"providers":[{"billed_charge":4764.63,"npi":[1962435792]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":630924.45,"providers":[{"billed_charge":2368478.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"204144787"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17210.73,"providers":[{"billed_charge":40844.00,"npi":[1619014156]}]}]},{"tin":{"type":"ein","value":"472228529"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1374.54,"providers":[{"billed_charge":8122.98,"npi":[1992103857]}]},{"allowed_amount":511.41,"providers":[{"billed_charge":5327.17,"npi":[1992103857]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22632.54,"providers":[{"billed_charge":120373.50,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":345280.33,"providers":[{"billed_charge":624995.00,"npi":[1093716979]}]},{"allowed_amount":362753.01,"providers":[{"billed_charge":690573.00,"npi":[1962403865]}]}]}]},{"name":"DIAGNOSTIC COLONOSCOPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"45378","description":"COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN ","allowed_amounts":[{"tin":{"type":"ein","value":"811319493"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1157.73,"providers":[{"billed_charge":2988.00,"npi":[1598052094]}]}]}]},{"name":"COLONOSCOPY W/LESION REMOVAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"45385","description":"COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"582207881"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":3165.80,"providers":[{"billed_charge":9394.00,"npi":[1598293326]}]}]}]},{"name":"PULMONARY FUNC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"460","description":"PULMONARY FUNCTION - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1305.87,"providers":[{"billed_charge":3074.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7921.12,"providers":[{"billed_charge":22438.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":344.70,"providers":[{"billed_charge":1538.28,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":496.76,"providers":[{"billed_charge":11414.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":816.92,"providers":[{"billed_charge":3168.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":27.54,"providers":[{"billed_charge":81.00,"npi":[1053824292]}]}]}]},{"name":"CARDIAC CATH LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"481","description":"CARDIOLOGY - CARDIAC CATH LAB","allowed_amounts":[{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14932.09,"providers":[{"billed_charge":34927.00,"npi":[1528056066]}]}]}]},{"name":"ECHOCARDIOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"483","description":"CARDIOLOGY - ECHOCARDIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":18457.50,"providers":[{"billed_charge":52853.00,"npi":[1144203563]}]},{"allowed_amount":2356.74,"providers":[{"billed_charge":13226.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45515.89,"providers":[{"billed_charge":161581.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26142.81,"providers":[{"billed_charge":75059.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5157.42,"providers":[{"billed_charge":16994.70,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":284.86,"providers":[{"billed_charge":7742.00,"npi":[1992799050]}]},{"allowed_amount":5714.44,"providers":[{"billed_charge":54948.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1378.34,"providers":[{"billed_charge":3500.00,"npi":[1952340994]}]},{"allowed_amount":1882.37,"providers":[{"billed_charge":7065.00,"npi":[1457396079]}]},{"allowed_amount":198.81,"providers":[{"billed_charge":423.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2586.72,"providers":[{"billed_charge":7608.00,"npi":[1053824292]}]},{"allowed_amount":12686.76,"providers":[{"billed_charge":37314.00,"npi":[1053824292]}]}]}]},{"name":"AMBUL SURG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"490","description":"AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"853147678"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":20326.68,"providers":[{"billed_charge":67129.11,"npi":[1598372963]}]}]},{"tin":{"type":"ein","value":"593737668"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":1645.38,"providers":[{"billed_charge":8500.00,"npi":[1841304797]}]}]},{"tin":{"type":"ein","value":"205896580"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":26424.20,"providers":[{"billed_charge":121357.12,"npi":[1750420147]}]}]},{"tin":{"type":"ein","value":"872711994"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":24090.12,"providers":[{"billed_charge":312407.70,"npi":[1437894276]}]}]},{"tin":{"type":"ein","value":"880572909"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":23411.95,"providers":[{"billed_charge":279993.00,"npi":[1154046019]}]}]},{"tin":{"type":"ein","value":"582508201"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":11057.34,"providers":[{"billed_charge":32850.00,"npi":[1952141756]}]},{"allowed_amount":38706.68,"providers":[{"billed_charge":112550.00,"npi":[1427052026]}]}]},{"tin":{"type":"ein","value":"460629729"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":15568.88,"providers":[{"billed_charge":128000.00,"npi":[1700389822]}]}]},{"tin":{"type":"ein","value":"550846177"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":2029.48,"providers":[{"billed_charge":3314.10,"npi":[1598412256]}]}]},{"tin":{"type":"ein","value":"264485600"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":25617.41,"providers":[{"billed_charge":120630.21,"npi":[1528297140]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":227856.60,"providers":[{"billed_charge":340338.41,"npi":[1881764553]}]}]},{"tin":{"type":"ein","value":"933236869"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":4736.09,"providers":[{"billed_charge":117996.50,"npi":[1538910930]}]}]}]},{"name":"ABD PARACENTESIS W/IMAGING","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"49083","description":"ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITH IMAGING GUIDANCE","allowed_amounts":[{"tin":{"type":"ein","value":"262988454"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":137.94,"providers":[{"billed_charge":1042.00,"npi":[1255321915]}]}]}]},{"name":"CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"510","description":"CLINIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":15367.03,"providers":[{"billed_charge":194541.80,"npi":[1992799050]}]},{"allowed_amount":159396.77,"providers":[{"billed_charge":815026.81,"npi":[1992799050]}]},{"allowed_amount":1439.06,"providers":[{"billed_charge":7220.00,"npi":[1992799050]}]}]}]},{"name":"URGENT CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"516","description":"CLINIC - URGENT CARE CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"582149128"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":187.67,"providers":[{"billed_charge":802.00,"npi":[1043270564]}]}]}]},{"name":"RURAL/CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"521","description":"FREE-STANDING CLINIC - RURAL HEALTH-CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"582001607"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":4092.34,"providers":[{"billed_charge":9428.00,"npi":[1528658911]}]}]},{"tin":{"type":"ein","value":"582019024"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":2852.69,"providers":[{"billed_charge":5180.18,"npi":[1336862499]}]},{"allowed_amount":957.50,"providers":[{"billed_charge":1856.65,"npi":[1467223818]}]}]},{"tin":{"type":"ein","value":"581338038"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":10339.23,"providers":[{"billed_charge":23124.00,"npi":[1174529192]}]}]},{"tin":{"type":"ein","value":"461859206"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":3830.00,"providers":[{"billed_charge":11276.84,"npi":[1821779570]}]}]},{"tin":{"type":"ein","value":"581413957"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":191.50,"providers":[{"billed_charge":183.20,"npi":[1790821023]}]}]},{"tin":{"type":"ein","value":"582001101"},"service_code":["22","50"],"billing_class":"institutional","payments":[{"allowed_amount":3008.10,"providers":[{"billed_charge":8197.00,"npi":[1932150422]}]},{"allowed_amount":730128.96,"providers":[{"billed_charge":2085276.65,"npi":[1932150422]}]}]}]},{"name":"AMBULANCE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"AMBULANCE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"810864789"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6785.51,"providers":[{"billed_charge":21069.50,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6724.07,"providers":[{"billed_charge":37356.06,"npi":[1508810565]}]}]}]},{"name":"MRI","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"610","description":"MRI - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":569.72,"providers":[{"billed_charge":16073.00,"npi":[1992799050]}]}]}]},{"name":"MRI-BRAIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"611","description":"MRI - BRAIN (INCLUDING BRAINSTEM)","allowed_amounts":[{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19408.90,"providers":[{"billed_charge":35299.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3265.05,"providers":[{"billed_charge":8091.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":192.80,"providers":[{"billed_charge":5561.00,"npi":[1992799050]}]}]}]},{"name":"MRI-SPINE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"612","description":"MRI - SPINAL CORD (INCLUDING SPINE)","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1870.85,"providers":[{"billed_charge":2296.00,"npi":[1144203563]}]}]}]},{"name":"DRUG/DETAIL CODE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"DRUGS REQ SPEC IDENTIFICATION - DRUGS REQ DETAILED CODING*","allowed_amounts":[{"tin":{"type":"ein","value":"811723202"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":285.30,"providers":[{"billed_charge":5747.60,"npi":[1649726738]}]},{"allowed_amount":246277.67,"providers":[{"billed_charge":523859.91,"npi":[1649726738]}]}]},{"tin":{"type":"ein","value":"650232993"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":384.00,"providers":[{"billed_charge":800.00,"npi":[1578547865]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19324.54,"providers":[{"billed_charge":52147.82,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1340.03,"providers":[{"billed_charge":4145.40,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"611259843"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4399.51,"providers":[{"billed_charge":19997.80,"npi":[1063466563]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":103636.37,"providers":[{"billed_charge":245749.72,"npi":[1992799050]}]},{"allowed_amount":8395.86,"providers":[{"billed_charge":103130.42,"npi":[1992799050]}]},{"allowed_amount":399155.22,"providers":[{"billed_charge":1403571.18,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"586025016"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":223.00,"providers":[{"billed_charge":953.00,"npi":[1326079260]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":162.79,"providers":[{"billed_charge":19432.00,"npi":[1720189517]}]},{"allowed_amount":0.82,"providers":[{"billed_charge":8770.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":167705.14,"providers":[{"billed_charge":506574.78,"npi":[1053824292]}]},{"allowed_amount":63316.31,"providers":[{"billed_charge":186275.65,"npi":[1053824292]}]},{"allowed_amount":93.77,"providers":[{"billed_charge":2534.92,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1185.62,"providers":[{"billed_charge":3976.80,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":11637.81,"providers":[{"billed_charge":17284.00,"npi":[1881764553]}]}]},{"tin":{"type":"ein","value":"582155150"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":144.93,"providers":[{"billed_charge":483.07,"npi":[1760498588]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1332.01,"providers":[{"billed_charge":4452.40,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"852556972"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":69.61,"providers":[{"billed_charge":204.73,"npi":[1790376564]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":35071.17,"providers":[{"billed_charge":52137.15,"npi":[1144203563]}]},{"allowed_amount":5905.92,"providers":[{"billed_charge":13248.74,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":136256.33,"providers":[{"billed_charge":471900.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"810851756"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":184.05,"providers":[{"billed_charge":613.50,"npi":[1750312997]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1061.50,"providers":[{"billed_charge":5093.91,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"42103590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22.44,"providers":[{"billed_charge":74.77,"npi":[1407804669]}]}]},{"tin":{"type":"ein","value":"581928247"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":32.40,"providers":[{"billed_charge":108.00,"npi":[1992789721]}]}]},{"tin":{"type":"ein","value":"510141601"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":124589.23,"providers":[{"billed_charge":391730.00,"npi":[1043311715]}]}]},{"tin":{"type":"ein","value":"636000526"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":751.37,"providers":[{"billed_charge":2558.26,"npi":[1780235002]}]},{"allowed_amount":1474.82,"providers":[{"billed_charge":29370.05,"npi":[1154386431]}]},{"allowed_amount":493.62,"providers":[{"billed_charge":1645.35,"npi":[1154386431]}]}]},{"tin":{"type":"ein","value":"720502505"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":58.96,"providers":[{"billed_charge":196.49,"npi":[1811973100]}]}]},{"tin":{"type":"ein","value":"590791028"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18.97,"providers":[{"billed_charge":138.55,"npi":[1639197395]}]}]},{"tin":{"type":"ein","value":"475348597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":62.80,"providers":[{"billed_charge":209.31,"npi":[1912428301]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14.72,"providers":[{"billed_charge":49.05,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":209.05,"providers":[{"billed_charge":696.75,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26.16,"providers":[{"billed_charge":8381.45,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"453957368"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":544.69,"providers":[{"billed_charge":1696.60,"npi":[1073927117]}]}]},{"tin":{"type":"ein","value":"300999841"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":130.12,"providers":[{"billed_charge":433.70,"npi":[1306355680]}]}]},{"tin":{"type":"ein","value":"582433432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":482.02,"providers":[{"billed_charge":1713.06,"npi":[1467406132]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7467.00,"providers":[{"billed_charge":193632.50,"npi":[1952340994]}]},{"allowed_amount":14928.84,"providers":[{"billed_charge":49259.87,"npi":[1457396079]}]},{"allowed_amount":38162.72,"providers":[{"billed_charge":113569.00,"npi":[1225050396]}]},{"allowed_amount":1966.80,"providers":[{"billed_charge":6556.00,"npi":[1376574277]}]},{"allowed_amount":5667.21,"providers":[{"billed_charge":18782.00,"npi":[1790715381]}]},{"allowed_amount":3330.50,"providers":[{"billed_charge":135016.50,"npi":[1225050396]}]},{"allowed_amount":28135.65,"providers":[{"billed_charge":94723.50,"npi":[1952340994]}]},{"allowed_amount":511.50,"providers":[{"billed_charge":1023.00,"npi":[1457396079]}]},{"allowed_amount":693.87,"providers":[{"billed_charge":3951.00,"npi":[1225050396]}]},{"allowed_amount":8867.00,"providers":[{"billed_charge":1336073.11,"npi":[1457396079]}]},{"allowed_amount":1791.00,"providers":[{"billed_charge":18767.00,"npi":[1376574277]}]}]},{"tin":{"type":"ein","value":"582513901"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42.00,"providers":[{"billed_charge":140.00,"npi":[1326028978]}]}]},{"tin":{"type":"ein","value":"621736985"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":176.84,"providers":[{"billed_charge":589.48,"npi":[1811940976]}]}]},{"tin":{"type":"ein","value":"590747311"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5.10,"providers":[{"billed_charge":2801.95,"npi":[1578620449]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":265.44,"providers":[{"billed_charge":331.80,"npi":[1588640692]}]},{"allowed_amount":72.88,"providers":[{"billed_charge":242.89,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11295.25,"providers":[{"billed_charge":35952.33,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"621736983"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":69.43,"providers":[{"billed_charge":231.43,"npi":[1598719643]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19047.01,"providers":[{"billed_charge":36409.67,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"581734026"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":115.80,"providers":[{"billed_charge":386.00,"npi":[1659376630]}]}]},{"tin":{"type":"ein","value":"582223937"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":122.66,"providers":[{"billed_charge":209.66,"npi":[1205843174]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":10312.53,"providers":[{"billed_charge":30295.16,"npi":[1962461681]}]},{"allowed_amount":5691.57,"providers":[{"billed_charge":26649.83,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11182.35,"providers":[{"billed_charge":36360.77,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":698.94,"providers":[{"billed_charge":2524.57,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581911751"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":500.84,"providers":[{"billed_charge":1669.46,"npi":[1598784720]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45687.44,"providers":[{"billed_charge":156015.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18451.23,"providers":[{"billed_charge":62890.68,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":319553.53,"providers":[{"billed_charge":1365612.57,"npi":[1043270564]}]},{"allowed_amount":4865.01,"providers":[{"billed_charge":16645.20,"npi":[1043270564]}]},{"allowed_amount":24.72,"providers":[{"billed_charge":105.60,"npi":[1043270564]}]},{"allowed_amount":673.87,"providers":[{"billed_charge":40027.35,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3649.36,"providers":[{"billed_charge":17093.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":459.15,"providers":[{"billed_charge":2946.43,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"592142859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.32,"providers":[{"billed_charge":6609.20,"npi":[1821186313]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":798.37,"providers":[{"billed_charge":14825.93,"npi":[1437186111]}]},{"allowed_amount":119196.82,"providers":[{"billed_charge":457950.64,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"576000094"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":183.14,"providers":[{"billed_charge":385.96,"npi":[1366436073]}]}]},{"tin":{"type":"ein","value":"580566223"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":19.43,"providers":[{"billed_charge":2559.90,"npi":[1871556621]}]},{"allowed_amount":2.70,"providers":[{"billed_charge":397.10,"npi":[1871556621]}]}]},{"tin":{"type":"ein","value":"590973502"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4.86,"providers":[{"billed_charge":708.62,"npi":[1063426823]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2610.58,"providers":[{"billed_charge":8277.86,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":102.84,"providers":[{"billed_charge":342.75,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"474393589"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":133.18,"providers":[{"billed_charge":397.65,"npi":[1811962756]}]},{"allowed_amount":1359.67,"providers":[{"billed_charge":4060.25,"npi":[1811962756]}]}]},{"tin":{"type":"ein","value":"814223395"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":300.31,"providers":[{"billed_charge":1001.00,"npi":[1922530468]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":54386.25,"providers":[{"billed_charge":205898.54,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"205077249"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":349.24,"providers":[{"billed_charge":1230.74,"npi":[1134133002]}]}]},{"tin":{"type":"ein","value":"810875069"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3512.52,"providers":[{"billed_charge":11708.40,"npi":[1619997079]}]}]},{"tin":{"type":"ein","value":"205497506"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":592.71,"providers":[{"billed_charge":1850.50,"npi":[1821221144]}]}]},{"tin":{"type":"ein","value":"621817469"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3933.69,"providers":[{"billed_charge":13341.17,"npi":[1285688234]}]},{"allowed_amount":4902.95,"providers":[{"billed_charge":15469.50,"npi":[1285688234]}]}]},{"tin":{"type":"ein","value":"562084959"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":102.26,"providers":[{"billed_charge":340.80,"npi":[1144247982]}]}]},{"tin":{"type":"ein","value":"874714839"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":458.64,"providers":[{"billed_charge":1528.75,"npi":[1144096553]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":28.26,"providers":[{"billed_charge":94.21,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"582144788"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":221.81,"providers":[{"billed_charge":693.30,"npi":[1437135902]}]}]},{"tin":{"type":"ein","value":"473637912"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.53,"providers":[{"billed_charge":430.84,"npi":[1215449954]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3933.38,"providers":[{"billed_charge":13111.26,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"570359174"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":307.50,"providers":[{"billed_charge":1025.00,"npi":[1417919531]}]}]},{"tin":{"type":"ein","value":"340714585"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8.28,"providers":[{"billed_charge":27.60,"npi":[1679525919]}]}]},{"tin":{"type":"ein","value":"161165049"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6.78,"providers":[{"billed_charge":22.60,"npi":[1518998699]}]}]},{"tin":{"type":"ein","value":"352228583"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":857.63,"providers":[{"billed_charge":3406.59,"npi":[1780643411]}]},{"allowed_amount":608.71,"providers":[{"billed_charge":1987.56,"npi":[1780643411]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47862.14,"providers":[{"billed_charge":161814.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"582190713"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2147.16,"providers":[{"billed_charge":13264.40,"npi":[1265486278]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":48.30,"providers":[{"billed_charge":161.00,"npi":[1700828852]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":25563.38,"providers":[{"billed_charge":28309.04,"npi":[1093716979]}]},{"allowed_amount":278.75,"providers":[{"billed_charge":1089.66,"npi":[1093716979]}]},{"allowed_amount":4166.41,"providers":[{"billed_charge":7623.01,"npi":[1962403865]}]}]}]},{"name":"SELF-ADMINISTRABLE DRUGS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"637","description":"SELF-ADMINISTRABLE DRUGS","allowed_amounts":[{"tin":{"type":"ein","value":"580566256"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1056.51,"providers":[{"billed_charge":3521.62,"npi":[1588640692]}]},{"allowed_amount":952.88,"providers":[{"billed_charge":9889.13,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6596.72,"providers":[{"billed_charge":21987.13,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":121.57,"providers":[{"billed_charge":405.25,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":46.15,"providers":[{"billed_charge":153.31,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":422.28,"providers":[{"billed_charge":1402.66,"npi":[1962403865]}]},{"allowed_amount":890.23,"providers":[{"billed_charge":2949.36,"npi":[1093716979]}]}]}]},{"name":"HOSPICE/RTN HOME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"651","description":"HOSPICE SERVICES - ROUTINE HOME CARE","allowed_amounts":[{"tin":{"type":"ein","value":"134350580"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":68973.15,"providers":[{"billed_charge":76581.00,"npi":[1407811060]}]}]},{"tin":{"type":"ein","value":"201531491"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":6396.00,"providers":[{"billed_charge":9455.42,"npi":[1932242260]}]}]},{"tin":{"type":"ein","value":"411458213"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":156.00,"providers":[{"billed_charge":156.00,"npi":[1720787211]}]}]},{"tin":{"type":"ein","value":"580566121"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":11232.00,"providers":[{"billed_charge":14760.00,"npi":[1326026782]}]}]},{"tin":{"type":"ein","value":"263599337"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":13654.86,"providers":[{"billed_charge":13626.60,"npi":[1720231343]}]}]},{"tin":{"type":"ein","value":"382621935"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":14089.43,"providers":[{"billed_charge":20100.00,"npi":[1447242623]}]}]},{"tin":{"type":"ein","value":"20674282"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":14032.66,"providers":[{"billed_charge":43964.00,"npi":[1427173699]}]}]},{"tin":{"type":"ein","value":"273195081"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":15115.68,"providers":[{"billed_charge":54576.00,"npi":[1770898678]}]}]}]},{"name":"COVER EYE W/MEMBRANE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"65778","description":"PLACEMENT OF AMNIOTIC MEMBRANE ON THE OCULAR SURFACE; WITHOUT SUTURES","allowed_amounts":[{"tin":{"type":"ein","value":"581485988"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":102397.81,"providers":[{"billed_charge":199000.00,"npi":[1497724447]}]}]}]},{"name":"CATARACT SURG W/IOL 1 STAGE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"66984","description":"EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1 STAGE PROCEDURE), MA","allowed_amounts":[{"tin":{"type":"ein","value":"581380450"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":2212.17,"providers":[{"billed_charge":12000.00,"npi":[1144203779]}]}]}]},{"name":"CT HEAD/BRAIN W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70450","description":"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"550840991"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":855.62,"providers":[{"billed_charge":1071.60,"npi":[1831312099]}]}]},{"tin":{"type":"ein","value":"208031441"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1555.48,"providers":[{"billed_charge":9154.00,"npi":[1760435416]}]},{"allowed_amount":68.24,"providers":[{"billed_charge":398.00,"npi":[1760435416]}]},{"allowed_amount":34.50,"providers":[{"billed_charge":199.00,"npi":[1760435416]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":65.69,"providers":[{"billed_charge":142.00,"npi":[1609226851]}]},{"allowed_amount":131.38,"providers":[{"billed_charge":284.00,"npi":[1942733597]}]},{"allowed_amount":198.24,"providers":[{"billed_charge":426.00,"npi":[1881198273,1760798565]}]},{"allowed_amount":197.07,"providers":[{"billed_charge":426.00,"npi":[1942733597,1144752817]}]},{"allowed_amount":724.93,"providers":[{"billed_charge":1562.00,"npi":[1437208246]}]},{"allowed_amount":132.55,"providers":[{"billed_charge":284.00,"npi":[1760798565]}]},{"allowed_amount":66.86,"providers":[{"billed_charge":142.00,"npi":[1437208246]}]}]},{"tin":{"type":"ein","value":"581717812"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":216.93,"providers":[{"billed_charge":585.00,"npi":[1992264212]}]}]}]},{"name":"CT MAXILLOFACIAL W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70486","description":"COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9195.68,"providers":[{"billed_charge":27105.00,"npi":[1558327072]}]}]}]},{"name":"RECOVERY ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"710","description":"RECOVERY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":787.20,"providers":[{"billed_charge":2624.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31413.30,"providers":[{"billed_charge":104711.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":31416.46,"providers":[{"billed_charge":96502.00,"npi":[1053824292]}]},{"allowed_amount":4685.54,"providers":[{"billed_charge":13781.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"10723254"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":22598.03,"providers":[{"billed_charge":33753.50,"npi":[1881764553]}]}]}]},{"name":"X-RAY EXAM CHEST 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71045","description":"RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"582030692"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":138.10,"providers":[{"billed_charge":400.00,"npi":[1801857909]}]}]},{"tin":{"type":"ein","value":"581839412"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":231.91,"providers":[{"billed_charge":675.00,"npi":[1942264981]}]},{"allowed_amount":525.60,"providers":[{"billed_charge":1530.00,"npi":[1942264981]}]}]},{"tin":{"type":"ein","value":"991380793"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":21.30,"providers":[{"billed_charge":126.00,"npi":[1982165890]}]},{"allowed_amount":42.11,"providers":[{"billed_charge":252.00,"npi":[1992150221]}]},{"allowed_amount":85.20,"providers":[{"billed_charge":504.00,"npi":[1982165890]}]}]},{"tin":{"type":"ein","value":"203728202"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":59.40,"providers":[{"billed_charge":285.00,"npi":[1851851646]}]},{"allowed_amount":85.16,"providers":[{"billed_charge":399.00,"npi":[1851851646]}]},{"allowed_amount":47.52,"providers":[{"billed_charge":228.00,"npi":[1851851646]}]}]},{"tin":{"type":"ein","value":"262824776"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":32.40,"providers":[{"billed_charge":64.00,"npi":[1205213162]}]},{"allowed_amount":62.22,"providers":[{"billed_charge":128.00,"npi":[1205213162]}]},{"allowed_amount":16.20,"providers":[{"billed_charge":32.00,"npi":[1205213162]}]}]},{"tin":{"type":"ein","value":"550840991"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":12.30,"providers":[{"billed_charge":15.48,"npi":[1831122761]}]},{"allowed_amount":1007.92,"providers":[{"billed_charge":1269.36,"npi":[1831312099]}]},{"allowed_amount":86.05,"providers":[{"billed_charge":108.36,"npi":[1831122761]}]},{"allowed_amount":36.88,"providers":[{"billed_charge":46.44,"npi":[1831312099]}]},{"allowed_amount":12.29,"providers":[{"billed_charge":15.48,"npi":[1831312099]}]},{"allowed_amount":36.87,"providers":[{"billed_charge":46.44,"npi":[1831122761]}]}]},{"tin":{"type":"ein","value":"208031441"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":14.59,"providers":[{"billed_charge":86.00,"npi":[1174664163]}]},{"allowed_amount":204.43,"providers":[{"billed_charge":1204.00,"npi":[1174664163]}]},{"allowed_amount":175.48,"providers":[{"billed_charge":1032.00,"npi":[1760435416]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":69.05,"providers":[{"billed_charge":140.00,"npi":[1609226851]}]},{"allowed_amount":35.91,"providers":[{"billed_charge":84.00,"npi":[1134252182]}]},{"allowed_amount":41.43,"providers":[{"billed_charge":84.00,"npi":[1750763157]}]},{"allowed_amount":151.91,"providers":[{"billed_charge":308.00,"npi":[1194164624]}]},{"allowed_amount":745.99,"providers":[{"billed_charge":1512.00,"npi":[1437208246]}]},{"allowed_amount":8.29,"providers":[{"billed_charge":28.00,"npi":[1699793455]}]},{"allowed_amount":449.10,"providers":[{"billed_charge":952.00,"npi":[1922033745]}]},{"allowed_amount":72.76,"providers":[{"billed_charge":140.00,"npi":[1912273483]}]},{"allowed_amount":13.81,"providers":[{"billed_charge":28.00,"npi":[1912273483,1942733597,1881987972,1609226851]}]},{"allowed_amount":48.85,"providers":[{"billed_charge":84.00,"npi":[1417038662]}]},{"allowed_amount":270.93,"providers":[{"billed_charge":560.00,"npi":[1275996316]}]},{"allowed_amount":55.24,"providers":[{"billed_charge":112.00,"npi":[1699793455]}]},{"allowed_amount":99.83,"providers":[{"billed_charge":224.00,"npi":[1437208246]}]},{"allowed_amount":221.46,"providers":[{"billed_charge":448.00,"npi":[1730441593]}]},{"allowed_amount":248.83,"providers":[{"billed_charge":504.00,"npi":[1356787840]}]},{"allowed_amount":83.36,"providers":[{"billed_charge":168.00,"npi":[1275996316]}]},{"allowed_amount":27.62,"providers":[{"billed_charge":56.00,"npi":[1841370723,1730441593]}]}]},{"tin":{"type":"ein","value":"582244832"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":128.68,"providers":[{"billed_charge":3168.00,"npi":[1396021648]}]},{"allowed_amount":14.14,"providers":[{"billed_charge":352.00,"npi":[1033379151]}]},{"allowed_amount":77.92,"providers":[{"billed_charge":1936.00,"npi":[1144410283]}]},{"allowed_amount":20.88,"providers":[{"billed_charge":528.00,"npi":[1386976207]}]},{"allowed_amount":22.24,"providers":[{"billed_charge":528.00,"npi":[1396021648]}]},{"allowed_amount":94.96,"providers":[{"billed_charge":2288.00,"npi":[1902883168]}]},{"allowed_amount":6.96,"providers":[{"billed_charge":176.00,"npi":[1720064512]}]},{"allowed_amount":7.64,"providers":[{"billed_charge":176.00,"npi":[1962923706,1902883168]}]},{"allowed_amount":13.92,"providers":[{"billed_charge":352.00,"npi":[1386976207,1144410283]}]},{"allowed_amount":99.48,"providers":[{"billed_charge":2464.00,"npi":[1144410283]}]},{"allowed_amount":191.32,"providers":[{"billed_charge":4752.00,"npi":[1396021648]}]},{"allowed_amount":49.38,"providers":[{"billed_charge":1232.00,"npi":[1033379151]}]},{"allowed_amount":84.20,"providers":[{"billed_charge":2112.00,"npi":[1386976207]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":176.96,"providers":[{"billed_charge":480.00,"npi":[1265457485]}]},{"allowed_amount":11.06,"providers":[{"billed_charge":30.00,"npi":[1265457485]}]}]}]},{"name":"X-RAY EXAM CHEST 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71046","description":"RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"582030692"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":68.40,"providers":[{"billed_charge":204.00,"npi":[1831351980]}]},{"allowed_amount":393.30,"providers":[{"billed_charge":1173.00,"npi":[1801857909]}]},{"allowed_amount":17.10,"providers":[{"billed_charge":51.00,"npi":[1427462811]}]},{"allowed_amount":222.92,"providers":[{"billed_charge":663.00,"npi":[1235379017]}]}]},{"tin":{"type":"ein","value":"205060581"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":14.37,"providers":[{"billed_charge":44.00,"npi":[1417272667]}]},{"allowed_amount":9.77,"providers":[{"billed_charge":44.00,"npi":[1417272667]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1145.70,"providers":[{"billed_charge":2278.00,"npi":[1437208246]}]},{"allowed_amount":291.01,"providers":[{"billed_charge":578.00,"npi":[1730441593]}]},{"allowed_amount":17.41,"providers":[{"billed_charge":34.00,"npi":[1962418764]}]},{"allowed_amount":444.60,"providers":[{"billed_charge":884.00,"npi":[1275996316]}]},{"allowed_amount":274.22,"providers":[{"billed_charge":544.00,"npi":[1770601882]}]},{"allowed_amount":34.20,"providers":[{"billed_charge":68.00,"npi":[1194164624]}]},{"allowed_amount":102.60,"providers":[{"billed_charge":204.00,"npi":[1538472543]}]},{"allowed_amount":872.10,"providers":[{"billed_charge":1734.00,"npi":[1194164624]}]},{"allowed_amount":359.41,"providers":[{"billed_charge":714.00,"npi":[1942733597]}]},{"allowed_amount":154.21,"providers":[{"billed_charge":306.00,"npi":[1609226851]}]},{"allowed_amount":17.10,"providers":[{"billed_charge":34.00,"npi":[1770601882,1609226851,1437208246,1194164624,1356787840]}]},{"allowed_amount":376.20,"providers":[{"billed_charge":748.00,"npi":[1356787840]}]},{"allowed_amount":222.92,"providers":[{"billed_charge":442.00,"npi":[1699793455]}]}]}]},{"name":"CT ANGIOGRAPHY CHEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71275","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST (NONCORONARY), WITH CONTRAST MATERIAL(S), INCLUDING NONCONTR","allowed_amounts":[{"tin":{"type":"ein","value":"581537752"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":140.87,"providers":[{"billed_charge":279.00,"npi":[1841370723]}]},{"allowed_amount":850.24,"providers":[{"billed_charge":1674.00,"npi":[1437208246]}]}]}]},{"name":"CT NECK SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72125","description":"COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"208031441"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":158.70,"providers":[{"billed_charge":944.00,"npi":[1760435416]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":77.30,"providers":[{"billed_charge":177.00,"npi":[1609226851,1437208246]}]},{"allowed_amount":851.68,"providers":[{"billed_charge":1947.00,"npi":[1437208246]}]}]}]},{"name":"EKG/ECG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"730","description":"EKG/ECG - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"810864789"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1147.41,"providers":[{"billed_charge":4704.00,"npi":[1972535318]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6212.22,"providers":[{"billed_charge":15552.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17930.96,"providers":[{"billed_charge":61074.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1197.30,"providers":[{"billed_charge":180614.05,"npi":[1992799050]}]},{"allowed_amount":1184.01,"providers":[{"billed_charge":46648.75,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1689.42,"providers":[{"billed_charge":5248.00,"npi":[1043270564]}]},{"allowed_amount":82.48,"providers":[{"billed_charge":1827.00,"npi":[1043270564]}]}]},{"tin":{"type":"ein","value":"831294232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1656.12,"providers":[{"billed_charge":5700.00,"npi":[1083174973]}]}]},{"tin":{"type":"ein","value":"922451946"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4843.33,"providers":[{"billed_charge":16758.00,"npi":[1740981430]}]}]},{"tin":{"type":"ein","value":"580655369"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":89.21,"providers":[{"billed_charge":4726.00,"npi":[1720189517]}]},{"allowed_amount":70.17,"providers":[{"billed_charge":542.00,"npi":[1720189517]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":49575.46,"providers":[{"billed_charge":147454.00,"npi":[1053824292]}]},{"allowed_amount":18839.74,"providers":[{"billed_charge":56884.00,"npi":[1053824292]}]}]},{"tin":{"type":"ein","value":"582032904"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2233.85,"providers":[{"billed_charge":8624.00,"npi":[1649248626]}]}]},{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4387.07,"providers":[{"billed_charge":17248.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"582179986"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":278.18,"providers":[{"billed_charge":15332.90,"npi":[1437186111]}]}]},{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":117404.83,"providers":[{"billed_charge":153360.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"586025393"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2553.19,"providers":[{"billed_charge":5025.50,"npi":[1487684122]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47293.59,"providers":[{"billed_charge":162188.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"475259919"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":733.02,"providers":[{"billed_charge":2700.00,"npi":[1033228168]}]}]},{"tin":{"type":"ein","value":"582322328"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1795.95,"providers":[{"billed_charge":8236.80,"npi":[1528027240]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":38744.92,"providers":[{"billed_charge":107759.25,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"581123037"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1491.86,"providers":[{"billed_charge":5963.94,"npi":[1508810565]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22689.22,"providers":[{"billed_charge":59308.00,"npi":[1457396079]}]},{"allowed_amount":1261.80,"providers":[{"billed_charge":3252.00,"npi":[1790715381]}]},{"allowed_amount":14872.51,"providers":[{"billed_charge":38894.00,"npi":[1225050396]}]},{"allowed_amount":5182.25,"providers":[{"billed_charge":13498.00,"npi":[1952340994]}]}]},{"tin":{"type":"ein","value":"582453303"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15172.78,"providers":[{"billed_charge":37584.00,"npi":[1851388748]}]}]},{"tin":{"type":"ein","value":"580566256"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5549.09,"providers":[{"billed_charge":7560.00,"npi":[1588640692]}]},{"allowed_amount":216.00,"providers":[{"billed_charge":16200.00,"npi":[1588640692]}]}]},{"tin":{"type":"ein","value":"582433438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2825.95,"providers":[{"billed_charge":8870.40,"npi":[1780638833]}]}]},{"tin":{"type":"ein","value":"582433436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":231.80,"providers":[{"billed_charge":270.00,"npi":[1679632137]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":79534.31,"providers":[{"billed_charge":274074.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566257"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":125.29,"providers":[{"billed_charge":270.00,"npi":[1679664395]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":106.38,"providers":[{"billed_charge":6336.00,"npi":[1962461681]}]},{"allowed_amount":6086.27,"providers":[{"billed_charge":29145.60,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"582414416"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4217.74,"providers":[{"billed_charge":11016.00,"npi":[1194712083]}]}]},{"tin":{"type":"ein","value":"582200195"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":199.55,"providers":[{"billed_charge":1267.20,"npi":[1225034333]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9434.77,"providers":[{"billed_charge":28890.00,"npi":[1962403865]}]},{"allowed_amount":11183.86,"providers":[{"billed_charge":32130.00,"npi":[1093716979]}]}]}]},{"name":"X-RAY EXAM OF WRIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73110","description":"RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":517.67,"providers":[{"billed_charge":1719.00,"npi":[1144218157]}]}]}]},{"name":"X-RAY EXAM OF HAND","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73130","description":"RADIOLOGIC EXAMINATION, HAND; MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":350.29,"providers":[{"billed_charge":1148.00,"npi":[1144218157]}]}]}]},{"name":"X-RAY EXAM OF KNEE 1 OR 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73560","description":"RADIOLOGIC EXAMINATION, KNEE; 1 OR 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":774.15,"providers":[{"billed_charge":2890.00,"npi":[1366430233]}]}]}]},{"name":"X-RAY EXAM OF FOOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73630","description":"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"582476390"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":116.73,"providers":[{"billed_charge":315.00,"npi":[1972584977]}]}]}]},{"name":"X-RAY EXAM ABDOMEN 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74018","description":"RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"581537752"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":156.48,"providers":[{"billed_charge":280.00,"npi":[1649296039]}]}]}]},{"name":"CT ANGIO ABD&PELV W/O&W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74174","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRA","allowed_amounts":[{"tin":{"type":"ein","value":"581537752"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1017.60,"providers":[{"billed_charge":2010.00,"npi":[1437208246]}]}]}]},{"name":"CT ABD & PELVIS W/O CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74176","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"991380793"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":66.92,"providers":[{"billed_charge":398.00,"npi":[1982165890]}]}]},{"tin":{"type":"ein","value":"208031441"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":68.89,"providers":[{"billed_charge":409.00,"npi":[1760435416]}]},{"allowed_amount":1106.00,"providers":[{"billed_charge":6544.00,"npi":[1760435416]}]}]}]},{"name":"CT ABD & PELV W/CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74177","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"581839412"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":157.32,"providers":[{"billed_charge":475.00,"npi":[1942264981]}]}]},{"tin":{"type":"ein","value":"550840991"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4397.55,"providers":[{"billed_charge":5252.04,"npi":[1831312099]}]}]},{"tin":{"type":"ein","value":"208031441"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":2402.85,"providers":[{"billed_charge":14157.00,"npi":[1760435416]}]},{"allowed_amount":218.65,"providers":[{"billed_charge":1287.00,"npi":[1760435416]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":327.65,"providers":[{"billed_charge":560.00,"npi":[1649296039]}]},{"allowed_amount":330.17,"providers":[{"billed_charge":560.00,"npi":[1649296039]}]},{"allowed_amount":281.60,"providers":[{"billed_charge":560.00,"npi":[1891288973]}]},{"allowed_amount":140.80,"providers":[{"billed_charge":280.00,"npi":[1730530080]}]},{"allowed_amount":422.40,"providers":[{"billed_charge":840.00,"npi":[1891288973]}]},{"allowed_amount":844.80,"providers":[{"billed_charge":1680.00,"npi":[1649296039]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":329.52,"providers":[{"billed_charge":888.00,"npi":[1265457485]}]}]}]},{"name":"GASTR-INTS SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"750","description":"GASTRO-INTESTINAL SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":20679.44,"providers":[{"billed_charge":116954.07,"npi":[1992799050]}]},{"allowed_amount":1314.39,"providers":[{"billed_charge":5442.00,"npi":[1992799050]}]}]}]},{"name":"TREATMENT ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"761","description":"TREATMENT OR OBSERVATION ROOM - TREATMENT ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"580968382"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7232.40,"providers":[{"billed_charge":24108.00,"npi":[1467420448]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":131.38,"providers":[{"billed_charge":708.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16263.36,"providers":[{"billed_charge":84910.00,"npi":[1528056066]}]}]}]},{"name":"OBSERVATION ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"762","description":"TREATMENT OR OBSERVATION ROOM - OBSERVATION ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":81595.20,"providers":[{"billed_charge":271984.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":132360.60,"providers":[{"billed_charge":441202.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"814015190"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5734.80,"providers":[{"billed_charge":19116.00,"npi":[1881144889]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":41001.68,"providers":[{"billed_charge":139939.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":65715.00,"providers":[{"billed_charge":226050.00,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1797.60,"providers":[{"billed_charge":5992.00,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"581966795"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2429.70,"providers":[{"billed_charge":22695.00,"npi":[1093716979]}]}]},{"tin":{"type":"ein","value":"581954432"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":834.60,"providers":[{"billed_charge":2782.00,"npi":[1225050396]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":16898.00,"providers":[{"billed_charge":49700.00,"npi":[1053824292]}]},{"allowed_amount":71504.06,"providers":[{"billed_charge":210306.06,"npi":[1053824292]}]}]}]},{"name":"OB US DETAILED SNGL FETUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76811","description":"ULTRSND, PREGNANT UTERUS, REAL TIME W IMG DOCUMENTATION, FETAL AND MATERNAL EVALUATION PLUS DETAILED","allowed_amounts":[{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":862.32,"providers":[{"billed_charge":2496.00,"npi":[1780615856]}]}]}]},{"name":"OB US FOLLOW-UP PER FETUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76816","description":"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FOLLOW-UP (EG, RE-EVALUATION OF FET","allowed_amounts":[{"tin":{"type":"ein","value":"581627802"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":38.87,"providers":[{"billed_charge":130.00,"npi":[1598127193]}]},{"allowed_amount":66.09,"providers":[{"billed_charge":130.00,"npi":[1598127193]}]},{"allowed_amount":299.31,"providers":[{"billed_charge":910.00,"npi":[1598127193]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4289.34,"providers":[{"billed_charge":12969.00,"npi":[1780615856]}]},{"allowed_amount":649.90,"providers":[{"billed_charge":1965.00,"npi":[1922260611]}]}]}]},{"name":"FETAL BIOPHYS PROFIL W/O NST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76819","description":"FETAL BIOPHYSICAL PROFILE; WITHOUT NON-STRESS TESTING","allowed_amounts":[{"tin":{"type":"ein","value":"581627802"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":598.35,"providers":[{"billed_charge":1770.00,"npi":[1598127193]}]},{"allowed_amount":69.98,"providers":[{"billed_charge":236.00,"npi":[1598127193]}]},{"allowed_amount":118.98,"providers":[{"billed_charge":236.00,"npi":[1598127193]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11","21"],"billing_class":"professional","payments":[{"allowed_amount":4138.00,"providers":[{"billed_charge":12000.00,"npi":[1780615856]}]},{"allowed_amount":1344.85,"providers":[{"billed_charge":3900.00,"npi":[1922260611]}]},{"allowed_amount":45.79,"providers":[{"billed_charge":126.00,"npi":[1922260611]}]}]}]},{"name":"UMBILICAL ARTERY ECHO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76820","description":"DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY","allowed_amounts":[{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":321.97,"providers":[{"billed_charge":1344.00,"npi":[1780615856]}]}]}]},{"name":"TRANSVAGINAL US, NON-OB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76830","description":"ULTRASOUND, TRANSVAGINAL","allowed_amounts":[{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3485.73,"providers":[{"billed_charge":13579.00,"npi":[1245261783]}]}]}]},{"name":"PREVENT CARE SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"770","description":"PREVENTIVE CARE SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"582019024"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":94.35,"providers":[{"billed_charge":942.00,"npi":[1336862499]}]}]}]},{"name":"CT SCAN FOR THERAPY GUIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77014","description":"COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS","allowed_amounts":[{"tin":{"type":"ein","value":"581537752"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":366.85,"providers":[{"billed_charge":690.00,"npi":[1346806890]}]},{"allowed_amount":220.11,"providers":[{"billed_charge":414.00,"npi":[1598080913]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77063","description":"SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P","allowed_amounts":[{"tin":{"type":"ein","value":"581839412"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":1764.62,"providers":[{"billed_charge":5775.00,"npi":[1942264981]}]},{"allowed_amount":307.20,"providers":[{"billed_charge":990.00,"npi":[1942264981]}]}]},{"tin":{"type":"ein","value":"275269030"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":693.68,"providers":[{"billed_charge":3600.00,"npi":[1255619441]}]}]},{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2834.90,"providers":[{"billed_charge":24895.00,"npi":[1538377528]}]}]},{"tin":{"type":"ein","value":"331804183"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":69.62,"providers":[{"billed_charge":188.00,"npi":[1841452968]}]},{"allowed_amount":674.23,"providers":[{"billed_charge":1786.00,"npi":[1841452968]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":602.94,"providers":[{"billed_charge":1196.00,"npi":[1558686667]}]},{"allowed_amount":232.73,"providers":[{"billed_charge":460.00,"npi":[1558894360]}]},{"allowed_amount":231.90,"providers":[{"billed_charge":460.00,"npi":[1801282066]}]},{"allowed_amount":46.38,"providers":[{"billed_charge":92.00,"npi":[1699162776]}]},{"allowed_amount":324.66,"providers":[{"billed_charge":644.00,"npi":[1982166476]}]},{"allowed_amount":463.80,"providers":[{"billed_charge":920.00,"npi":[1699162776]}]},{"allowed_amount":418.25,"providers":[{"billed_charge":828.00,"npi":[1386132421]}]}]}]},{"name":"SCR MAMMO BI INCL CAD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77067","description":"SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (","allowed_amounts":[{"tin":{"type":"ein","value":"581839412"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":2246.86,"providers":[{"billed_charge":5425.00,"npi":[1942264981]}]},{"allowed_amount":389.16,"providers":[{"billed_charge":930.00,"npi":[1942264981]}]}]},{"tin":{"type":"ein","value":"275269030"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1695.72,"providers":[{"billed_charge":7120.00,"npi":[1255619441]}]}]},{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6985.20,"providers":[{"billed_charge":25872.00,"npi":[1538377528]}]}]},{"tin":{"type":"ein","value":"550840991"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":612.72,"providers":[{"billed_charge":772.08,"npi":[1831122761]}]}]},{"tin":{"type":"ein","value":"331804183"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":44.25,"providers":[{"billed_charge":119.00,"npi":[1841452968]}]},{"allowed_amount":950.69,"providers":[{"billed_charge":2499.00,"npi":[1841452968]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":413.63,"providers":[{"billed_charge":826.00,"npi":[1982166476]}]},{"allowed_amount":652.09,"providers":[{"billed_charge":1298.00,"npi":[1699162776]}]},{"allowed_amount":768.17,"providers":[{"billed_charge":1534.00,"npi":[1558686667]}]},{"allowed_amount":532.86,"providers":[{"billed_charge":1062.00,"npi":[1386132421]}]},{"allowed_amount":295.45,"providers":[{"billed_charge":590.00,"npi":[1558894360,1801282066]}]}]}]},{"name":"VACCINE ADMIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"771","description":"PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":728.72,"providers":[{"billed_charge":1640.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":341.61,"providers":[{"billed_charge":860.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":446.95,"providers":[{"billed_charge":1638.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":322.80,"providers":[{"billed_charge":2216.20,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23","19"],"billing_class":"institutional","payments":[{"allowed_amount":6005.90,"providers":[{"billed_charge":26308.50,"npi":[1992799050]}]},{"allowed_amount":73.60,"providers":[{"billed_charge":3154.00,"npi":[1992799050]}]},{"allowed_amount":4034.85,"providers":[{"billed_charge":19759.75,"npi":[1992799050]}]}]}]},{"name":"TELEMEDICINE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"780","description":"TELEMEDICINE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22","19"],"billing_class":"institutional","payments":[{"allowed_amount":49.66,"providers":[{"billed_charge":244.00,"npi":[1992799050]}]},{"allowed_amount":3231.71,"providers":[{"billed_charge":15738.00,"npi":[1992799050]}]}]}]},{"name":"HT MUSCLE IMAGE SPECT MULT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"78452","description":"MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT) (INCL ATTENUATION CORRECTION, QUALITATIVE OR QUANT","allowed_amounts":[{"tin":{"type":"ein","value":"994689720"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5194.40,"providers":[{"billed_charge":32270.00,"npi":[1780772731]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":75.83,"providers":[{"billed_charge":262.00,"npi":[1700906427]}]},{"allowed_amount":612.10,"providers":[{"billed_charge":2096.00,"npi":[1700906427]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":127.35,"providers":[{"billed_charge":1522.80,"npi":[1234567893]}]}]}]},{"name":"GENERAL HEALTH PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80050","description":"GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":247.30,"providers":[{"billed_charge":896.02,"npi":[1234567893]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80053","description":"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1240.80,"providers":[{"billed_charge":4963.20,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3521.21,"providers":[{"billed_charge":41392.95,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.95,"providers":[{"billed_charge":158.40,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":834.24,"providers":[{"billed_charge":3318.00,"npi":[1225021678]}]}]}]},{"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1072.00,"providers":[{"billed_charge":8985.60,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.55,"providers":[{"billed_charge":200.85,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4197.70,"providers":[{"billed_charge":48060.08,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":589.16,"providers":[{"billed_charge":2552.00,"npi":[1225021678]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":116.89,"providers":[{"billed_charge":1443.12,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.22,"providers":[{"billed_charge":457.52,"npi":[1234567893]}]}]}]},{"name":"DRUG TEST PRSMV DIR OPT OBS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80305","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE ","allowed_amounts":[{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.80,"providers":[{"billed_charge":360.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"582640568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":198.60,"providers":[{"billed_charge":2250.00,"npi":[1306860101]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":327.60,"providers":[{"billed_charge":1528.80,"npi":[1225021678]}]}]}]},{"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":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":193.95,"providers":[{"billed_charge":779.59,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"821447166"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1187.21,"providers":[{"billed_charge":1988.48,"npi":[1336956564]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14013.93,"providers":[{"billed_charge":119058.34,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"822647012"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.99,"providers":[{"billed_charge":130.00,"npi":[1649001058]}]}]},{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7.95,"providers":[{"billed_charge":66.45,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.02,"providers":[{"billed_charge":1005.44,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS NONAUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81002","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.96,"providers":[{"billed_charge":72.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":78.69,"providers":[{"billed_charge":593.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":12.54,"providers":[{"billed_charge":74.00,"npi":[1124064316]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8.70,"providers":[{"billed_charge":150.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"205870972"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":45.24,"providers":[{"billed_charge":520.00,"npi":[1285325282]}]}]},{"tin":{"type":"ein","value":"453766969"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.28,"providers":[{"billed_charge":377.44,"npi":[1053536177]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":302.84,"providers":[{"billed_charge":938.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"582640568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.49,"providers":[{"billed_charge":26.40,"npi":[1306860101]}]}]},{"tin":{"type":"ein","value":"205558808"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.44,"providers":[{"billed_charge":19.26,"npi":[1851406359]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":123.69,"providers":[{"billed_charge":427.50,"npi":[1164166922]}]},{"allowed_amount":44.34,"providers":[{"billed_charge":157.50,"npi":[1194953638]}]},{"allowed_amount":75.38,"providers":[{"billed_charge":270.00,"npi":[1295806495]}]},{"allowed_amount":289.67,"providers":[{"billed_charge":1035.00,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.10,"providers":[{"billed_charge":56.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"465736753"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":7.40,"providers":[{"billed_charge":75.00,"npi":[1144887472]}]},{"allowed_amount":2.96,"providers":[{"billed_charge":30.00,"npi":[1750179412]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"581109444"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.39,"providers":[{"billed_charge":22.00,"npi":[1700632338]}]}]},{"tin":{"type":"ein","value":"582618143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":20.90,"providers":[{"billed_charge":130.00,"npi":[1154397677]}]}]},{"tin":{"type":"ein","value":"990909070"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.50,"providers":[{"billed_charge":30.00,"npi":[1538557061,1861125312]}]},{"allowed_amount":20.70,"providers":[{"billed_charge":54.00,"npi":[1285971796]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2.81,"providers":[{"billed_charge":9.00,"npi":[1295969228]}]}]}]},{"name":"MICROSCOPIC EXAM OF URINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81015","description":"URINALYSIS; MICROSCOPIC ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":53.34,"providers":[{"billed_charge":168.00,"npi":[1912167578]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"582618143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.96,"providers":[{"billed_charge":100.00,"npi":[1154397677]}]}]},{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":36.60,"providers":[{"billed_charge":180.00,"npi":[1477008902]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":327.87,"providers":[{"billed_charge":525.00,"npi":[1073612115]}]}]}]},{"name":"ANES LWR INTST NDSC NOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"811","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; NOT ","allowed_amounts":[{"tin":{"type":"ein","value":"821877553"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":195.00,"providers":[{"billed_charge":1600.00,"npi":[1336716737]}]}]},{"tin":{"type":"ein","value":"471578052"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":160.72,"providers":[{"billed_charge":840.00,"npi":[1144525940]}]}]}]},{"name":"ANES LWR INTST SCR COLSC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"812","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; SCRE","allowed_amounts":[{"tin":{"type":"ein","value":"461116325"},"service_code":["22","24"],"billing_class":"professional","payments":[{"allowed_amount":10600.00,"providers":[{"billed_charge":18545.00,"npi":[1528010659]}]},{"allowed_amount":5300.00,"providers":[{"billed_charge":8485.00,"npi":[1083717029]}]},{"allowed_amount":14700.00,"providers":[{"billed_charge":26025.00,"npi":[1831143932]}]}]}]},{"name":"ANES UPR LWR GI NDSC PX","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"813","description":"ANESTHESIA FOR COMBINED UPPER AND LOWER GASTROINTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED","allowed_amounts":[{"tin":{"type":"ein","value":"461116325"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":1700.00,"providers":[{"billed_charge":3040.00,"npi":[1528010659]}]},{"allowed_amount":9900.00,"providers":[{"billed_charge":16515.00,"npi":[1831143932]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":106.93,"providers":[{"billed_charge":660.08,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":280.52,"providers":[{"billed_charge":3345.18,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":43.38,"providers":[{"billed_charge":144.00,"npi":[1295969228]}]}]}]},{"name":"HEMO/COMPOSITE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"HEMODIALYSIS - OUTPT OR HOME - HEMODIALYSIS/COMPOSITE RATE","allowed_amounts":[{"tin":{"type":"ein","value":"261305281"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":5232.08,"providers":[{"billed_charge":87695.69,"npi":[1235317454]}]}]},{"tin":{"type":"ein","value":"463731566"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":7000.00,"providers":[{"billed_charge":61824.00,"npi":[1760899710]}]}]},{"tin":{"type":"ein","value":"300996078"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":9737.60,"providers":[{"billed_charge":231180.65,"npi":[1093237836]}]}]},{"tin":{"type":"ein","value":"582350026"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":78000.00,"providers":[{"billed_charge":688896.00,"npi":[1003928821]}]}]},{"tin":{"type":"ein","value":"952977916"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":21843.37,"providers":[{"billed_charge":126240.00,"npi":[1356302921]}]}]},{"tin":{"type":"ein","value":"953372911"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":18651.65,"providers":[{"billed_charge":264221.00,"npi":[1861825515]}]}]},{"tin":{"type":"ein","value":"994035406"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":5820.74,"providers":[{"billed_charge":185472.00,"npi":[1346060043]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20.16,"providers":[{"billed_charge":240.96,"npi":[1234567893]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2486.40,"providers":[{"billed_charge":20845.44,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3475.18,"providers":[{"billed_charge":36017.70,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.60,"providers":[{"billed_charge":355.20,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1391.20,"providers":[{"billed_charge":7050.00,"npi":[1225021678]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.45,"providers":[{"billed_charge":205.02,"npi":[1235186800]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82570","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":108.78,"providers":[{"billed_charge":910.98,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":259.11,"providers":[{"billed_charge":2993.68,"npi":[1234567893]}]}]}]},{"name":"VITAMIN B-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82607","description":"CYANOCOBALAMIN (VITAMIN B-12);","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":836.94,"providers":[{"billed_charge":7012.98,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.78,"providers":[{"billed_charge":135.72,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1443.68,"providers":[{"billed_charge":14672.42,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":603.20,"providers":[{"billed_charge":2800.00,"npi":[1225021678]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82627","description":"DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":222.40,"providers":[{"billed_charge":1864.20,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.44,"providers":[{"billed_charge":344.59,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF ESTRADIOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82670","description":"ESTRADIOL","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":614.68,"providers":[{"billed_charge":5153.28,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1404.28,"providers":[{"billed_charge":15285.61,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":313.72,"providers":[{"billed_charge":2626.14,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":491.57,"providers":[{"billed_charge":5536.96,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":68.15,"providers":[{"billed_charge":340.00,"npi":[1225021678]}]}]}]},{"name":"ASSAY OF FOLIC ACID SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82746","description":"FOLIC ACID; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":441.00,"providers":[{"billed_charge":3697.20,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":462.65,"providers":[{"billed_charge":5016.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":29.40,"providers":[{"billed_charge":128.00,"npi":[1225021678]}]}]}]},{"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":21.50,"providers":[{"billed_charge":257.40,"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":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.84,"providers":[{"billed_charge":425.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"582545719"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.94,"providers":[{"billed_charge":270.00,"npi":[1063515815]}]}]},{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":84.29,"providers":[{"billed_charge":510.00,"npi":[1124064316]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":111.67,"providers":[{"billed_charge":227.24,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":49.20,"providers":[{"billed_charge":120.00,"npi":[1790281723]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.60,"providers":[{"billed_charge":259.20,"npi":[1234567893]}]}]}]},{"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":260.12,"providers":[{"billed_charge":2181.48,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":631.21,"providers":[{"billed_charge":6456.36,"npi":[1234567893]}]}]}]},{"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.42,"providers":[{"billed_charge":1319.88,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":287.81,"providers":[{"billed_charge":3361.38,"npi":[1234567893]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":262.23,"providers":[{"billed_charge":1700.00,"npi":[1124064316]}]}]},{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70.21,"providers":[{"billed_charge":374.00,"npi":[1497486047]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":593.14,"providers":[{"billed_charge":1692.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":748.44,"providers":[{"billed_charge":6264.72,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"331166863"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.10,"providers":[{"billed_charge":160.00,"npi":[1790707925]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":96.26,"providers":[{"billed_charge":157.38,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":4.86,"providers":[{"billed_charge":50.00,"npi":[1234567893]}]},{"allowed_amount":1644.88,"providers":[{"billed_charge":18098.09,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.83,"providers":[{"billed_charge":87.39,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":157.82,"providers":[{"billed_charge":520.00,"npi":[1790281723]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":534.05,"providers":[{"billed_charge":2530.00,"npi":[1225021678]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":93.00,"providers":[{"billed_charge":1082.96,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":97.20,"providers":[{"billed_charge":814.50,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":270.09,"providers":[{"billed_charge":3068.44,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.58,"providers":[{"billed_charge":448.00,"npi":[1225021678]}]}]}]},{"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":69.92,"providers":[{"billed_charge":586.08,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":280.43,"providers":[{"billed_charge":3288.32,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.36,"providers":[{"billed_charge":490.00,"npi":[1225021678]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"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":153.33,"providers":[{"billed_charge":1504.15,"npi":[1234567893]}]}]}]},{"name":"ASSAY FOR CALPROTECTIN FECAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83993","description":"CALPROTECTIN, FECAL","allowed_amounts":[{"tin":{"type":"ein","value":"853877508"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":88.38,"providers":[{"billed_charge":335.70,"npi":[1497423198]}]}]}]},{"name":"ASSAY OF PROGESTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84144","description":"PROGESTERONE","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":281.61,"providers":[{"billed_charge":2361.15,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":283.49,"providers":[{"billed_charge":2722.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":228.70,"providers":[{"billed_charge":2688.88,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PSA, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84153","description":"PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":174.80,"providers":[{"billed_charge":1464.90,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":935.40,"providers":[{"billed_charge":10992.56,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PSA, FREE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84154","description":"PROSTATE SPECIFIC ANTIGEN (PSA); FREE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":290.72,"providers":[{"billed_charge":3434.26,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF SEX HORMONE GLOBUL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84270","description":"SEX HORMONE BINDING GLOBULIN (SHBG)","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":380.45,"providers":[{"billed_charge":3187.80,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":465.24,"providers":[{"billed_charge":5255.77,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FREE TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84402","description":"TESTOSTERONE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":595.70,"providers":[{"billed_charge":7131.60,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF TOTAL TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84403","description":"TESTOSTERONE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":852.06,"providers":[{"billed_charge":7143.84,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1540.33,"providers":[{"billed_charge":16068.16,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF TOTAL THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84436","description":"THYROXINE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":122.53,"providers":[{"billed_charge":1377.45,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":207.46,"providers":[{"billed_charge":1738.80,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":928.11,"providers":[{"billed_charge":10938.95,"npi":[1234567893]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84443","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1386.00,"providers":[{"billed_charge":11617.65,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4103.79,"providers":[{"billed_charge":48445.52,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":34.32,"providers":[{"billed_charge":151.20,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":940.80,"providers":[{"billed_charge":4032.00,"npi":[1225021678]}]}]}]},{"name":"ASSAY OF TRANSFERRIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84466","description":"TRANSFERRIN","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4.26,"providers":[{"billed_charge":51.04,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.54,"providers":[{"billed_charge":1191.12,"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":211.75,"providers":[{"billed_charge":1775.25,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":231.98,"providers":[{"billed_charge":2473.24,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.66,"providers":[{"billed_charge":1193.28,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.12,"providers":[{"billed_charge":496.00,"npi":[1225021678]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":253.43,"providers":[{"billed_charge":2874.20,"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":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.48,"providers":[{"billed_charge":46.64,"npi":[1174092548]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":47.40,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":47.40,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"831005259"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.48,"providers":[{"billed_charge":46.60,"npi":[1174092548]}]}]}]},{"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":"921353241"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":9.20,"providers":[{"billed_charge":23.00,"npi":[1811286446]}]}]},{"tin":{"type":"ein","value":"621647259"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":242.32,"providers":[{"billed_charge":728.00,"npi":[1861473472]}]}]},{"tin":{"type":"ein","value":"824681345"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":93.24,"providers":[{"billed_charge":348.00,"npi":[1649831314]}]}]},{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":789.67,"providers":[{"billed_charge":3151.06,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":353.50,"providers":[{"billed_charge":1120.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2582.98,"providers":[{"billed_charge":30206.76,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":213.62,"providers":[{"billed_charge":704.00,"npi":[1912167578]}]},{"allowed_amount":87.39,"providers":[{"billed_charge":288.00,"npi":[1073254363]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":629.37,"providers":[{"billed_charge":3240.00,"npi":[1225021678]}]}]}]},{"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":"591228604"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":28.80,"providers":[{"billed_charge":72.00,"npi":[1619060787]}]},{"allowed_amount":3.60,"providers":[{"billed_charge":9.00,"npi":[1619060787]}]}]},{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.88,"providers":[{"billed_charge":325.44,"npi":[1235186800]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.64,"providers":[{"billed_charge":127.68,"npi":[1234567893]}]}]}]},{"name":"RBC SED RATE, NONAUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85651","description":"SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":49.33,"providers":[{"billed_charge":570.05,"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.75,"providers":[{"billed_charge":56.55,"npi":[1235186800]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86038","description":"ANTINUCLEAR ANTIBODIES (ANA);","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":86.85,"providers":[{"billed_charge":985.34,"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":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20.72,"providers":[{"billed_charge":173.52,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":43.24,"providers":[{"billed_charge":491.61,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":100.98,"providers":[{"billed_charge":1209.12,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":68.00,"providers":[{"billed_charge":552.92,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.96,"providers":[{"billed_charge":189.95,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":289.80,"providers":[{"billed_charge":5600.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":307.16,"providers":[{"billed_charge":3452.47,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":98.55,"providers":[{"billed_charge":1181.40,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":241.27,"providers":[{"billed_charge":2877.30,"npi":[1234567893]}]}]}]},{"name":"HEP B CORE ANTIBODY, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86704","description":"HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":154.16,"providers":[{"billed_charge":1816.50,"npi":[1234567893]}]}]}]},{"name":"HEP B SURFACE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86706","description":"HEPATITIS B SURFACE ANTIBODY (HBSAB)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":119.84,"providers":[{"billed_charge":1320.88,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS A ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86708","description":"HEPATITIS A ANTIBODY (HAAB)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.36,"providers":[{"billed_charge":1189.44,"npi":[1234567893]}]}]}]},{"name":"RUBELLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86762","description":"ANTIBODY; RUBELLA","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.05,"providers":[{"billed_charge":287.80,"npi":[1234567893]}]}]}]},{"name":"TREPONEMA PALLIDUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86780","description":"ANTIBODY; TREPONEMA PALLIDUM","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.86,"providers":[{"billed_charge":170.73,"npi":[1235186800]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.70,"providers":[{"billed_charge":299.10,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":366.18,"providers":[{"billed_charge":4080.48,"npi":[1234567893]}]}]}]},{"name":"COOMBS TEST, INDIRECT, TITER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86886","description":"ANTIHUMAN GLOBULIN TEST (COOMBS TEST); INDIRECT, EACH ANTIBODY TITER","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":44.98,"providers":[{"billed_charge":538.72,"npi":[1234567893]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86900","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.35,"providers":[{"billed_charge":115.84,"npi":[1234567893]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC RH(D)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86901","description":"BLOOD TYPING, SEROLOGIC; RH (D)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.00,"providers":[{"billed_charge":119.60,"npi":[1234567893]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12.12,"providers":[{"billed_charge":101.61,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":167.64,"providers":[{"billed_charge":1916.28,"npi":[1234567893]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":173.72,"providers":[{"billed_charge":1455.12,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":448.73,"providers":[{"billed_charge":3877.99,"npi":[1234567893]}]}]}]},{"name":"MICROBE SUSCEPTIBLE, DISK","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87184","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; DISK METHOD, PER PLATE (12 OR FEWER AGENTS)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40.00,"providers":[{"billed_charge":478.72,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":244.20,"providers":[{"billed_charge":2706.00,"npi":[1234567893]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"810576059"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":252.84,"providers":[{"billed_charge":1353.45,"npi":[1235186800]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1497.89,"providers":[{"billed_charge":16344.89,"npi":[1234567893]}]}]}]},{"name":"INFLUENZA A/B AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87400","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, INFLUENZA, A OR B, EACH; (EG, ENZYME IM","allowed_amounts":[{"tin":{"type":"ein","value":"300780743"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":234.15,"providers":[{"billed_charge":435.00,"npi":[1780092684]}]}]}]},{"name":"CORONAVIRUS AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":88.35,"providers":[{"billed_charge":375.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":754.59,"providers":[{"billed_charge":1200.00,"npi":[1073612115]}]},{"allowed_amount":1389.21,"providers":[{"billed_charge":2100.00,"npi":[1164166922]}]},{"allowed_amount":847.75,"providers":[{"billed_charge":1300.00,"npi":[1194953638]}]},{"allowed_amount":131.18,"providers":[{"billed_charge":200.00,"npi":[1295806495]}]}]}]},{"name":"SARSCOV & INF VIR A&B AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","allowed_amounts":[{"tin":{"type":"ein","value":"30417049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":354.90,"providers":[{"billed_charge":584.00,"npi":[1225846173]}]}]}]},{"name":"STREP A AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87430","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, STREPTOCOCCUS, GROUP A; (EG, ENZYME IMM","allowed_amounts":[{"tin":{"type":"ein","value":"30417049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":17.15,"providers":[{"billed_charge":33.00,"npi":[1225846173]}]}]}]},{"name":"AG DETECT NOS IA MULT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87449","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE; MULTIPLE-STEP METHOD, EACH ORGANISM; (E","allowed_amounts":[{"tin":{"type":"ein","value":"853877508"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":47.92,"providers":[{"billed_charge":287.52,"npi":[1497423198]}]}]}]},{"name":"CANDIDA, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87481","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"382084239"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":252.60,"providers":[{"billed_charge":1919.07,"npi":[1780620526]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1442.05,"providers":[{"billed_charge":14617.69,"npi":[1234567893]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87491","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4375.61,"providers":[{"billed_charge":35499.68,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"271738064"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":166.14,"providers":[{"billed_charge":408.00,"npi":[1407895618]}]}]}]},{"name":"INFLUENZA DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87502","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-","allowed_amounts":[{"tin":{"type":"ein","value":"581973570"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":488.60,"providers":[{"billed_charge":1392.00,"npi":[1669016747]}]}]}]},{"name":"GARDNER VAG, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87511","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":187.52,"providers":[{"billed_charge":2080.00,"npi":[1234567893]}]}]}]},{"name":"GARDNER VAG, DNA, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87512","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, QUANTIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":934.65,"providers":[{"billed_charge":8393.76,"npi":[1234567893]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":521.51,"providers":[{"billed_charge":5448.81,"npi":[1234567893]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87591","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4367.96,"providers":[{"billed_charge":35343.42,"npi":[1234567893]}]}]}]},{"name":"HPV HIGH-RISK TYPES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87624","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1772.55,"providers":[{"billed_charge":11110.00,"npi":[1093753303]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1738.63,"providers":[{"billed_charge":17825.51,"npi":[1234567893]}]}]}]},{"name":"Infectious Agent Antigen Detection","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87626","description":"the detection of human papillomavirus (HPV) by nucleic acid (DNA or RNA) tests, specifically reporting separately the high-risk types (16, 18, 31, 45, 51, and 52) and any high-risk pooled results.","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":94.77,"providers":[{"billed_charge":421.20,"npi":[1234567893]}]}]}]},{"name":"RESP VIRUS 3-5 TARGETS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87631","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ","allowed_amounts":[{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2830.00,"providers":[{"billed_charge":2830.00,"npi":[1881889277]}]}]}]},{"name":"SARS-COV-2 COVID-19 AMP PRB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); (SARS-CoV-2) [COVID-19], amplified probe te","allowed_amounts":[{"tin":{"type":"ein","value":"581973570"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.42,"providers":[{"billed_charge":180.00,"npi":[1669016747]}]}]}]},{"name":"SARSCOV2&INF A&B&RSV AMP PRB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","allowed_amounts":[{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":142.64,"providers":[{"billed_charge":400.00,"npi":[1770655987]}]}]}]},{"name":"STAPH A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87640","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":351.60,"providers":[{"billed_charge":3162.11,"npi":[1234567893]}]}]}]},{"name":"STREP B, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87653","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":245.70,"providers":[{"billed_charge":1382.92,"npi":[1942526447]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":531.47,"providers":[{"billed_charge":4812.62,"npi":[1234567893]}]}]}]},{"name":"TRICHOMONAS VAGINALIS AMPLIF","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87661","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1822.77,"providers":[{"billed_charge":15132.98,"npi":[1234567893]}]}]}]},{"name":"DETECT AGENT NOS, DNA, AMP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87798","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE TE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1394.68,"providers":[{"billed_charge":16234.63,"npi":[1234567893]}]}]}]},{"name":"DETECT AGENT NOS, DNA, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87799","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; QUANTIFICATION, EA","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2160.81,"providers":[{"billed_charge":19406.52,"npi":[1234567893]}]}]}]},{"name":"DETECT AGNT MULT, DNA, AMPLI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87801","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":772.20,"providers":[{"billed_charge":8341.30,"npi":[1942526447]}]},{"allowed_amount":3931.20,"providers":[{"billed_charge":47019.72,"npi":[1093753303]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3392.20,"providers":[{"billed_charge":37351.94,"npi":[1234567893]}]}]}]},{"name":"INFLUENZA ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87804","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA","allowed_amounts":[{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.40,"providers":[{"billed_charge":250.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1333.93,"providers":[{"billed_charge":2170.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":635.17,"providers":[{"billed_charge":926.10,"npi":[1295806495]}]},{"allowed_amount":1275.67,"providers":[{"billed_charge":1896.30,"npi":[1073612115]}]},{"allowed_amount":1380.97,"providers":[{"billed_charge":1984.50,"npi":[1194953638]}]},{"allowed_amount":30.73,"providers":[{"billed_charge":44.10,"npi":[1821374380]}]},{"allowed_amount":1876.33,"providers":[{"billed_charge":2690.10,"npi":[1164166922]}]}]},{"tin":{"type":"ein","value":"455266876"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":354.90,"providers":[{"billed_charge":2340.00,"npi":[1992787428]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":314.63,"providers":[{"billed_charge":1768.90,"npi":[1235411547]}]}]}]},{"name":"RSV ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87807","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; RESPIRATORY SYNCY","allowed_amounts":[{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":24.32,"providers":[{"billed_charge":33.00,"npi":[1295806495]}]},{"allowed_amount":255.49,"providers":[{"billed_charge":363.00,"npi":[1073612115]}]},{"allowed_amount":387.30,"providers":[{"billed_charge":528.00,"npi":[1164166922]}]},{"allowed_amount":319.08,"providers":[{"billed_charge":429.00,"npi":[1194953638]}]}]}]},{"name":"SARS-COV-2 COVID19 W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87811","description":"IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"300780743"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":365.76,"providers":[{"billed_charge":584.00,"npi":[1780092684]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1700.00,"providers":[{"billed_charge":1700.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"455266876"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":295.88,"providers":[{"billed_charge":1950.00,"npi":[1992787428]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":496.56,"providers":[{"billed_charge":3216.00,"npi":[1235411547]}]}]}]},{"name":"STREP A ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87880","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GR","allowed_amounts":[{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":773.64,"providers":[{"billed_charge":1134.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":403.57,"providers":[{"billed_charge":546.78,"npi":[1194953638]}]},{"allowed_amount":549.19,"providers":[{"billed_charge":757.08,"npi":[1164166922]}]},{"allowed_amount":358.14,"providers":[{"billed_charge":504.72,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":90.97,"providers":[{"billed_charge":517.00,"npi":[1235411547]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":157.13,"providers":[{"billed_charge":323.00,"npi":[1811874696]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":93.17,"providers":[{"billed_charge":658.00,"npi":[1942526447]}]},{"allowed_amount":2901.58,"providers":[{"billed_charge":20492.00,"npi":[1093753303]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2768.58,"providers":[{"billed_charge":30434.33,"npi":[1234567893]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88304","description":"LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION, INDUCED ABSCESS ANEURYSM","allowed_amounts":[{"tin":{"type":"ein","value":"582083505"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":11.46,"providers":[{"billed_charge":250.00,"npi":[1295919694]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":125.00,"npi":[1295919694]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":302.63,"providers":[{"billed_charge":2213.10,"npi":[1366862203]}]},{"allowed_amount":139.48,"providers":[{"billed_charge":983.60,"npi":[1962848671]}]}]},{"tin":{"type":"ein","value":"582083505"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":301.91,"providers":[{"billed_charge":3104.00,"npi":[1295919694]}]},{"allowed_amount":506.24,"providers":[{"billed_charge":5238.00,"npi":[1295919694]}]}]},{"tin":{"type":"ein","value":"582222817"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1072.54,"providers":[{"billed_charge":1368.36,"npi":[1043413271]}]}]},{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":610.40,"providers":[{"billed_charge":1120.00,"npi":[1831169762]}]},{"allowed_amount":4559.52,"providers":[{"billed_charge":8540.00,"npi":[1164955928]}]}]},{"tin":{"type":"ein","value":"581763128"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":2453.16,"providers":[{"billed_charge":13600.00,"npi":[1760793673]}]},{"allowed_amount":360.79,"providers":[{"billed_charge":2000.00,"npi":[1194112078]}]},{"allowed_amount":54.07,"providers":[{"billed_charge":300.00,"npi":[1063695773]}]},{"allowed_amount":849.42,"providers":[{"billed_charge":4700.00,"npi":[1063695773]}]},{"allowed_amount":198.91,"providers":[{"billed_charge":1100.00,"npi":[1760793673]}]}]},{"tin":{"type":"ein","value":"43740411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2009.81,"providers":[{"billed_charge":9766.50,"npi":[1548294465]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["22","81"],"billing_class":"professional","payments":[{"allowed_amount":385.56,"providers":[{"billed_charge":3692.00,"npi":[1234567893]}]},{"allowed_amount":66.45,"providers":[{"billed_charge":242.80,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6585.39,"providers":[{"billed_charge":18788.00,"npi":[1659574127]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":114.12,"providers":[{"billed_charge":640.00,"npi":[1639164296]}]},{"allowed_amount":1573.15,"providers":[{"billed_charge":8832.00,"npi":[1639164296]}]},{"allowed_amount":45.58,"providers":[{"billed_charge":256.00,"npi":[1366437444]}]},{"allowed_amount":2670.55,"providers":[{"billed_charge":14891.00,"npi":[1366437444]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":123.80,"providers":[{"billed_charge":236.00,"npi":[1164082814]}]},{"allowed_amount":120.97,"providers":[{"billed_charge":236.00,"npi":[1164082814]}]}]},{"tin":{"type":"ein","value":"581267100"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3873.53,"providers":[{"billed_charge":10647.00,"npi":[1679751978]}]},{"allowed_amount":65.95,"providers":[{"billed_charge":163.80,"npi":[1093906422]}]}]}]},{"name":"SPECIAL STAINS GROUP 1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88312","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":218.40,"providers":[{"billed_charge":400.00,"npi":[1164955928]}]}]},{"tin":{"type":"ein","value":"581763128"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":333.86,"providers":[{"billed_charge":1820.00,"npi":[1760793673]}]},{"allowed_amount":38.59,"providers":[{"billed_charge":210.00,"npi":[1760793673]}]}]}]},{"name":"SPECIAL STAINS GROUP 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88313","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":713.07,"providers":[{"billed_charge":1626.00,"npi":[1164955928]}]}]},{"tin":{"type":"ein","value":"43740411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":461.64,"providers":[{"billed_charge":2248.00,"npi":[1548294465]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":470.18,"providers":[{"billed_charge":1331.00,"npi":[1659574127]}]}]}]},{"name":"IMMUNOHISTO ANTB 1ST STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88342","description":"IMMUNOHISTOCHEMISTRY OR IMMUNOCYTOCHEMISTRY, PER SPECIMEN; INITIAL SINGLE ANTIBODY STAIN PROCEDURE","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1198.12,"providers":[{"billed_charge":3066.00,"npi":[1164955928]}]}]},{"tin":{"type":"ein","value":"43740411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":626.10,"providers":[{"billed_charge":2717.50,"npi":[1548294465]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":130.02,"providers":[{"billed_charge":369.00,"npi":[1659574127]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":533.04,"providers":[{"billed_charge":6150.00,"npi":[1639164296]}]},{"allowed_amount":255.73,"providers":[{"billed_charge":2943.00,"npi":[1366437444]}]},{"allowed_amount":85.60,"providers":[{"billed_charge":984.00,"npi":[1366437444]}]}]}]},{"name":"PSTAY TREATMENT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"900","description":"PSYCHIATRIC/PSYCHOLOGICAL TREATMENTS - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"581413957"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":383.00,"providers":[{"billed_charge":488.28,"npi":[1417011487]}]}]},{"tin":{"type":"ein","value":"582001101"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":17426.50,"providers":[{"billed_charge":17524.00,"npi":[1932150422]}]}]},{"tin":{"type":"ein","value":"311840668"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":383.00,"providers":[{"billed_charge":533.60,"npi":[1790223352]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":16328.82,"providers":[{"billed_charge":39200.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"581136296"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":11998.04,"providers":[{"billed_charge":24536.65,"npi":[1750314183]}]}]},{"tin":{"type":"ein","value":"270380035"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":15097.27,"providers":[{"billed_charge":24423.00,"npi":[1922301472]}]}]}]},{"name":"IM ADMIN 1ST/ONLY COMPONENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90460","description":"IMMUNIZATION ADMINISTRATION THROUGH 18 YEARS OF AGE VIA ANY ROUTE OF ADMINISTRATION, W COUNSELING BY","allowed_amounts":[{"tin":{"type":"ein","value":"472597330"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":245.28,"providers":[{"billed_charge":625.00,"npi":[1164543344]}]}]}]},{"name":"IMMUNIZATION ADMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90471","description":"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJE","allowed_amounts":[{"tin":{"type":"ein","value":"954112121"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":893.84,"providers":[{"billed_charge":5394.88,"npi":[1548260508]}]}]},{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":726.57,"providers":[{"billed_charge":994.11,"npi":[1093789075]}]},{"allowed_amount":259.03,"providers":[{"billed_charge":328.25,"npi":[1598051724]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":494.19,"providers":[{"billed_charge":1037.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"581719867"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":136.88,"providers":[{"billed_charge":276.00,"npi":[1669728697]}]}]},{"tin":{"type":"ein","value":"364928227"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":94.10,"providers":[{"billed_charge":280.00,"npi":[1821558305]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":239.06,"providers":[{"billed_charge":448.00,"npi":[1447847298]}]}]}]},{"name":"IMMUNIZATION ADMIN EACH ADD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90472","description":"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJE","allowed_amounts":[{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":374.04,"providers":[{"billed_charge":669.79,"npi":[1093789075]}]}]}]},{"name":"BH/INTENS OP/PSYCH","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"905","description":"INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"262700697"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35775.00,"providers":[{"billed_charge":75684.00,"npi":[1770742132]}]}]},{"tin":{"type":"ein","value":"851648079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1035.54,"providers":[{"billed_charge":20845.00,"npi":[1861089690]}]}]}]},{"name":"BH/INTENS OP/CHEM DEP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"906","description":"INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"901035381"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17251.60,"providers":[{"billed_charge":196000.00,"npi":[1164811121]}]}]},{"tin":{"type":"ein","value":"300827435"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1281.00,"providers":[{"billed_charge":5985.00,"npi":[1336114321]}]}]},{"tin":{"type":"ein","value":"581534607"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5822.00,"providers":[{"billed_charge":28044.00,"npi":[1205809571]}]}]},{"tin":{"type":"ein","value":"631198286"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2000.00,"providers":[{"billed_charge":7440.00,"npi":[1336297605]}]}]},{"tin":{"type":"ein","value":"233044968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":75579.00,"providers":[{"billed_charge":355680.00,"npi":[1275765307]}]}]},{"tin":{"type":"ein","value":"882431968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6694.40,"providers":[{"billed_charge":159360.00,"npi":[1265216683]}]}]},{"tin":{"type":"ein","value":"933060676"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":44213.00,"providers":[{"billed_charge":594400.00,"npi":[1730954777]}]}]},{"tin":{"type":"ein","value":"760751278"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":23850.00,"providers":[{"billed_charge":265000.00,"npi":[1669691473]}]}]},{"tin":{"type":"ein","value":"800059706"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8000.00,"providers":[{"billed_charge":12500.00,"npi":[1427139179]}]}]},{"tin":{"type":"ein","value":"332452524"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":1129.68,"providers":[{"billed_charge":38400.00,"npi":[1396556643]}]},{"allowed_amount":282.42,"providers":[{"billed_charge":9600.00,"npi":[1396556643]}]}]},{"tin":{"type":"ein","value":"863419840"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8835.00,"providers":[{"billed_charge":8835.00,"npi":[1467020701]}]}]},{"tin":{"type":"ein","value":"814742688"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":732.41,"providers":[{"billed_charge":2100.00,"npi":[1770080632]}]}]},{"tin":{"type":"ein","value":"264686480"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":720.00,"providers":[{"billed_charge":2600.00,"npi":[1053648774]}]}]},{"tin":{"type":"ein","value":"820650237"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7585.00,"providers":[{"billed_charge":74000.00,"npi":[1649775123]}]}]},{"tin":{"type":"ein","value":"822144748"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":57236.00,"providers":[{"billed_charge":872500.00,"npi":[1992209811]}]}]},{"tin":{"type":"ein","value":"920265597"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3557.42,"providers":[{"billed_charge":71476.00,"npi":[1366150799]}]}]}]},{"name":"IIV3 VACC NO PRSV 0.5 ML IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90656","description":"INFLUENZA VIRUS VACCINE, TRIVALENT (IIV3), SPLIT VIRUS, PRESERVATIVE FREE, 0.5 ML DOSAGE, FOR INTRAM","allowed_amounts":[{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.76,"providers":[{"billed_charge":185.76,"npi":[1093789075]}]}]},{"tin":{"type":"ein","value":"364928227"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":92.88,"providers":[{"billed_charge":144.00,"npi":[1821558305]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":117.70,"providers":[{"billed_charge":180.00,"npi":[1447847298]}]}]}]},{"name":"LAIV3 VACCINE INTRANASAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90660","description":"INFLUENZA VIRUS VACCINE, TRIVALENT, LIVE (LAIV3), FOR INTRANASAL USE","allowed_amounts":[{"tin":{"type":"ein","value":"472597330"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":98.04,"providers":[{"billed_charge":165.00,"npi":[1164543344]}]}]}]},{"name":"CCIIV3 VAC NO PRSV 0.5 ML IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90661","description":"INFLUENZA VIRUS VACCINE, TRIVALENT (CCIIV3), DERIVED FROM CELL CULTURES, SUBUNIT, PRESERVATIVE AND A","allowed_amounts":[{"tin":{"type":"ein","value":"954112121"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":490.05,"providers":[{"billed_charge":606.10,"npi":[1548260508]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":537.54,"providers":[{"billed_charge":888.00,"npi":[1093391997]}]}]}]},{"name":"RIV3 VACCINE NO PRESERV IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90673","description":"INFLUENZA VIRUS VACCINE, TRIVALENT (RIV3), DERIVED FROM RECOMBINANT DNA, HEMAGGLUTININ (HA) PROTEIN ","allowed_amounts":[{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1050.42,"providers":[{"billed_charge":1079.76,"npi":[1598051724]}]}]}]},{"name":"TDAP VACCINE 7 YRS/> IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90715","description":"TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (TDAP), WHEN ADMINISTERED TO INDIVIDUALS","allowed_amounts":[{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":39.81,"providers":[{"billed_charge":76.00,"npi":[1093789075]}]}]}]},{"name":"PSYTX COMPLEX INTERACTIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90785","description":"INTERACTIVE COMPLEXITY (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)","allowed_amounts":[{"tin":{"type":"ein","value":"203786534"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":25.42,"providers":[{"billed_charge":50.00,"npi":[1194950857]}]},{"allowed_amount":444.85,"providers":[{"billed_charge":875.00,"npi":[1194950857]}]}]},{"tin":{"type":"ein","value":"842126707"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":295.43,"providers":[{"billed_charge":1550.00,"npi":[1053854521]}]},{"allowed_amount":28.59,"providers":[{"billed_charge":150.00,"npi":[1053854521]}]}]}]},{"name":"PSYCH DIAGNOSTIC EVALUATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90791","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":10198.71,"providers":[{"billed_charge":15237.72,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":834.55,"providers":[{"billed_charge":2080.00,"npi":[1437568698]}]},{"allowed_amount":333.82,"providers":[{"billed_charge":832.00,"npi":[1376215715]}]},{"allowed_amount":340.26,"providers":[{"billed_charge":832.00,"npi":[1437568698]}]},{"allowed_amount":166.91,"providers":[{"billed_charge":416.00,"npi":[1376215715]}]}]},{"tin":{"type":"ein","value":"822639811"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":352.03,"providers":[{"billed_charge":600.00,"npi":[1962430892]}]}]},{"tin":{"type":"ein","value":"582109306"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":262.17,"providers":[{"billed_charge":495.00,"npi":[1043066392]}]},{"allowed_amount":392.13,"providers":[{"billed_charge":660.00,"npi":[1043066392]}]},{"allowed_amount":679.92,"providers":[{"billed_charge":990.00,"npi":[1558478214]}]},{"allowed_amount":116.51,"providers":[{"billed_charge":165.00,"npi":[1558478214]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":388.38,"providers":[{"billed_charge":615.00,"npi":[1982358065]}]}]}]},{"name":"PSYCH DIAG EVAL W/MED SRVCS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90792","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":5218.48,"providers":[{"billed_charge":9576.71,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1879.30,"providers":[{"billed_charge":3880.00,"npi":[1154742542]}]},{"allowed_amount":3396.89,"providers":[{"billed_charge":6984.00,"npi":[1912338633]}]},{"allowed_amount":187.93,"providers":[{"billed_charge":388.00,"npi":[1437408093,1194388967]}]},{"allowed_amount":2527.99,"providers":[{"billed_charge":5044.00,"npi":[1619226834]}]},{"allowed_amount":1315.51,"providers":[{"billed_charge":2716.00,"npi":[1194388967]}]},{"allowed_amount":11087.87,"providers":[{"billed_charge":22892.00,"npi":[1912338633]}]},{"allowed_amount":953.80,"providers":[{"billed_charge":1940.00,"npi":[1932521440]}]},{"allowed_amount":2255.16,"providers":[{"billed_charge":4656.00,"npi":[1619226834]}]},{"allowed_amount":563.79,"providers":[{"billed_charge":1164.00,"npi":[1154742542]}]},{"allowed_amount":3006.88,"providers":[{"billed_charge":6208.00,"npi":[1932521440]}]}]},{"tin":{"type":"ein","value":"830350178"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":524.34,"providers":[{"billed_charge":828.00,"npi":[1033229661]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":775.20,"providers":[{"billed_charge":2574.00,"npi":[1356456685]}]}]},{"tin":{"type":"ein","value":"582109306"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":196.96,"providers":[{"billed_charge":233.37,"npi":[1275577520]}]},{"allowed_amount":764.95,"providers":[{"billed_charge":1166.85,"npi":[1275577520]}]}]}]},{"name":"PSYTX W PT 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90832","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":3393.99,"providers":[{"billed_charge":7783.00,"npi":[1376215715]}]},{"allowed_amount":1026.09,"providers":[{"billed_charge":2353.00,"npi":[1376215715]}]},{"allowed_amount":947.16,"providers":[{"billed_charge":2172.00,"npi":[1558481556]}]},{"allowed_amount":408.47,"providers":[{"billed_charge":905.00,"npi":[1558481556]}]}]},{"tin":{"type":"ein","value":"582108521"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":142.38,"providers":[{"billed_charge":450.00,"npi":[1063864171]}]},{"allowed_amount":62.07,"providers":[{"billed_charge":105.00,"npi":[1063864171]}]}]},{"tin":{"type":"ein","value":"203786534"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":341.70,"providers":[{"billed_charge":720.00,"npi":[1194950857]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":972.23,"providers":[{"billed_charge":3264.00,"npi":[1356456685]}]}]}]},{"name":"PSYTX W PT W E/M 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90833","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"581534607"},"service_code":["22","11","19","51","52"],"billing_class":"professional","payments":[{"allowed_amount":53.99,"providers":[{"billed_charge":80.00,"npi":[1336562727]}]},{"allowed_amount":380.05,"providers":[{"billed_charge":560.00,"npi":[1336562727]}]},{"allowed_amount":301.50,"providers":[{"billed_charge":400.00,"npi":[1336562727]}]},{"allowed_amount":652.42,"providers":[{"billed_charge":960.00,"npi":[1336562727]}]},{"allowed_amount":920.63,"providers":[{"billed_charge":1360.00,"npi":[1336562727]}]}]},{"tin":{"type":"ein","value":"821505834"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":522.93,"providers":[{"billed_charge":800.00,"npi":[1225144140]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1382.82,"providers":[{"billed_charge":3154.00,"npi":[1427290071]}]},{"allowed_amount":582.24,"providers":[{"billed_charge":1328.00,"npi":[1427290071]}]}]},{"tin":{"type":"ein","value":"874461181"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5705.54,"providers":[{"billed_charge":29100.00,"npi":[1831548536]}]}]},{"tin":{"type":"ein","value":"582651479"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1233.06,"providers":[{"billed_charge":2487.10,"npi":[1770858953]}]}]},{"tin":{"type":"ein","value":"830350178"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5329.00,"providers":[{"billed_charge":12600.00,"npi":[1033229661]}]},{"allowed_amount":7640.76,"providers":[{"billed_charge":18044.00,"npi":[1033229661]}]}]},{"tin":{"type":"ein","value":"863879162"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":118.92,"providers":[{"billed_charge":210.00,"npi":[1588985766]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"201020949"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":319.79,"providers":[{"billed_charge":800.00,"npi":[1710244918]}]},{"allowed_amount":632.27,"providers":[{"billed_charge":1600.00,"npi":[1891914149]}]},{"allowed_amount":1996.86,"providers":[{"billed_charge":5000.00,"npi":[1588978209]}]},{"allowed_amount":546.84,"providers":[{"billed_charge":1400.00,"npi":[1164898607]}]},{"allowed_amount":241.67,"providers":[{"billed_charge":600.00,"npi":[1437687308]}]},{"allowed_amount":1428.09,"providers":[{"billed_charge":3600.00,"npi":[1245574359]}]},{"allowed_amount":234.36,"providers":[{"billed_charge":600.00,"npi":[1811291008]}]},{"allowed_amount":639.58,"providers":[{"billed_charge":1600.00,"npi":[1780080374]}]},{"allowed_amount":390.60,"providers":[{"billed_charge":1000.00,"npi":[1992377378]}]},{"allowed_amount":1179.11,"providers":[{"billed_charge":3000.00,"npi":[1972893519]}]},{"allowed_amount":1577.02,"providers":[{"billed_charge":4000.00,"npi":[1649308339]}]},{"allowed_amount":78.12,"providers":[{"billed_charge":200.00,"npi":[1164898607,1043658933,1891914149,1992377378,1972893519,1427305804]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":208.32,"providers":[{"billed_charge":520.00,"npi":[1871939777,1104116912]}]},{"allowed_amount":104.16,"providers":[{"billed_charge":260.00,"npi":[1154055747,1033755137]}]},{"allowed_amount":322.22,"providers":[{"billed_charge":780.00,"npi":[1528310455]}]},{"allowed_amount":729.12,"providers":[{"billed_charge":1820.00,"npi":[1104116912]}]},{"allowed_amount":1145.76,"providers":[{"billed_charge":2860.00,"npi":[1528310455]}]},{"allowed_amount":624.96,"providers":[{"billed_charge":1560.00,"npi":[1659191880]}]},{"allowed_amount":530.54,"providers":[{"billed_charge":1300.00,"npi":[1558481556]}]},{"allowed_amount":1354.08,"providers":[{"billed_charge":3380.00,"npi":[1558481556]}]},{"allowed_amount":426.38,"providers":[{"billed_charge":1040.00,"npi":[1659990026]}]},{"allowed_amount":312.48,"providers":[{"billed_charge":780.00,"npi":[1346014560]}]},{"allowed_amount":416.64,"providers":[{"billed_charge":1040.00,"npi":[1154055747]}]},{"allowed_amount":3645.60,"providers":[{"billed_charge":9100.00,"npi":[1376215715]}]},{"allowed_amount":2708.16,"providers":[{"billed_charge":6760.00,"npi":[1346014560]}]},{"allowed_amount":1458.24,"providers":[{"billed_charge":3640.00,"npi":[1659990026]}]},{"allowed_amount":1790.20,"providers":[{"billed_charge":4420.00,"npi":[1376215715]}]},{"allowed_amount":1041.60,"providers":[{"billed_charge":2600.00,"npi":[1659191880]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":3101.71,"providers":[{"billed_charge":5550.00,"npi":[1982358065]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":156.44,"providers":[{"billed_charge":304.00,"npi":[1871283630]}]}]}]},{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90837","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"822356870"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5949.30,"providers":[{"billed_charge":12250.00,"npi":[1528170511]}]}]},{"tin":{"type":"ein","value":"412025888"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1686.54,"providers":[{"billed_charge":2275.00,"npi":[1114401759]}]}]},{"tin":{"type":"ein","value":"260243165"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":9912.14,"providers":[{"billed_charge":10577.54,"npi":[1003268533]}]},{"allowed_amount":4567.92,"providers":[{"billed_charge":4809.12,"npi":[1003268533]}]}]},{"tin":{"type":"ein","value":"852246046"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":300.00,"providers":[{"billed_charge":300.00,"npi":[1639577232]}]}]},{"tin":{"type":"ein","value":"582109771"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":185.34,"providers":[{"billed_charge":700.00,"npi":[1124683750]}]},{"allowed_amount":802.02,"providers":[{"billed_charge":3150.00,"npi":[1124683750]}]}]},{"tin":{"type":"ein","value":"582419239"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":101.66,"providers":[{"billed_charge":175.00,"npi":[1770246803]}]},{"allowed_amount":304.98,"providers":[{"billed_charge":525.00,"npi":[1770246803]}]}]},{"tin":{"type":"ein","value":"813899444"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":300.00,"providers":[{"billed_charge":300.00,"npi":[1447778410]}]},{"allowed_amount":3300.00,"providers":[{"billed_charge":3300.00,"npi":[1447778410]}]}]},{"tin":{"type":"ein","value":"203489786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9405.56,"providers":[{"billed_charge":9960.00,"npi":[1235224882]}]}]},{"tin":{"type":"ein","value":"921652524"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":325.20,"providers":[{"billed_charge":500.00,"npi":[1629864590]}]}]},{"tin":{"type":"ein","value":"822639811"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":2546.34,"providers":[{"billed_charge":4025.00,"npi":[1225768070]}]},{"allowed_amount":784.38,"providers":[{"billed_charge":1225.00,"npi":[1225768070]}]},{"allowed_amount":115.71,"providers":[{"billed_charge":175.00,"npi":[1962430892]}]},{"allowed_amount":8966.67,"providers":[{"billed_charge":14175.00,"npi":[1962430892]}]},{"allowed_amount":17466.33,"providers":[{"billed_charge":27825.00,"npi":[1962430892]}]}]},{"tin":{"type":"ein","value":"825102696"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":2068.40,"providers":[{"billed_charge":2076.60,"npi":[1265644207]}]},{"allowed_amount":4950.89,"providers":[{"billed_charge":4965.24,"npi":[1265644207]}]},{"allowed_amount":1009.96,"providers":[{"billed_charge":1009.96,"npi":[1265644207]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":368.13,"providers":[{"billed_charge":600.00,"npi":[1023552494]}]}]},{"tin":{"type":"ein","value":"580566121"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":1498.30,"providers":[{"billed_charge":3504.00,"npi":[1700527264]}]}]},{"tin":{"type":"ein","value":"383920221"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1359.84,"providers":[{"billed_charge":1500.00,"npi":[1033644471]}]},{"allowed_amount":1031.56,"providers":[{"billed_charge":1125.00,"npi":[1033644471]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1388.61,"providers":[{"billed_charge":3159.00,"npi":[1437568698,1649711151]}]},{"allowed_amount":1697.19,"providers":[{"billed_charge":3861.00,"npi":[1558481556]}]},{"allowed_amount":1234.32,"providers":[{"billed_charge":2808.00,"npi":[1568469054,1265521132,1295908473,1144738063,1952844300,1659191880,1376062539]}]},{"allowed_amount":154.29,"providers":[{"billed_charge":351.00,"npi":[1619290178]}]},{"allowed_amount":771.45,"providers":[{"billed_charge":1755.00,"npi":[1770051088,1013723246,1528658663,1275050916]}]},{"allowed_amount":617.16,"providers":[{"billed_charge":1404.00,"npi":[1558481556,1518619808,1952844300,1174840268,1376062539]}]},{"allowed_amount":784.16,"providers":[{"billed_charge":1755.00,"npi":[1659191880]}]},{"allowed_amount":3548.67,"providers":[{"billed_charge":8073.00,"npi":[1871939777]}]},{"allowed_amount":3702.96,"providers":[{"billed_charge":8424.00,"npi":[1316247620,1063299501]}]},{"allowed_amount":1927.74,"providers":[{"billed_charge":4212.00,"npi":[1265521132]}]},{"allowed_amount":925.74,"providers":[{"billed_charge":2106.00,"npi":[1841737681]}]},{"allowed_amount":3394.38,"providers":[{"billed_charge":7722.00,"npi":[1295238335]}]},{"allowed_amount":2777.22,"providers":[{"billed_charge":6318.00,"npi":[1568469054]}]},{"allowed_amount":4165.83,"providers":[{"billed_charge":9477.00,"npi":[1386195014]}]},{"allowed_amount":1080.03,"providers":[{"billed_charge":2457.00,"npi":[1770051088,1346014560,1659990026]}]},{"allowed_amount":2069.32,"providers":[{"billed_charge":4563.00,"npi":[1871939777]}]},{"allowed_amount":17743.35,"providers":[{"billed_charge":40365.00,"npi":[1992176952]}]},{"allowed_amount":1864.19,"providers":[{"billed_charge":4212.00,"npi":[1316247620]}]},{"allowed_amount":475.58,"providers":[{"billed_charge":1053.00,"npi":[1144738063]}]},{"allowed_amount":2314.35,"providers":[{"billed_charge":5265.00,"npi":[1306699954,1346014560,1174840268,1649711151]}]},{"allowed_amount":2802.64,"providers":[{"billed_charge":6318.00,"npi":[1386195014]}]},{"allowed_amount":2198.19,"providers":[{"billed_charge":4914.00,"npi":[1295238335]}]},{"allowed_amount":6171.60,"providers":[{"billed_charge":14040.00,"npi":[1437568698]}]},{"allowed_amount":1851.48,"providers":[{"billed_charge":4212.00,"npi":[1376215715]}]},{"allowed_amount":5091.57,"providers":[{"billed_charge":11583.00,"npi":[1376215715]}]},{"allowed_amount":462.87,"providers":[{"billed_charge":1053.00,"npi":[1619290178,1659990026,1700216058]}]},{"allowed_amount":2622.93,"providers":[{"billed_charge":5967.00,"npi":[1528658663]}]},{"allowed_amount":1464.87,"providers":[{"billed_charge":3159.00,"npi":[1306699954]}]},{"allowed_amount":1568.32,"providers":[{"billed_charge":3510.00,"npi":[1295908473]}]},{"allowed_amount":308.58,"providers":[{"billed_charge":702.00,"npi":[1760021729,1942896089,1346875036,1275050916,1700216058]}]},{"allowed_amount":1414.03,"providers":[{"billed_charge":3159.00,"npi":[1528310455]}]},{"allowed_amount":8407.92,"providers":[{"billed_charge":18954.00,"npi":[1992176952]}]},{"allowed_amount":2005.77,"providers":[{"billed_charge":4563.00,"npi":[1841737681,1528310455]}]},{"allowed_amount":2944.22,"providers":[{"billed_charge":6669.00,"npi":[1063299501]}]},{"allowed_amount":2160.06,"providers":[{"billed_charge":4914.00,"npi":[1497431043,1760021729]}]}]},{"tin":{"type":"ein","value":"474175042"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1466.59,"providers":[{"billed_charge":1500.76,"npi":[1316382948]}]},{"allowed_amount":345.08,"providers":[{"billed_charge":346.88,"npi":[1316382948]}]}]},{"tin":{"type":"ein","value":"200690840"},"service_code":["11","02","53"],"billing_class":"professional","payments":[{"allowed_amount":1354.68,"providers":[{"billed_charge":1449.60,"npi":[1174891774]}]},{"allowed_amount":11753.15,"providers":[{"billed_charge":12459.78,"npi":[1174891774]}]},{"allowed_amount":360.73,"providers":[{"billed_charge":392.37,"npi":[1174891774]}]}]},{"tin":{"type":"ein","value":"863421111"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":424.95,"providers":[{"billed_charge":875.00,"npi":[1669830030]}]},{"allowed_amount":169.98,"providers":[{"billed_charge":350.00,"npi":[1669830030]}]}]},{"tin":{"type":"ein","value":"844000208"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":227.10,"providers":[{"billed_charge":600.00,"npi":[1225390032]}]},{"allowed_amount":455.21,"providers":[{"billed_charge":1200.00,"npi":[1831495670]}]}]},{"tin":{"type":"ein","value":"822250498"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":345.08,"providers":[{"billed_charge":720.00,"npi":[1043877087]}]}]},{"tin":{"type":"ein","value":"582523113"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":517.62,"providers":[{"billed_charge":900.00,"npi":[1326689472]}]}]},{"tin":{"type":"ein","value":"850638856"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":1564.50,"providers":[{"billed_charge":2250.00,"npi":[1659019792]}]}]},{"tin":{"type":"ein","value":"823720969"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":258.81,"providers":[{"billed_charge":450.00,"npi":[1720660855]}]},{"allowed_amount":86.27,"providers":[{"billed_charge":150.00,"npi":[1720660855]}]}]},{"tin":{"type":"ein","value":"843707279"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":153.62,"providers":[{"billed_charge":445.00,"npi":[1346411725]}]},{"allowed_amount":5376.70,"providers":[{"billed_charge":15470.00,"npi":[1548205982]}]}]},{"tin":{"type":"ein","value":"823440519"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":339.96,"providers":[{"billed_charge":480.00,"npi":[1780136796]}]},{"allowed_amount":509.94,"providers":[{"billed_charge":720.00,"npi":[1780136796]}]}]},{"tin":{"type":"ein","value":"582109188"},"service_code":["02","53","10"],"billing_class":"professional","payments":[{"allowed_amount":2755.72,"providers":[{"billed_charge":5720.00,"npi":[1669456620]}]},{"allowed_amount":125.91,"providers":[{"billed_charge":260.00,"npi":[1669456620]}]},{"allowed_amount":251.82,"providers":[{"billed_charge":520.00,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"582324574"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1610.28,"providers":[{"billed_charge":2560.00,"npi":[1376612770]}]},{"allowed_amount":575.10,"providers":[{"billed_charge":925.00,"npi":[1376612770]}]}]},{"tin":{"type":"ein","value":"311833262"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":4139.68,"providers":[{"billed_charge":6720.00,"npi":[1750328977]}]},{"allowed_amount":688.88,"providers":[{"billed_charge":1120.00,"npi":[1750328977]}]},{"allowed_amount":431.35,"providers":[{"billed_charge":700.00,"npi":[1750328977]}]}]},{"tin":{"type":"ein","value":"453793564"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":679.92,"providers":[{"billed_charge":1200.00,"npi":[1336372424]}]}]},{"tin":{"type":"ein","value":"562641669"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":230.04,"providers":[{"billed_charge":360.00,"npi":[1497028427]}]}]},{"tin":{"type":"ein","value":"582109306"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":881.28,"providers":[{"billed_charge":1161.66,"npi":[1558478214]}]}]},{"tin":{"type":"ein","value":"922615645"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":936.40,"providers":[{"billed_charge":1200.00,"npi":[1669169231]}]},{"allowed_amount":351.15,"providers":[{"billed_charge":450.00,"npi":[1669169231]}]}]},{"tin":{"type":"ein","value":"203073911"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":2190.30,"providers":[{"billed_charge":3675.00,"npi":[1174166029]}]}]},{"tin":{"type":"ein","value":"842126707"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":7394.13,"providers":[{"billed_charge":21315.00,"npi":[1053854521]}]},{"allowed_amount":1869.78,"providers":[{"billed_charge":5390.00,"npi":[1053854521]}]},{"allowed_amount":1189.86,"providers":[{"billed_charge":3430.00,"npi":[1194269704]}]},{"allowed_amount":4504.47,"providers":[{"billed_charge":12985.00,"npi":[1194269704]}]}]}]},{"name":"GROUP PSYCHOTHERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90853","description":"GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","allowed_amounts":[{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":175.56,"providers":[{"billed_charge":525.00,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"200690840"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":10525.66,"providers":[{"billed_charge":30405.12,"npi":[1174891774]}]}]},{"tin":{"type":"ein","value":"582108521"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3321.70,"providers":[{"billed_charge":10816.00,"npi":[1063864171]}]},{"allowed_amount":544.16,"providers":[{"billed_charge":1792.00,"npi":[1639902109]}]}]}]},{"name":"TCRANIAL MAGN STIM TX DELI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90868","description":"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MA","allowed_amounts":[{"tin":{"type":"ein","value":"822138262"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9885.44,"providers":[{"billed_charge":101200.00,"npi":[1659959765]}]}]}]},{"name":"PSTAY/PARTIAL HOSP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"912","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - PARTIAL HOSPITALIZATION","allowed_amounts":[{"tin":{"type":"ein","value":"262700697"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":34111.00,"providers":[{"billed_charge":57750.00,"npi":[1770742132]}]}]},{"tin":{"type":"ein","value":"901035381"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9942.50,"providers":[{"billed_charge":72500.00,"npi":[1164811121]}]}]},{"tin":{"type":"ein","value":"631198286"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":32850.00,"providers":[{"billed_charge":160200.00,"npi":[1336297605]}]},{"allowed_amount":7783.03,"providers":[{"billed_charge":90200.00,"npi":[1184450967]}]}]},{"tin":{"type":"ein","value":"581534607"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":28075.00,"providers":[{"billed_charge":58140.00,"npi":[1205809571]}]}]},{"tin":{"type":"ein","value":"842851129"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35640.92,"providers":[{"billed_charge":343200.00,"npi":[1629611520]}]}]},{"tin":{"type":"ein","value":"461912262"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10275.00,"providers":[{"billed_charge":36300.00,"npi":[1558788802]}]}]},{"tin":{"type":"ein","value":"233044968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":106860.00,"providers":[{"billed_charge":335400.00,"npi":[1275765307]}]}]},{"tin":{"type":"ein","value":"933060676"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":100450.00,"providers":[{"billed_charge":860965.00,"npi":[1730954777]}]}]},{"tin":{"type":"ein","value":"760751278"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":114905.00,"providers":[{"billed_charge":1063300.00,"npi":[1669691473]}]}]},{"tin":{"type":"ein","value":"332452524"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":695.22,"providers":[{"billed_charge":10600.00,"npi":[1396556643]}]}]},{"tin":{"type":"ein","value":"823470979"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5627.31,"providers":[{"billed_charge":36300.00,"npi":[1265447015]}]}]},{"tin":{"type":"ein","value":"863419840"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":15965.00,"providers":[{"billed_charge":15965.00,"npi":[1467020701]}]}]},{"tin":{"type":"ein","value":"881402698"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8756.70,"providers":[{"billed_charge":119000.00,"npi":[1700511367]}]}]},{"tin":{"type":"ein","value":"474918169"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35570.78,"providers":[{"billed_charge":42500.00,"npi":[1134596794]}]}]},{"tin":{"type":"ein","value":"332887382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":213.00,"providers":[{"billed_charge":1550.00,"npi":[1912896556]}]}]},{"tin":{"type":"ein","value":"820650237"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":11400.00,"providers":[{"billed_charge":87000.00,"npi":[1649775123]}]}]},{"tin":{"type":"ein","value":"822144748"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":77420.00,"providers":[{"billed_charge":588000.00,"npi":[1992209811]}]}]},{"tin":{"type":"ein","value":"920265597"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2575.50,"providers":[{"billed_charge":40000.00,"npi":[1366150799]}]}]}]},{"name":"PSYCHIATRIC CARE INTENSIVE 4","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"913","description":"PSYCHIATRIC CARE INTENSIVE 4-6 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"931373954"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5948.75,"providers":[{"billed_charge":93600.00,"npi":[1508549155]}]}]},{"tin":{"type":"ein","value":"863916163"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2650.32,"providers":[{"billed_charge":63000.00,"npi":[1023688157]}]}]},{"tin":{"type":"ein","value":"300827435"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":411.00,"providers":[{"billed_charge":1290.00,"npi":[1336114321]}]}]},{"tin":{"type":"ein","value":"883646627"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6987.00,"providers":[{"billed_charge":51000.00,"npi":[1891411351]}]}]},{"tin":{"type":"ein","value":"233044968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":61239.00,"providers":[{"billed_charge":215430.00,"npi":[1275765307]}]}]},{"tin":{"type":"ein","value":"814742688"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1030.20,"providers":[{"billed_charge":2400.00,"npi":[1770080632]}]}]},{"tin":{"type":"ein","value":"760751278"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":13400.00,"providers":[{"billed_charge":124000.00,"npi":[1669691473]}]}]},{"tin":{"type":"ein","value":"461281853"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":11970.00,"providers":[{"billed_charge":151810.00,"npi":[1457232589]}]}]}]},{"name":"PSTAY/INDIV RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"914","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - INDIVIDUAL THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":60695.45,"providers":[{"billed_charge":129592.00,"npi":[1992799050]}]}]}]},{"name":"PSTAY/TESTING","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"918","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - TESTING","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":545.30,"providers":[{"billed_charge":587.00,"npi":[1992799050]}]}]}]},{"name":"OTHER DX SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"920","description":"OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1807.42,"providers":[{"billed_charge":29568.00,"npi":[1992799050]}]}]}]},{"name":"EYE EXAM NEW PATIENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92004","description":"OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION W INITIATION OF DIAGNOSTIC AND TRTMNT ","allowed_amounts":[{"tin":{"type":"ein","value":"581906891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1061.16,"providers":[{"billed_charge":1590.00,"npi":[1174605372]}]}]}]},{"name":"EYE EXAM&TX ESTAB PT 1/>VST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92014","description":"OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, W INITIATION OR CONTINUATION OF DIAGN","allowed_amounts":[{"tin":{"type":"ein","value":"581906891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":449.00,"providers":[{"billed_charge":610.00,"npi":[1174605372]}]}]}]},{"name":"PERI VASCUL LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"921","description":"OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB","allowed_amounts":[{"tin":{"type":"ein","value":"580566200"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24646.38,"providers":[{"billed_charge":54840.00,"npi":[1144203563]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12620.87,"providers":[{"billed_charge":42447.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"581519911"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9972.44,"providers":[{"billed_charge":27550.00,"npi":[1528056066]}]}]},{"tin":{"type":"ein","value":"580566213"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":792.93,"providers":[{"billed_charge":1843.38,"npi":[1962461681]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8575.48,"providers":[{"billed_charge":23067.16,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2041.00,"providers":[{"billed_charge":32989.15,"npi":[1992799050]}]},{"allowed_amount":4541.17,"providers":[{"billed_charge":55546.00,"npi":[1992799050]}]}]},{"tin":{"type":"ein","value":"821969974"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":19567.08,"providers":[{"billed_charge":58791.00,"npi":[1053824292]}]},{"allowed_amount":15186.78,"providers":[{"billed_charge":52655.00,"npi":[1053824292]}]}]}]},{"name":"CPTR OPHTH DX IMG POST SEGMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92134","description":"SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING, POSTERIOR SEGMENT, W INTERPRETATION AND RPT, UN","allowed_amounts":[{"tin":{"type":"ein","value":"581380450"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":486.49,"providers":[{"billed_charge":2185.00,"npi":[1417907973]}]}]}]},{"name":"OPHTHALMIC BIOMETRY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92136","description":"OPHTHALMIC BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY WITH INTRAOCULAR LENS POWER CALCULATION","allowed_amounts":[{"tin":{"type":"ein","value":"581380450"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":267.46,"providers":[{"billed_charge":1200.00,"npi":[1144203779]}]}]}]},{"name":"EYE EXAM WITH PHOTOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92250","description":"FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"581906891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.94,"providers":[{"billed_charge":245.00,"npi":[1174605372]}]}]}]},{"name":"SPEECH/HEARING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92507","description":"TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER; INDIVIDUAL","allowed_amounts":[{"tin":{"type":"ein","value":"581940036"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1029.66,"providers":[{"billed_charge":2040.00,"npi":[1740956333]}]}]},{"tin":{"type":"ein","value":"814201540"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":399.98,"providers":[{"billed_charge":884.52,"npi":[1558156828]}]}]}]},{"name":"COMPREHENSIVE HEARING TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92557","description":"COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH RECOGNITION (92553 AND 92556 COMBINED)","allowed_amounts":[{"tin":{"type":"ein","value":"475419443"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":167.18,"providers":[{"billed_charge":233.97,"npi":[1073344404]}]}]}]},{"name":"TYMPANOMETRY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92567","description":"TYMPANOMETRY (IMPEDANCE TESTING)","allowed_amounts":[{"tin":{"type":"ein","value":"475419443"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.45,"providers":[{"billed_charge":117.21,"npi":[1073344404]}]}]}]},{"name":"AEP SCR AUDITORY POTENTIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92650","description":"AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS","allowed_amounts":[{"tin":{"type":"ein","value":"650592449"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":703.88,"providers":[{"billed_charge":7000.00,"npi":[1184705642]}]},{"allowed_amount":1259.93,"providers":[{"billed_charge":12750.00,"npi":[1912960048]}]}]}]},{"name":"ELECTROCARDIOGRAM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93000","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"581322279"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":28.90,"providers":[{"billed_charge":280.00,"npi":[1881432714]}]}]},{"tin":{"type":"ein","value":"582471834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":243.64,"providers":[{"billed_charge":910.00,"npi":[1043203011]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":102.00,"providers":[{"billed_charge":348.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.18,"providers":[{"billed_charge":240.00,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":428.30,"providers":[{"billed_charge":2066.00,"npi":[1700906427]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"475419443"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":18.70,"providers":[{"billed_charge":25.85,"npi":[1386165470]}]},{"allowed_amount":56.10,"providers":[{"billed_charge":77.55,"npi":[1386165470]}]}]},{"tin":{"type":"ein","value":"581627802"},"service_code":["22","19","21"],"billing_class":"professional","payments":[{"allowed_amount":70.87,"providers":[{"billed_charge":270.00,"npi":[1679991632]}]},{"allowed_amount":55.94,"providers":[{"billed_charge":210.00,"npi":[1679991632]}]},{"allowed_amount":15.60,"providers":[{"billed_charge":60.00,"npi":[1679991632]}]}]},{"tin":{"type":"ein","value":"582030692"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":18.38,"providers":[{"billed_charge":46.00,"npi":[1598028094]}]}]},{"tin":{"type":"ein","value":"581734026"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":7.81,"providers":[{"billed_charge":30.00,"npi":[1508880352]}]},{"allowed_amount":30.90,"providers":[{"billed_charge":114.00,"npi":[1508880352]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":22.74,"providers":[{"billed_charge":58.00,"npi":[1275698235,1205126851]}]},{"allowed_amount":34.11,"providers":[{"billed_charge":87.00,"npi":[1205126851]}]},{"allowed_amount":11.37,"providers":[{"billed_charge":29.00,"npi":[1275698235]}]}]},{"tin":{"type":"ein","value":"811558273"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":374.85,"providers":[{"billed_charge":2397.00,"npi":[1134869217]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":18.38,"providers":[{"billed_charge":30.00,"npi":[1720264765]}]},{"allowed_amount":15.40,"providers":[{"billed_charge":30.00,"npi":[1720264765]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":390.02,"providers":[{"billed_charge":3314.00,"npi":[1700906427]}]},{"allowed_amount":207.59,"providers":[{"billed_charge":1743.00,"npi":[1265423339]}]},{"allowed_amount":392.81,"providers":[{"billed_charge":3397.00,"npi":[1700906427]}]},{"allowed_amount":395.09,"providers":[{"billed_charge":3394.00,"npi":[1265423339]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["22","11","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":1453.69,"providers":[{"billed_charge":5255.00,"npi":[1245469519]}]},{"allowed_amount":2168.76,"providers":[{"billed_charge":7844.00,"npi":[1245469519]}]},{"allowed_amount":20.46,"providers":[{"billed_charge":74.00,"npi":[1245469519,1104879782]}]},{"allowed_amount":624.03,"providers":[{"billed_charge":2257.00,"npi":[1245469519]}]},{"allowed_amount":757.03,"providers":[{"billed_charge":2738.00,"npi":[1245469519]}]},{"allowed_amount":2281.29,"providers":[{"billed_charge":8251.00,"npi":[1922217926]}]},{"allowed_amount":1831.17,"providers":[{"billed_charge":6623.00,"npi":[1104879782]}]},{"allowed_amount":30.69,"providers":[{"billed_charge":111.00,"npi":[1922007541]}]},{"allowed_amount":61.38,"providers":[{"billed_charge":222.00,"npi":[1922217926]}]},{"allowed_amount":838.86,"providers":[{"billed_charge":3034.00,"npi":[1922217926]}]},{"allowed_amount":40.92,"providers":[{"billed_charge":148.00,"npi":[1922007541]}]},{"allowed_amount":3102.78,"providers":[{"billed_charge":11214.00,"npi":[1104879782]}]},{"allowed_amount":334.94,"providers":[{"billed_charge":1221.00,"npi":[1922217926]}]},{"allowed_amount":654.72,"providers":[{"billed_charge":2368.00,"npi":[1104879782]}]}]}]},{"name":"CARDIOVASCULAR STRESS TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93016","description":"CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINUOUS ELE","allowed_amounts":[{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":123.19,"providers":[{"billed_charge":1290.00,"npi":[1700906427]}]},{"allowed_amount":73.41,"providers":[{"billed_charge":780.00,"npi":[1265423339]}]},{"allowed_amount":419.35,"providers":[{"billed_charge":4410.00,"npi":[1265423339]}]}]}]},{"name":"CARDIOVASCULAR STRESS TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93018","description":"CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINUOUS ELE","allowed_amounts":[{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":16.58,"providers":[{"billed_charge":260.00,"npi":[1700906427]}]},{"allowed_amount":481.42,"providers":[{"billed_charge":7500.00,"npi":[1700906427]}]}]}]},{"name":"ART PRESSURE WAVEFORM ANALYS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93050","description":"ARTERIAL PRESSURE WAVEFORM ANALYSIS FOR ASSESSMENT OF CENTRAL ARTERIAL PRESSURES, INCLUDES OBTAINING","allowed_amounts":[{"tin":{"type":"ein","value":"880564098"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":177.60,"providers":[{"billed_charge":720.00,"npi":[1316439987]}]}]}]},{"name":"REMOTE 30 DAY ECG TECH SUPP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93229","description":"EXTERNAL MOBILE CARDIOVASCULAR TELEMETRY W ELECTROCARDIOGRAPHIC RECORDING, CONCURRENT COMPUTERIZED R","allowed_amounts":[{"tin":{"type":"ein","value":"770644336"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13474.64,"providers":[{"billed_charge":44910.00,"npi":[1063414258]}]}]}]},{"name":"EXT ECG>48HR<7D SCAN A/R","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93243","description":"EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"770644336"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":454.48,"providers":[{"billed_charge":700.00,"npi":[1063414258]}]}]}]},{"name":"ECG/REVIEW INTERPRET ONLY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93272","description":"EXTERNAL PATIENT AND, WHEN PERFORMED, AUTO ACTIVATED ELECTROCARDIOGRAPHIC RHYTHM DERIVED EVENT RECOR","allowed_amounts":[{"tin":{"type":"ein","value":"453072990"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":537.32,"providers":[{"billed_charge":1603.00,"npi":[1700906427]}]}]}]},{"name":"PM/ICD REMOTE TECH SERV","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93296","description":"INTERROGATION DEVICE EVALUATION(S) (REMOTE), UP TO 90 DAYS; SINGLE, DUAL, OR MULTIPLE LEAD PACEMAKER","allowed_amounts":[{"tin":{"type":"ein","value":"844519944"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":80.06,"providers":[{"billed_charge":600.00,"npi":[1659401974]}]}]}]},{"name":"TTE W/DOPPLER COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93306","description":"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W IMG DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN","allowed_amounts":[{"tin":{"type":"ein","value":"582030692"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":154.48,"providers":[{"billed_charge":373.00,"npi":[1053331215]}]},{"allowed_amount":308.96,"providers":[{"billed_charge":746.00,"npi":[1053331215]}]}]},{"tin":{"type":"ein","value":"581627802"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":65.46,"providers":[{"billed_charge":225.00,"npi":[1831652817]}]},{"allowed_amount":68.24,"providers":[{"billed_charge":225.00,"npi":[1831652817]}]}]},{"tin":{"type":"ein","value":"994689720"},"service_code":["11","21"],"billing_class":"professional","payments":[{"allowed_amount":5998.92,"providers":[{"billed_charge":53788.00,"npi":[1780772731]}]},{"allowed_amount":63.53,"providers":[{"billed_charge":1582.00,"npi":[1780772731]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1550.10,"providers":[{"billed_charge":2250.00,"npi":[1437155074]}]},{"allowed_amount":2626.16,"providers":[{"billed_charge":3825.00,"npi":[1437155074]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":3383.41,"providers":[{"billed_charge":69339.00,"npi":[1700906427]}]},{"allowed_amount":485.24,"providers":[{"billed_charge":10101.00,"npi":[1700906427]}]},{"allowed_amount":68.62,"providers":[{"billed_charge":1416.00,"npi":[1265423339]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11","22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":2401.56,"providers":[{"billed_charge":9492.00,"npi":[1245469519]}]},{"allowed_amount":1458.09,"providers":[{"billed_charge":5763.00,"npi":[1104879782]}]},{"allowed_amount":171.54,"providers":[{"billed_charge":678.00,"npi":[1346326287,1245469519]}]},{"allowed_amount":696.69,"providers":[{"billed_charge":2118.00,"npi":[1346326287]}]},{"allowed_amount":85.77,"providers":[{"billed_charge":339.00,"npi":[1245469519]}]},{"allowed_amount":257.31,"providers":[{"billed_charge":1017.00,"npi":[1104879782]}]}]}]},{"name":"CARDIAC REHAB/MONITOR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93798","description":"PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL SERVICES FOR OUTPATIENT CARDIAC REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"874134822"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":105.10,"providers":[{"billed_charge":385.00,"npi":[1932381035]}]},{"allowed_amount":2769.09,"providers":[{"billed_charge":10318.00,"npi":[1124089784]}]},{"allowed_amount":2391.90,"providers":[{"billed_charge":8778.00,"npi":[1124089784]}]}]}]},{"name":"EXTREMITY STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93970","description":"DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE BILA","allowed_amounts":[{"tin":{"type":"ein","value":"581537752"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":49.58,"providers":[{"billed_charge":475.00,"npi":[1649296039]}]},{"allowed_amount":408.35,"providers":[{"billed_charge":1900.00,"npi":[1649296039]}]}]}]},{"name":"VASCULAR STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93976","description":"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETR","allowed_amounts":[{"tin":{"type":"ein","value":"581394645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1902.15,"providers":[{"billed_charge":6540.00,"npi":[1245261783]}]}]}]},{"name":"OTHER RX SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"940","description":"OTHER THERAPEUTIC SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"581973570"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1420.46,"providers":[{"billed_charge":2513.00,"npi":[1154377166]}]}]},{"tin":{"type":"ein","value":"453957368"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3274.18,"providers":[{"billed_charge":8022.00,"npi":[1073927117]}]}]},{"tin":{"type":"ein","value":"300885567"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12731.81,"providers":[{"billed_charge":46274.93,"npi":[1154795581]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":63.69,"providers":[{"billed_charge":271.00,"npi":[1043270564]}]},{"allowed_amount":4423.57,"providers":[{"billed_charge":19291.00,"npi":[1043270564]}]},{"allowed_amount":30.89,"providers":[{"billed_charge":132.00,"npi":[1043270564]}]}]}]},{"name":"BREATHING CAPACITY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"94010","description":"SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREME","allowed_amounts":[{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":228.90,"providers":[{"billed_charge":644.00,"npi":[1831355833]}]}]}]},{"name":"EDUC/TRAINING","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"942","description":"OTHER THERAPEUTIC SERVICES - EDUCATION/TRAINING","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":53.56,"providers":[{"billed_charge":220.00,"npi":[1992799050]}]},{"allowed_amount":796.10,"providers":[{"billed_charge":5156.00,"npi":[1992799050]}]}]}]},{"name":"DRUG REHAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"944","description":"OTHER THERAPEUTIC SERVICES - DRUG REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"871500809"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":75960.00,"providers":[{"billed_charge":896750.00,"npi":[1497327720]}]}]}]},{"name":"PERCUT ALLERGY SKIN TESTS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95004","description":"PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, INC","allowed_amounts":[{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3234.23,"providers":[{"billed_charge":8160.00,"npi":[1558327072]}]}]}]},{"name":"ICUT ALLERGY TEST DRUG/BUG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95024","description":"INTRACUTANEOUS (INTRADERMAL) TESTS W ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, INCL TEST INTERPR","allowed_amounts":[{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2805.86,"providers":[{"billed_charge":4485.00,"npi":[1558327072]}]}]}]},{"name":"IMMUNOTHERAPY, ONE INJECTION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95115","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; SIN","allowed_amounts":[{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":522.90,"providers":[{"billed_charge":1260.00,"npi":[1639303605]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1155.69,"providers":[{"billed_charge":1920.00,"npi":[1902942220]}]}]}]},{"name":"IMMUNOTHERAPY INJECTIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95117","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; 2 O","allowed_amounts":[{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1653.70,"providers":[{"billed_charge":4370.00,"npi":[1427238666]}]},{"allowed_amount":4404.88,"providers":[{"billed_charge":11666.00,"npi":[1831355833]}]},{"allowed_amount":2962.28,"providers":[{"billed_charge":7828.00,"npi":[1639303605]}]}]},{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1574.23,"providers":[{"billed_charge":2485.00,"npi":[1558327072]}]}]}]},{"name":"ANTIGEN THERAPY SERVICES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95165","description":"PROF SERVICES FOR THE SPRVSN OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHAPY; SING","allowed_amounts":[{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4759.07,"providers":[{"billed_charge":7000.00,"npi":[1639303605]}]},{"allowed_amount":8838.27,"providers":[{"billed_charge":13000.00,"npi":[1831355833]}]}]},{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":18212.81,"providers":[{"billed_charge":30150.00,"npi":[1558327072]}]}]}]},{"name":"SLP STDY UNATTENDED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95800","description":"SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; HEART RATE, OXYGEN SATURATION, RESPIRATORY ANALYSIS","allowed_amounts":[{"tin":{"type":"ein","value":"832867658"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":3981.85,"providers":[{"billed_charge":5799.73,"npi":[1487657508]}]}]}]},{"name":"EEG, AWAKE AND DROWSY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95816","description":"ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND DROWSY","allowed_amounts":[{"tin":{"type":"ein","value":"582307485"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":349.70,"providers":[{"billed_charge":6680.00,"npi":[1467832600]}]},{"allowed_amount":489.58,"providers":[{"billed_charge":9352.00,"npi":[1467832600]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"581338038"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":246.86,"providers":[{"billed_charge":276.00,"npi":[1174529192]}]}]},{"tin":{"type":"ein","value":"205870972"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":143.02,"providers":[{"billed_charge":280.86,"npi":[1285325282]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":586.04,"providers":[{"billed_charge":1800.00,"npi":[1073612115]}]},{"allowed_amount":7.57,"providers":[{"billed_charge":25.00,"npi":[1194953638]}]},{"allowed_amount":215.48,"providers":[{"billed_charge":725.00,"npi":[1295806495]}]},{"allowed_amount":8.47,"providers":[{"billed_charge":25.00,"npi":[1073612115]}]},{"allowed_amount":320.55,"providers":[{"billed_charge":975.00,"npi":[1194953638]}]},{"allowed_amount":9.85,"providers":[{"billed_charge":25.00,"npi":[1164166922]}]},{"allowed_amount":631.52,"providers":[{"billed_charge":1750.00,"npi":[1164166922]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8.68,"providers":[{"billed_charge":36.00,"npi":[1194545632]}]},{"allowed_amount":15.91,"providers":[{"billed_charge":54.00,"npi":[1073254363]}]},{"allowed_amount":51.61,"providers":[{"billed_charge":180.00,"npi":[1912167578]}]}]}]},{"name":"PT-FOCUSED HLTH RISK ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96160","description":"ADMINISTRATION OF PATIENT-FOCUSED HEALTH RISK ASSESSMENT INSTRUMENT (EG, HEALTH HAZARD APPRAISAL) WI","allowed_amounts":[{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":119.14,"providers":[{"billed_charge":1575.00,"npi":[1902942220]}]}]}]},{"name":"THER/PROPH/DIAG IV INF INIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96365","description":"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); INITIAL, U","allowed_amounts":[{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.31,"providers":[{"billed_charge":500.00,"npi":[1073612115]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96372","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":105.30,"providers":[{"billed_charge":420.00,"npi":[1831355833]}]}]},{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":1672.05,"providers":[{"billed_charge":4260.00,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":322.23,"providers":[{"billed_charge":547.80,"npi":[1164166922]}]},{"allowed_amount":949.63,"providers":[{"billed_charge":1734.70,"npi":[1073612115]}]},{"allowed_amount":806.29,"providers":[{"billed_charge":1460.80,"npi":[1194953638]}]},{"allowed_amount":682.45,"providers":[{"billed_charge":1323.85,"npi":[1295806495]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":56.46,"providers":[{"billed_charge":240.00,"npi":[1235411547]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12.33,"providers":[{"billed_charge":32.00,"npi":[1447847298]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":319.10,"providers":[{"billed_charge":840.00,"npi":[1225021678]}]}]},{"tin":{"type":"ein","value":"954112121"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":906.57,"providers":[{"billed_charge":4657.25,"npi":[1780695809]}]},{"allowed_amount":28.08,"providers":[{"billed_charge":143.30,"npi":[1548260508]}]}]},{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":184.43,"providers":[{"billed_charge":715.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"582041471"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":339.34,"providers":[{"billed_charge":735.00,"npi":[1598949166]}]}]},{"tin":{"type":"ein","value":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":132.58,"providers":[{"billed_charge":316.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":487.46,"providers":[{"billed_charge":2345.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"471461454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":156.00,"providers":[{"billed_charge":600.00,"npi":[1760708580]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":66.31,"providers":[{"billed_charge":360.00,"npi":[1851010466]}]}]},{"tin":{"type":"ein","value":"582112427"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":99.67,"providers":[{"billed_charge":287.35,"npi":[1942270558]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":320.14,"providers":[{"billed_charge":840.00,"npi":[1811874696]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":23.03,"providers":[{"billed_charge":64.00,"npi":[1356456685]}]}]},{"tin":{"type":"ein","value":"473524701"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":32.67,"providers":[{"billed_charge":150.00,"npi":[1669252656]}]}]}]},{"name":"MECHANICAL TRACTION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97012","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; TRACTION, MECHANICAL","allowed_amounts":[{"tin":{"type":"ein","value":"582068734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":518.73,"providers":[{"billed_charge":1815.00,"npi":[1174005284]}]},{"allowed_amount":225.00,"providers":[{"billed_charge":225.00,"npi":[1265656003]}]}]}]},{"name":"ELECTRIC STIMULATION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97014","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED)","allowed_amounts":[{"tin":{"type":"ein","value":"582068734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":93.74,"providers":[{"billed_charge":140.00,"npi":[1265656003]}]},{"allowed_amount":516.41,"providers":[{"billed_charge":2470.00,"npi":[1174005284]}]}]},{"tin":{"type":"ein","value":"43596339"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":452.07,"providers":[{"billed_charge":2400.00,"npi":[1063301307]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"882696697"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.40,"providers":[{"billed_charge":220.00,"npi":[1922653732]}]}]},{"tin":{"type":"ein","value":"581545162"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":918.94,"providers":[{"billed_charge":2475.00,"npi":[1508005901]}]}]},{"tin":{"type":"ein","value":"200174459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1799.41,"providers":[{"billed_charge":3220.00,"npi":[1447068713]}]},{"allowed_amount":196.15,"providers":[{"billed_charge":350.00,"npi":[1306463807]}]},{"allowed_amount":808.79,"providers":[{"billed_charge":1400.00,"npi":[1184469363]}]},{"allowed_amount":4815.96,"providers":[{"billed_charge":8680.00,"npi":[1538980917]}]}]},{"tin":{"type":"ein","value":"626000101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3555.25,"providers":[{"billed_charge":7314.00,"npi":[1174362446]}]}]},{"tin":{"type":"ein","value":"581443056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2039.39,"providers":[{"billed_charge":8188.00,"npi":[1134899917]}]}]},{"tin":{"type":"ein","value":"933980945"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":232.12,"providers":[{"billed_charge":1610.00,"npi":[1659897791]}]}]},{"tin":{"type":"ein","value":"811271493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1941.10,"providers":[{"billed_charge":5580.00,"npi":[1831725605]}]}]},{"tin":{"type":"ein","value":"43596339"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":930.20,"providers":[{"billed_charge":2950.00,"npi":[1063301307]}]}]},{"tin":{"type":"ein","value":"800954871"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":663.56,"providers":[{"billed_charge":900.00,"npi":[1164182333]}]}]},{"tin":{"type":"ein","value":"621488455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":578.21,"providers":[{"billed_charge":2290.95,"npi":[1407731433]}]},{"allowed_amount":2224.13,"providers":[{"billed_charge":8569.85,"npi":[1710999099]}]},{"allowed_amount":133.41,"providers":[{"billed_charge":509.10,"npi":[1447078670]}]}]},{"tin":{"type":"ein","value":"270039366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":389.73,"providers":[{"billed_charge":1602.00,"npi":[1306509310]}]},{"allowed_amount":2120.47,"providers":[{"billed_charge":8722.00,"npi":[1083193627]}]}]},{"tin":{"type":"ein","value":"800090215"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.58,"providers":[{"billed_charge":340.00,"npi":[1972240307]}]},{"allowed_amount":443.69,"providers":[{"billed_charge":1870.00,"npi":[1720552300]}]}]},{"tin":{"type":"ein","value":"461588158"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":913.92,"providers":[{"billed_charge":2246.16,"npi":[1396766879]}]}]},{"tin":{"type":"ein","value":"582529505"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":450.43,"providers":[{"billed_charge":1495.00,"npi":[1285270314]}]},{"allowed_amount":176.25,"providers":[{"billed_charge":585.00,"npi":[1891162244]}]},{"allowed_amount":176.26,"providers":[{"billed_charge":585.00,"npi":[1033837299]}]}]},{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3596.95,"providers":[{"billed_charge":14196.00,"npi":[1780455675]}]},{"allowed_amount":2816.21,"providers":[{"billed_charge":11232.00,"npi":[1144399494]}]},{"allowed_amount":1221.52,"providers":[{"billed_charge":4836.00,"npi":[1407684236]}]},{"allowed_amount":998.87,"providers":[{"billed_charge":3978.00,"npi":[1730999582]}]},{"allowed_amount":9940.85,"providers":[{"billed_charge":38376.00,"npi":[1851029268]}]},{"allowed_amount":2645.73,"providers":[{"billed_charge":10530.00,"npi":[1518651116]}]},{"allowed_amount":1822.43,"providers":[{"billed_charge":7176.00,"npi":[1942337159]}]}]},{"tin":{"type":"ein","value":"582444186"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":995.50,"providers":[{"billed_charge":3000.00,"npi":[1619045770]}]}]}]},{"name":"NEUROMUSCULAR REEDUCATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97112","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALA","allowed_amounts":[{"tin":{"type":"ein","value":"882696697"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":164.88,"providers":[{"billed_charge":264.00,"npi":[1922653732]}]}]},{"tin":{"type":"ein","value":"200174459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3662.47,"providers":[{"billed_charge":6075.00,"npi":[1538980917]}]}]},{"tin":{"type":"ein","value":"581443056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1041.23,"providers":[{"billed_charge":4158.00,"npi":[1134899917]}]}]},{"tin":{"type":"ein","value":"933980945"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":18.44,"providers":[{"billed_charge":120.00,"npi":[1659897791]}]}]},{"tin":{"type":"ein","value":"811271493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":289.05,"providers":[{"billed_charge":720.00,"npi":[1831725605]}]}]},{"tin":{"type":"ein","value":"204965849"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5443.42,"providers":[{"billed_charge":14976.00,"npi":[1871329656]}]}]},{"tin":{"type":"ein","value":"43596339"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1910.92,"providers":[{"billed_charge":5400.00,"npi":[1063301307]}]}]},{"tin":{"type":"ein","value":"582537447"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1523.48,"providers":[{"billed_charge":6500.00,"npi":[1932653813]}]}]},{"tin":{"type":"ein","value":"800954871"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1409.24,"providers":[{"billed_charge":1650.00,"npi":[1164182333]}]}]},{"tin":{"type":"ein","value":"270039366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1748.69,"providers":[{"billed_charge":7128.00,"npi":[1083193627]}]},{"allowed_amount":356.90,"providers":[{"billed_charge":1485.00,"npi":[1306509310]}]}]},{"tin":{"type":"ein","value":"621488455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":642.18,"providers":[{"billed_charge":2158.78,"npi":[1710999099]}]}]},{"tin":{"type":"ein","value":"800090215"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":157.69,"providers":[{"billed_charge":581.00,"npi":[1720552300]}]}]},{"tin":{"type":"ein","value":"582529505"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":304.92,"providers":[{"billed_charge":910.00,"npi":[1285270314]}]},{"allowed_amount":21.78,"providers":[{"billed_charge":65.00,"npi":[1689612814]}]},{"allowed_amount":108.90,"providers":[{"billed_charge":325.00,"npi":[1033837299]}]}]},{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2760.46,"providers":[{"billed_charge":10750.00,"npi":[1518651116]}]},{"allowed_amount":879.21,"providers":[{"billed_charge":3440.00,"npi":[1730999582]}]},{"allowed_amount":1579.64,"providers":[{"billed_charge":6020.00,"npi":[1851029268]}]},{"allowed_amount":1978.07,"providers":[{"billed_charge":7826.00,"npi":[1144399494]}]},{"allowed_amount":86.25,"providers":[{"billed_charge":344.00,"npi":[1407684236]}]},{"allowed_amount":453.26,"providers":[{"billed_charge":1720.00,"npi":[1780455675]}]}]}]},{"name":"MANUAL THERAPY 1/> REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97140","description":"MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTIO","allowed_amounts":[{"tin":{"type":"ein","value":"582537447"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":176.75,"providers":[{"billed_charge":927.00,"npi":[1932653813]}]}]},{"tin":{"type":"ein","value":"800954871"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":863.63,"providers":[{"billed_charge":1200.00,"npi":[1164182333]}]}]},{"tin":{"type":"ein","value":"581443056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1081.86,"providers":[{"billed_charge":4368.00,"npi":[1134899917]}]}]},{"tin":{"type":"ein","value":"626000101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":923.38,"providers":[{"billed_charge":1984.00,"npi":[1174362446]}]}]},{"tin":{"type":"ein","value":"270039366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":350.26,"providers":[{"billed_charge":1428.00,"npi":[1083193627]}]}]},{"tin":{"type":"ein","value":"621488455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":392.59,"providers":[{"billed_charge":1234.81,"npi":[1710999099]}]},{"allowed_amount":21.09,"providers":[{"billed_charge":64.99,"npi":[1447078670]}]}]},{"tin":{"type":"ein","value":"933980945"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":187.80,"providers":[{"billed_charge":1260.00,"npi":[1659897791]}]}]},{"tin":{"type":"ein","value":"582068734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2226.21,"providers":[{"billed_charge":2280.00,"npi":[1265656003]}]}]},{"tin":{"type":"ein","value":"811271493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":496.45,"providers":[{"billed_charge":1375.00,"npi":[1831725605]}]}]},{"tin":{"type":"ein","value":"204965849"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2824.84,"providers":[{"billed_charge":8664.00,"npi":[1871329656]}]}]},{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":483.84,"providers":[{"billed_charge":1898.00,"npi":[1730999582]}]},{"allowed_amount":331.46,"providers":[{"billed_charge":1314.00,"npi":[1144399494]}]},{"allowed_amount":311.64,"providers":[{"billed_charge":1241.00,"npi":[1407684236]}]},{"allowed_amount":386.13,"providers":[{"billed_charge":1533.00,"npi":[1851029268]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"994597000"},"service_code":["03"],"billing_class":"professional","payments":[{"allowed_amount":28317.24,"providers":[{"billed_charge":129600.00,"npi":[1346565223]}]}]},{"tin":{"type":"ein","value":"203511076"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5349.56,"providers":[{"billed_charge":14054.10,"npi":[1851931281]}]}]},{"tin":{"type":"ein","value":"861811180"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":3927.09,"providers":[{"billed_charge":16900.00,"npi":[1467178616]}]}]},{"tin":{"type":"ein","value":"851129860"},"service_code":["03"],"billing_class":"professional","payments":[{"allowed_amount":8116.09,"providers":[{"billed_charge":27720.00,"npi":[1316420284]}]}]},{"tin":{"type":"ein","value":"822271906"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13608.82,"providers":[{"billed_charge":28700.00,"npi":[1104617679]}]}]},{"tin":{"type":"ein","value":"842724688"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":29984.27,"providers":[{"billed_charge":59355.00,"npi":[1215518121]}]},{"allowed_amount":28188.39,"providers":[{"billed_charge":55800.00,"npi":[1134612435]}]}]},{"tin":{"type":"ein","value":"461663719"},"service_code":["12","03"],"billing_class":"professional","payments":[{"allowed_amount":217.80,"providers":[{"billed_charge":217.80,"npi":[1497565733]}]},{"allowed_amount":3394.05,"providers":[{"billed_charge":3394.05,"npi":[1497565733]}]}]},{"tin":{"type":"ein","value":"824428105"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14969.63,"providers":[{"billed_charge":83737.50,"npi":[1801201397]}]}]},{"tin":{"type":"ein","value":"825484002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12965.39,"providers":[{"billed_charge":18428.34,"npi":[1437032547]}]},{"allowed_amount":8873.64,"providers":[{"billed_charge":12458.11,"npi":[1841968138]}]}]},{"tin":{"type":"ein","value":"462577988"},"service_code":["03"],"billing_class":"professional","payments":[{"allowed_amount":18304.27,"providers":[{"billed_charge":18304.27,"npi":[1881960664]}]}]},{"tin":{"type":"ein","value":"883405344"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":70756.94,"providers":[{"billed_charge":101210.74,"npi":[1033568027]}]}]},{"tin":{"type":"ein","value":"861542155"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":19253.87,"providers":[{"billed_charge":95962.50,"npi":[1255942108]}]},{"allowed_amount":8594.08,"providers":[{"billed_charge":41850.00,"npi":[1518696996]}]}]},{"tin":{"type":"ein","value":"205268843"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":7550.40,"providers":[{"billed_charge":7550.40,"npi":[1336726942]}]},{"allowed_amount":3738.90,"providers":[{"billed_charge":3738.90,"npi":[1881262806]}]}]}]},{"name":"GRP ADAPT BHV TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97154","description":"GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"851129860"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":521.30,"providers":[{"billed_charge":8415.00,"npi":[1629692595]}]}]}]},{"name":"ADAPT BEHAVIOR TX PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97155","description":"ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"822271906"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":227.93,"providers":[{"billed_charge":500.00,"npi":[1104617679]}]}]},{"tin":{"type":"ein","value":"842724688"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":136.40,"providers":[{"billed_charge":300.00,"npi":[1215518121]}]},{"allowed_amount":1659.48,"providers":[{"billed_charge":3650.00,"npi":[1134612435]}]}]},{"tin":{"type":"ein","value":"825484002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":811.15,"providers":[{"billed_charge":1138.83,"npi":[1841968138]}]},{"allowed_amount":2500.84,"providers":[{"billed_charge":3554.53,"npi":[1437032547]}]}]},{"tin":{"type":"ein","value":"824428105"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1253.63,"providers":[{"billed_charge":9562.50,"npi":[1801201397]}]}]},{"tin":{"type":"ein","value":"883405344"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3060.98,"providers":[{"billed_charge":8233.48,"npi":[1033568027]}]}]},{"tin":{"type":"ein","value":"861542155"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1670.34,"providers":[{"billed_charge":12025.00,"npi":[1255942108]}]}]}]},{"name":"PT EVAL LOW COMPLEX 20 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97161","description":"PHYSICAL THERAPY EVALUATION: LOW COMPLEXITY, REQUIRING THESE COMPONENTS: A HISTORY WITH NO PERSONAL ","allowed_amounts":[{"tin":{"type":"ein","value":"204965849"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":593.04,"providers":[{"billed_charge":1160.00,"npi":[1871329656]}]}]},{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":147.20,"providers":[{"billed_charge":528.00,"npi":[1780455675]}]}]}]},{"name":"THERAPEUTIC ACTIVITIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97530","description":"THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FU","allowed_amounts":[{"tin":{"type":"ein","value":"200174459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3111.89,"providers":[{"billed_charge":4720.00,"npi":[1538980917]}]}]},{"tin":{"type":"ein","value":"581443056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1476.20,"providers":[{"billed_charge":5457.00,"npi":[1134899917]}]}]},{"tin":{"type":"ein","value":"933980945"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":383.04,"providers":[{"billed_charge":2250.00,"npi":[1659897791]}]}]},{"tin":{"type":"ein","value":"811271493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1314.69,"providers":[{"billed_charge":2880.00,"npi":[1831725605]}]}]},{"tin":{"type":"ein","value":"204965849"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":434.14,"providers":[{"billed_charge":1122.00,"npi":[1871329656]}]}]},{"tin":{"type":"ein","value":"43596339"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1779.02,"providers":[{"billed_charge":4400.00,"npi":[1063301307]}]}]},{"tin":{"type":"ein","value":"582537447"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2607.02,"providers":[{"billed_charge":8827.00,"npi":[1932653813]}]}]},{"tin":{"type":"ein","value":"800954871"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2155.43,"providers":[{"billed_charge":2325.00,"npi":[1164182333]}]}]},{"tin":{"type":"ein","value":"621488455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3306.32,"providers":[{"billed_charge":8934.96,"npi":[1710999099]}]},{"allowed_amount":361.77,"providers":[{"billed_charge":984.36,"npi":[1447078670]}]},{"allowed_amount":1266.74,"providers":[{"billed_charge":3558.84,"npi":[1407731433]}]}]},{"tin":{"type":"ein","value":"270039366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2031.16,"providers":[{"billed_charge":7811.00,"npi":[1083193627]}]},{"allowed_amount":810.99,"providers":[{"billed_charge":3210.00,"npi":[1306509310]}]}]},{"tin":{"type":"ein","value":"582443991"},"service_code":["11","12"],"billing_class":"professional","payments":[{"allowed_amount":110.69,"providers":[{"billed_charge":220.00,"npi":[1194477752]}]},{"allowed_amount":188.91,"providers":[{"billed_charge":385.00,"npi":[1134008063]}]},{"allowed_amount":166.20,"providers":[{"billed_charge":330.00,"npi":[1134008063]}]}]},{"tin":{"type":"ein","value":"800090215"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":859.11,"providers":[{"billed_charge":2686.00,"npi":[1720552300]}]}]},{"tin":{"type":"ein","value":"582529505"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":49.10,"providers":[{"billed_charge":130.00,"npi":[1689612814]}]},{"allowed_amount":493.58,"providers":[{"billed_charge":1300.00,"npi":[1285270314]}]},{"allowed_amount":297.19,"providers":[{"billed_charge":780.00,"npi":[1891162244]}]},{"allowed_amount":170.56,"providers":[{"billed_charge":455.00,"npi":[1033837299]}]}]},{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1071.13,"providers":[{"billed_charge":3906.00,"npi":[1780455675]}]},{"allowed_amount":3405.72,"providers":[{"billed_charge":12834.00,"npi":[1144399494]}]},{"allowed_amount":480.32,"providers":[{"billed_charge":1767.00,"npi":[1407684236]}]},{"allowed_amount":773.18,"providers":[{"billed_charge":2883.00,"npi":[1942337159]}]},{"allowed_amount":1056.37,"providers":[{"billed_charge":3906.00,"npi":[1730999582]}]},{"allowed_amount":3955.14,"providers":[{"billed_charge":14880.00,"npi":[1518651116]}]},{"allowed_amount":2757.68,"providers":[{"billed_charge":10137.00,"npi":[1851029268]}]}]},{"tin":{"type":"ein","value":"582444186"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":830.31,"providers":[{"billed_charge":1989.00,"npi":[1619045770]}]}]}]},{"name":"SELF CARE MNGMENT TRAINING","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97535","description":"SELF-CARE/HOME MANAGEMENT TRAINING (EG, ACTIVITIES OF DAILY LIVING (ADL) AND COMPENSATORY TRAINING, ","allowed_amounts":[{"tin":{"type":"ein","value":"883148972"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":64.62,"providers":[{"billed_charge":258.00,"npi":[1780455675]}]}]}]},{"name":"RMVL DEVITAL TIS 20 CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97597","description":"DEBRIDEMENT (EG, HIGH PRESSURE WATERJET W/WOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT W SCISSORS, SCAL","allowed_amounts":[{"tin":{"type":"ein","value":"992834576"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":399.60,"providers":[{"billed_charge":2661.12,"npi":[1356865489]}]}]}]},{"name":"Under Established Patient","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98005","description":"Under Established Patient","allowed_amounts":[{"tin":{"type":"ein","value":"581973570"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2823.50,"providers":[{"billed_charge":5647.00,"npi":[1063687747]}]},{"allowed_amount":3976.00,"providers":[{"billed_charge":7952.00,"npi":[1235158866]}]},{"allowed_amount":120.50,"providers":[{"billed_charge":241.00,"npi":[1063687747]}]}]}]},{"name":"Under Established Patient","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98006","description":"Under Established Patient","allowed_amounts":[{"tin":{"type":"ein","value":"262037695"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":107.14,"providers":[{"billed_charge":271.00,"npi":[1679573141]}]},{"allowed_amount":99.74,"providers":[{"billed_charge":271.00,"npi":[1679573141]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98941","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"271845035"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1028.92,"providers":[{"billed_charge":1820.00,"npi":[1952406100]}]}]},{"tin":{"type":"ein","value":"582068734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1115.04,"providers":[{"billed_charge":1485.00,"npi":[1265656003]}]},{"allowed_amount":1864.28,"providers":[{"billed_charge":4400.00,"npi":[1174005284]}]}]}]},{"name":"CHIROPRACTIC MANJ 5 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98942","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"461588158"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":238.50,"providers":[{"billed_charge":467.00,"npi":[1396766879]}]}]}]},{"name":"CHIROPRACT MANJ XTRSPINL 1/>","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98943","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); EXTRASPINAL, 1 OR MORE REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"461588158"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":551.31,"providers":[{"billed_charge":1380.00,"npi":[1396766879]}]}]}]},{"name":"MED SERV EVE/WKEND/HOLIDAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99051","description":"SERVICE(S) PROVIDED IN THE OFFICE DURING REGULARLY SCHEDULED EVENING, WEEKEND, OR HOLIDAY OFFICE HOU","allowed_amounts":[{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":358.80,"providers":[{"billed_charge":897.00,"npi":[1093391997]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99202","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":204.00,"providers":[{"billed_charge":584.00,"npi":[1234567893]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99203","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":766.57,"providers":[{"billed_charge":1750.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"582476390"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":134.63,"providers":[{"billed_charge":330.00,"npi":[1972584977]}]}]},{"tin":{"type":"ein","value":"832867658"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3767.68,"providers":[{"billed_charge":5490.69,"npi":[1861909251]}]},{"allowed_amount":1029.95,"providers":[{"billed_charge":1525.26,"npi":[1962277905]}]},{"allowed_amount":294.90,"providers":[{"billed_charge":415.98,"npi":[1861909251]}]},{"allowed_amount":708.64,"providers":[{"billed_charge":930.38,"npi":[1073180774]}]},{"allowed_amount":911.11,"providers":[{"billed_charge":1386.60,"npi":[1598395592]}]},{"allowed_amount":206.87,"providers":[{"billed_charge":277.32,"npi":[1861909251]}]},{"allowed_amount":88.03,"providers":[{"billed_charge":133.55,"npi":[1962277905]},{"billed_charge":138.66,"npi":[1962277905]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1448.92,"providers":[{"billed_charge":2492.00,"npi":[1164166922]}]}]},{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10546.65,"providers":[{"billed_charge":13832.00,"npi":[1558327072]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":793.95,"providers":[{"billed_charge":1645.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"465736753"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":95.41,"providers":[{"billed_charge":180.00,"npi":[1538132857]}]}]},{"tin":{"type":"ein","value":"811319493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":406.64,"providers":[{"billed_charge":634.00,"npi":[1861654840]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1295.98,"providers":[{"billed_charge":1911.00,"npi":[1841697539]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":2097.27,"providers":[{"billed_charge":5700.00,"npi":[1811874696]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":4631.11,"providers":[{"billed_charge":10738.56,"npi":[1235411547]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"581812376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":651.90,"providers":[{"billed_charge":1616.00,"npi":[1124136452]}]}]},{"tin":{"type":"ein","value":"581380450"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":968.79,"providers":[{"billed_charge":1080.00,"npi":[1144203779]}]}]},{"tin":{"type":"ein","value":"582207881"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6175.50,"providers":[{"billed_charge":8360.00,"npi":[1598293326]}]}]},{"tin":{"type":"ein","value":"582471834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7315.13,"providers":[{"billed_charge":11375.00,"npi":[1043203011]}]}]},{"tin":{"type":"ein","value":"990909070"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8052.50,"providers":[{"billed_charge":19257.00,"npi":[1285971796]}]},{"allowed_amount":3469.47,"providers":[{"billed_charge":8253.00,"npi":[1861125312]}]},{"allowed_amount":4583.03,"providers":[{"billed_charge":11004.00,"npi":[1538557061]}]},{"allowed_amount":1358.50,"providers":[{"billed_charge":3144.00,"npi":[1689209819]}]},{"allowed_amount":1764.19,"providers":[{"billed_charge":4323.00,"npi":[1801517446]}]}]},{"tin":{"type":"ein","value":"43800503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1897.71,"providers":[{"billed_charge":4379.28,"npi":[1558698423]}]}]},{"tin":{"type":"ein","value":"455266876"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4712.11,"providers":[{"billed_charge":9630.40,"npi":[1992787428]}]}]},{"tin":{"type":"ein","value":"453694469"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1795.50,"providers":[{"billed_charge":5916.00,"npi":[1083303226]}]}]},{"tin":{"type":"ein","value":"811319493"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2214.14,"providers":[{"billed_charge":3388.00,"npi":[1194715813]}]},{"allowed_amount":2478.31,"providers":[{"billed_charge":3872.00,"npi":[1598052094]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3636.00,"providers":[{"billed_charge":5100.00,"npi":[1700906427]}]},{"allowed_amount":2602.24,"providers":[{"billed_charge":3588.00,"npi":[1255562567]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2773.87,"providers":[{"billed_charge":6626.09,"npi":[1235411547]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99205","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"581812376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4069.33,"providers":[{"billed_charge":10138.40,"npi":[1124136452]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99211","description":"OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, THAT M","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["17","10"],"billing_class":"professional","payments":[{"allowed_amount":18.68,"providers":[{"billed_charge":70.56,"npi":[1234567893]}]},{"allowed_amount":750.00,"providers":[{"billed_charge":750.00,"npi":[1234567893]}]}]}]},{"name":"OFFICE OR OTH OUTPATIENT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99212","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"954112121"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":104.01,"providers":[{"billed_charge":330.12,"npi":[1548260508]}]},{"allowed_amount":148.77,"providers":[{"billed_charge":495.18,"npi":[1548260508]}]},{"allowed_amount":174.02,"providers":[{"billed_charge":495.18,"npi":[1780695809]}]},{"allowed_amount":429.06,"providers":[{"billed_charge":1320.48,"npi":[1548260508]}]}]},{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":252.80,"providers":[{"billed_charge":278.98,"npi":[1093789075]}]}]},{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":636.91,"providers":[{"billed_charge":1593.00,"npi":[1124064316]}]},{"allowed_amount":102.30,"providers":[{"billed_charge":177.00,"npi":[1932131281]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":495.90,"providers":[{"billed_charge":990.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"582056996"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":534.24,"providers":[{"billed_charge":950.00,"npi":[1407960289]}]}]},{"tin":{"type":"ein","value":"582109771"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":669.59,"providers":[{"billed_charge":4960.00,"npi":[1558147553]}]},{"allowed_amount":95.19,"providers":[{"billed_charge":480.00,"npi":[1558147553]}]},{"allowed_amount":746.19,"providers":[{"billed_charge":5600.00,"npi":[1750197406]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":220.00,"providers":[{"billed_charge":220.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"582112427"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":1281.99,"providers":[{"billed_charge":1350.00,"npi":[1942270558]}]},{"allowed_amount":478.71,"providers":[{"billed_charge":990.00,"npi":[1942270558]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2486.82,"providers":[{"billed_charge":6006.00,"npi":[1710357926,1427419209]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"462494632"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":766.71,"providers":[{"billed_charge":1960.00,"npi":[1770601734]}]}]},{"tin":{"type":"ein","value":"582056996"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":343.25,"providers":[{"billed_charge":500.00,"npi":[1821102617]}]},{"allowed_amount":440.00,"providers":[{"billed_charge":625.00,"npi":[1407960289]}]}]},{"tin":{"type":"ein","value":"582109771"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":849.15,"providers":[{"billed_charge":5460.00,"npi":[1750197406]}]},{"allowed_amount":171.66,"providers":[{"billed_charge":1040.00,"npi":[1932908969]}]}]},{"tin":{"type":"ein","value":"760717890"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4908.60,"providers":[{"billed_charge":9936.00,"npi":[1013094184]}]}]},{"tin":{"type":"ein","value":"582476390"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1456.37,"providers":[{"billed_charge":3510.00,"npi":[1972584977]}]}]},{"tin":{"type":"ein","value":"582640568"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":10803.60,"providers":[{"billed_charge":19441.65,"npi":[1306860101]}]},{"allowed_amount":944.84,"providers":[{"billed_charge":1720.50,"npi":[1306860101]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":9668.31,"providers":[{"billed_charge":16020.00,"npi":[1073612115]}]},{"allowed_amount":2436.44,"providers":[{"billed_charge":4272.00,"npi":[1295806495]}]},{"allowed_amount":982.94,"providers":[{"billed_charge":1602.00,"npi":[1194953638]}]},{"allowed_amount":1952.70,"providers":[{"billed_charge":3204.00,"npi":[1164166922]}]},{"allowed_amount":828.40,"providers":[{"billed_charge":1335.00,"npi":[1073612115]}]},{"allowed_amount":10443.03,"providers":[{"billed_charge":16821.00,"npi":[1194953638]}]},{"allowed_amount":156.42,"providers":[{"billed_charge":267.00,"npi":[1295806495]}]},{"allowed_amount":165.68,"providers":[{"billed_charge":267.00,"npi":[1821374380]}]},{"allowed_amount":18543.24,"providers":[{"billed_charge":28836.00,"npi":[1164166922]}]}]},{"tin":{"type":"ein","value":"331166863"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4162.14,"providers":[{"billed_charge":8322.00,"npi":[1790707925]}]}]},{"tin":{"type":"ein","value":"582108521"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":76.93,"providers":[{"billed_charge":143.79,"npi":[1487138590]}]},{"allowed_amount":2576.93,"providers":[{"billed_charge":3541.63,"npi":[1487138590]}]}]},{"tin":{"type":"ein","value":"800863895"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1222.64,"providers":[{"billed_charge":1929.26,"npi":[1508997362]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1251.14,"providers":[{"billed_charge":2541.00,"npi":[1922198407]}]},{"allowed_amount":1706.10,"providers":[{"billed_charge":3578.00,"npi":[1598179228]}]},{"allowed_amount":1489.77,"providers":[{"billed_charge":3013.00,"npi":[1811330707]}]},{"allowed_amount":1137.40,"providers":[{"billed_charge":2310.00,"npi":[1699894873]}]},{"allowed_amount":96.68,"providers":[{"billed_charge":231.00,"npi":[1518371129]}]},{"allowed_amount":1256.84,"providers":[{"billed_charge":3003.00,"npi":[1821874132]}]}]},{"tin":{"type":"ein","value":"581812376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2824.75,"providers":[{"billed_charge":7100.00,"npi":[1124136452]}]}]},{"tin":{"type":"ein","value":"586004640"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":89.52,"providers":[{"billed_charge":252.75,"npi":[1619758083]}]},{"allowed_amount":323.75,"providers":[{"billed_charge":758.25,"npi":[1346249109]}]},{"allowed_amount":1342.80,"providers":[{"billed_charge":3791.25,"npi":[1619758083]}]},{"allowed_amount":526.55,"providers":[{"billed_charge":1263.75,"npi":[1346249109]}]}]},{"tin":{"type":"ein","value":"586010601"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":746.04,"providers":[{"billed_charge":784.00,"npi":[1639770027]}]}]},{"tin":{"type":"ein","value":"465168203"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":343.25,"providers":[{"billed_charge":700.00,"npi":[1629341862]}]}]},{"tin":{"type":"ein","value":"204700877"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2571.98,"providers":[{"billed_charge":4264.62,"npi":[1902463284]}]},{"allowed_amount":4977.16,"providers":[{"billed_charge":8278.38,"npi":[1396279030]}]},{"allowed_amount":150.66,"providers":[{"billed_charge":250.86,"npi":[1215222567]}]},{"allowed_amount":2875.99,"providers":[{"billed_charge":4766.34,"npi":[1659738995]}]},{"allowed_amount":1818.68,"providers":[{"billed_charge":3010.32,"npi":[1821610270]}]}]},{"tin":{"type":"ein","value":"43800503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2624.75,"providers":[{"billed_charge":6057.00,"npi":[1558698423]}]}]},{"tin":{"type":"ein","value":"453694469"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":853.40,"providers":[{"billed_charge":2948.00,"npi":[1083303226]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":51.00,"providers":[{"billed_charge":182.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"582112427"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":223.40,"providers":[{"billed_charge":300.00,"npi":[1942270558]}]},{"allowed_amount":721.50,"providers":[{"billed_charge":900.00,"npi":[1942270558]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":1054.87,"providers":[{"billed_charge":1930.00,"npi":[1629856075]}]},{"allowed_amount":1632.83,"providers":[{"billed_charge":1806.00,"npi":[1700906427]}]},{"allowed_amount":1915.71,"providers":[{"billed_charge":2581.00,"npi":[1033890405]}]}]},{"tin":{"type":"ein","value":"582139333"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.60,"providers":[{"billed_charge":183.00,"npi":[1407052160]}]}]},{"tin":{"type":"ein","value":"620863368"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1706.10,"providers":[{"billed_charge":2805.00,"npi":[1831355833]}]}]},{"tin":{"type":"ein","value":"201020949"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":969.00,"providers":[{"billed_charge":3458.00,"npi":[1598883233]}]},{"allowed_amount":51.00,"providers":[{"billed_charge":182.00,"npi":[1598883233]}]},{"allowed_amount":459.00,"providers":[{"billed_charge":1638.00,"npi":[1669883146]}]}]},{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":4028.13,"providers":[{"billed_charge":12150.00,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":429.68,"providers":[{"billed_charge":880.00,"npi":[1669016747]}]}]},{"tin":{"type":"ein","value":"582477056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1884.15,"providers":[{"billed_charge":2030.00,"npi":[1821037433]}]},{"allowed_amount":1750.04,"providers":[{"billed_charge":2220.00,"npi":[1053383406]}]}]},{"tin":{"type":"ein","value":"582109306"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":44.76,"providers":[{"billed_charge":82.58,"npi":[1275577520]}]},{"allowed_amount":106.22,"providers":[{"billed_charge":165.16,"npi":[1427561752]}]}]},{"tin":{"type":"ein","value":"581327528"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.30,"providers":[{"billed_charge":217.00,"npi":[1346716412]}]}]},{"tin":{"type":"ein","value":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3576.28,"providers":[{"billed_charge":4560.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"582147112"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3056.60,"providers":[{"billed_charge":3713.98,"npi":[1407218613]},{"billed_charge":3656.77,"npi":[1982866976]}]},{"allowed_amount":3667.92,"providers":[{"billed_charge":4403.38,"npi":[1285153684]}]},{"allowed_amount":2139.62,"providers":[{"billed_charge":2584.53,"npi":[1912169079]}]}]},{"tin":{"type":"ein","value":"471461454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1600.75,"providers":[{"billed_charge":3173.00,"npi":[1760708580]}]}]},{"tin":{"type":"ein","value":"30417049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5896.82,"providers":[{"billed_charge":10395.00,"npi":[1225846173]}]}]},{"tin":{"type":"ein","value":"453766969"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":483.46,"providers":[{"billed_charge":1000.00,"npi":[1053536177]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":11775.40,"providers":[{"billed_charge":24388.00,"npi":[1093391997]}]},{"allowed_amount":776.40,"providers":[{"billed_charge":1608.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":315.93,"providers":[{"billed_charge":549.00,"npi":[1295969228]}]},{"allowed_amount":1068.74,"providers":[{"billed_charge":1830.00,"npi":[1912167578]}]},{"allowed_amount":13445.27,"providers":[{"billed_charge":22875.00,"npi":[1790281723]}]},{"allowed_amount":113.13,"providers":[{"billed_charge":183.00,"npi":[1295969228]}]}]},{"tin":{"type":"ein","value":"582489235"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2895.75,"providers":[{"billed_charge":4896.00,"npi":[1144384827]}]}]},{"tin":{"type":"ein","value":"472597330"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":294.49,"providers":[{"billed_charge":598.08,"npi":[1164543344]}]}]},{"tin":{"type":"ein","value":"455272847"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":90.50,"providers":[{"billed_charge":179.00,"npi":[1063595973]}]},{"allowed_amount":7708.25,"providers":[{"billed_charge":15790.20,"npi":[1063595973]}]}]},{"tin":{"type":"ein","value":"581534607"},"service_code":["22","11","19"],"billing_class":"professional","payments":[{"allowed_amount":363.81,"providers":[{"billed_charge":910.00,"npi":[1336562727]}]},{"allowed_amount":52.67,"providers":[{"billed_charge":130.00,"npi":[1336562727]}]},{"allowed_amount":659.90,"providers":[{"billed_charge":1170.00,"npi":[1336562727]}]}]},{"tin":{"type":"ein","value":"581380450"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1320.20,"providers":[{"billed_charge":1800.00,"npi":[1144203779]}]},{"allowed_amount":6453.22,"providers":[{"billed_charge":8880.00,"npi":[1417907973]}]}]},{"tin":{"type":"ein","value":"582471834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1448.25,"providers":[{"billed_charge":2405.00,"npi":[1043203011]}]}]},{"tin":{"type":"ein","value":"30572112"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5373.55,"providers":[{"billed_charge":8820.00,"npi":[1215934898]}]}]},{"tin":{"type":"ein","value":"581974299"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1110.00,"providers":[{"billed_charge":1580.00,"npi":[1215472360]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":505.50,"providers":[{"billed_charge":960.00,"npi":[1225021678]}]},{"allowed_amount":22985.25,"providers":[{"billed_charge":42880.00,"npi":[1225021678]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3508.50,"providers":[{"billed_charge":4500.00,"npi":[1447847298]}]}]},{"tin":{"type":"ein","value":"463285783"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2158.76,"providers":[{"billed_charge":2720.00,"npi":[1770909236]}]}]},{"tin":{"type":"ein","value":"300780743"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6648.10,"providers":[{"billed_charge":15330.00,"npi":[1780092684]}]}]},{"tin":{"type":"ein","value":"582545719"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":921.07,"providers":[{"billed_charge":1160.00,"npi":[1063515815]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7585.40,"providers":[{"billed_charge":25500.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"821785874"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1314.36,"providers":[{"billed_charge":3469.00,"npi":[1861487225]}]}]},{"tin":{"type":"ein","value":"582577387"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":25198.34,"providers":[{"billed_charge":29445.00,"npi":[1558327072]}]}]},{"tin":{"type":"ein","value":"475403568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3484.66,"providers":[{"billed_charge":5880.00,"npi":[1215950944]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":880.60,"providers":[{"billed_charge":3166.00,"npi":[1073175923]}]},{"allowed_amount":8072.57,"providers":[{"billed_charge":31191.00,"npi":[1851010466]}]},{"allowed_amount":744.80,"providers":[{"billed_charge":2248.00,"npi":[1194007971]}]}]},{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":138.86,"providers":[{"billed_charge":396.00,"npi":[1982358065]}]},{"allowed_amount":8653.77,"providers":[{"billed_charge":19998.00,"npi":[1811874696]}]}]},{"tin":{"type":"ein","value":"830350178"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5246.35,"providers":[{"billed_charge":6975.00,"npi":[1033229661]}]},{"allowed_amount":7702.93,"providers":[{"billed_charge":10137.00,"npi":[1033229661]}]}]},{"tin":{"type":"ein","value":"581906891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1363.96,"providers":[{"billed_charge":1620.00,"npi":[1174605372]}]}]},{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":6519.30,"providers":[{"billed_charge":7917.00,"npi":[1932131281]}]},{"allowed_amount":8274.51,"providers":[{"billed_charge":12180.00,"npi":[1124064316]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":369.88,"providers":[{"billed_charge":440.00,"npi":[1003834557]}]},{"allowed_amount":739.76,"providers":[{"billed_charge":880.00,"npi":[1568091197]}]},{"allowed_amount":3594.84,"providers":[{"billed_charge":4620.00,"npi":[1881889277]}]},{"allowed_amount":2416.92,"providers":[{"billed_charge":5940.00,"npi":[1235411547]}]},{"allowed_amount":1946.11,"providers":[{"billed_charge":2420.00,"npi":[1770570236]}]}]},{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1174.90,"providers":[{"billed_charge":3789.00,"npi":[1366430233]}]},{"allowed_amount":3379.58,"providers":[{"billed_charge":10946.00,"npi":[1144218157]}]}]},{"tin":{"type":"ein","value":"452621912"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8965.42,"providers":[{"billed_charge":15140.00,"npi":[1770731713]}]}]},{"tin":{"type":"ein","value":"581413278"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":1458.80,"providers":[{"billed_charge":2840.00,"npi":[1366400095]}]}]},{"tin":{"type":"ein","value":"954112121"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":751.56,"providers":[{"billed_charge":2397.06,"npi":[1780695809]}]},{"allowed_amount":1791.37,"providers":[{"billed_charge":5593.14,"npi":[1548260508]}]},{"allowed_amount":174.08,"providers":[{"billed_charge":532.68,"npi":[1487752911]}]},{"allowed_amount":2443.76,"providers":[{"billed_charge":7723.86,"npi":[1548260508]}]},{"allowed_amount":349.49,"providers":[{"billed_charge":1065.36,"npi":[1548260508]}]},{"allowed_amount":5266.18,"providers":[{"billed_charge":16513.08,"npi":[1780695809]}]}]},{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1517.08,"providers":[{"billed_charge":3825.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4351.24,"providers":[{"billed_charge":4619.72,"npi":[1598051724]}]}]},{"tin":{"type":"ein","value":"822647012"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":126.38,"providers":[{"billed_charge":261.00,"npi":[1275160210]}]}]},{"tin":{"type":"ein","value":"205870972"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":14477.13,"providers":[{"billed_charge":29946.00,"npi":[1285325282]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":26500.00,"providers":[{"billed_charge":26500.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"832867658"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1261.67,"providers":[{"billed_charge":1843.26,"npi":[1962277905]}]},{"allowed_amount":71.61,"providers":[{"billed_charge":112.66,"npi":[1962277905,1861909251]}]},{"allowed_amount":837.85,"providers":[{"billed_charge":1230.78,"npi":[1861909251]}]}]},{"tin":{"type":"ein","value":"465736753"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10888.31,"providers":[{"billed_charge":22200.00,"npi":[1144887472]}]},{"allowed_amount":1320.00,"providers":[{"billed_charge":2250.00,"npi":[1801004155]}]},{"allowed_amount":8339.68,"providers":[{"billed_charge":17100.00,"npi":[1053860361]}]},{"allowed_amount":3185.08,"providers":[{"billed_charge":6450.00,"npi":[1255381950]}]},{"allowed_amount":6021.53,"providers":[{"billed_charge":12300.00,"npi":[1679319875]}]},{"allowed_amount":6779.98,"providers":[{"billed_charge":13950.00,"npi":[1750179412]}]},{"allowed_amount":3713.84,"providers":[{"billed_charge":7650.00,"npi":[1548016645]}]},{"allowed_amount":3938.55,"providers":[{"billed_charge":8250.00,"npi":[1346064177]}]},{"allowed_amount":4927.08,"providers":[{"billed_charge":10050.00,"npi":[1538132857]}]}]},{"tin":{"type":"ein","value":"581485988"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8904.26,"providers":[{"billed_charge":13000.00,"npi":[1497724447]}]}]},{"tin":{"type":"ein","value":"581298104"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":728.86,"providers":[{"billed_charge":1200.00,"npi":[1952395550]}]},{"allowed_amount":178.48,"providers":[{"billed_charge":300.00,"npi":[1952395550]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99214","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"800760739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1944.45,"providers":[{"billed_charge":2900.00,"npi":[1760588743]}]}]},{"tin":{"type":"ein","value":"883706617"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2727.44,"providers":[{"billed_charge":13193.28,"npi":[1427398007]}]}]},{"tin":{"type":"ein","value":"462494632"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4176.09,"providers":[{"billed_charge":10746.00,"npi":[1770601734]}]}]},{"tin":{"type":"ein","value":"270339151"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":220.90,"providers":[{"billed_charge":250.00,"npi":[1891738118]}]}]},{"tin":{"type":"ein","value":"263792403"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":176.98,"providers":[{"billed_charge":182.00,"npi":[1568715340]}]}]},{"tin":{"type":"ein","value":"760717890"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":401.25,"providers":[{"billed_charge":783.00,"npi":[1013094184]}]}]},{"tin":{"type":"ein","value":"581643029"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4655.22,"providers":[{"billed_charge":10200.00,"npi":[1619039476]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":184.42,"providers":[{"billed_charge":375.00,"npi":[1295806495]}]},{"allowed_amount":11176.49,"providers":[{"billed_charge":18000.00,"npi":[1164166922]}]},{"allowed_amount":2099.16,"providers":[{"billed_charge":3375.00,"npi":[1073612115]}]},{"allowed_amount":8536.94,"providers":[{"billed_charge":14625.00,"npi":[1194953638]}]},{"allowed_amount":15062.94,"providers":[{"billed_charge":25875.00,"npi":[1295806495]}]},{"allowed_amount":33678.00,"providers":[{"billed_charge":55875.00,"npi":[1073612115]}]}]},{"tin":{"type":"ein","value":"331166863"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10672.23,"providers":[{"billed_charge":22632.00,"npi":[1790707925]}]}]},{"tin":{"type":"ein","value":"586025016"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1755.01,"providers":[{"billed_charge":4037.00,"npi":[1417841982]}]}]},{"tin":{"type":"ein","value":"465633323"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":504.29,"providers":[{"billed_charge":843.00,"npi":[1699481713]}]}]},{"tin":{"type":"ein","value":"270904127"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":608.10,"providers":[{"billed_charge":1830.00,"npi":[1194507657]}]}]},{"tin":{"type":"ein","value":"863879162"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":196.08,"providers":[{"billed_charge":550.00,"npi":[1588985766]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":499.66,"providers":[{"billed_charge":992.00,"npi":[1457882342]}]},{"allowed_amount":803.10,"providers":[{"billed_charge":1630.00,"npi":[1922198407,1598179228]}]},{"allowed_amount":963.72,"providers":[{"billed_charge":1956.00,"npi":[1558948752]}]},{"allowed_amount":1774.89,"providers":[{"billed_charge":4238.00,"npi":[1861639809]}]},{"allowed_amount":682.65,"providers":[{"billed_charge":1630.00,"npi":[1922637354]}]}]},{"tin":{"type":"ein","value":"581812376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":982.77,"providers":[{"billed_charge":2476.80,"npi":[1124136452]}]}]},{"tin":{"type":"ein","value":"586004640"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":895.89,"providers":[{"billed_charge":2498.58,"npi":[1619758083]}]},{"allowed_amount":126.42,"providers":[{"billed_charge":356.94,"npi":[1619758083]}]},{"allowed_amount":4164.44,"providers":[{"billed_charge":9994.32,"npi":[1346249109]}]},{"allowed_amount":1674.67,"providers":[{"billed_charge":3926.34,"npi":[1346249109]}]}]},{"tin":{"type":"ein","value":"208583725"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":502.52,"providers":[{"billed_charge":1192.00,"npi":[1578690467]}]}]},{"tin":{"type":"ein","value":"465168203"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1111.15,"providers":[{"billed_charge":2025.00,"npi":[1629341862]}]}]},{"tin":{"type":"ein","value":"832155896"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":251.26,"providers":[{"billed_charge":704.00,"npi":[1942258314]}]}]},{"tin":{"type":"ein","value":"811075201"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":520.85,"providers":[{"billed_charge":1040.00,"npi":[1588093587]}]}]},{"tin":{"type":"ein","value":"204700877"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":637.41,"providers":[{"billed_charge":1067.04,"npi":[1902463284]}]}]},{"tin":{"type":"ein","value":"43800503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5291.85,"providers":[{"billed_charge":12212.04,"npi":[1558698423]}]}]},{"tin":{"type":"ein","value":"453694469"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":747.53,"providers":[{"billed_charge":2639.00,"npi":[1083303226]}]},{"allowed_amount":1049.90,"providers":[{"billed_charge":3393.00,"npi":[1679336606]}]}]},{"tin":{"type":"ein","value":"582112427"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":10175.10,"providers":[{"billed_charge":15300.00,"npi":[1942270558]}]},{"allowed_amount":2526.57,"providers":[{"billed_charge":5100.00,"npi":[1942270558]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":8298.08,"providers":[{"billed_charge":9838.00,"npi":[1811429558]}]},{"allowed_amount":715.75,"providers":[{"billed_charge":1351.00,"npi":[1629856075]}]},{"allowed_amount":481.86,"providers":[{"billed_charge":582.00,"npi":[1871545921]}]},{"allowed_amount":508.49,"providers":[{"billed_charge":582.00,"npi":[1336143619]}]},{"allowed_amount":8327.17,"providers":[{"billed_charge":9859.00,"npi":[1700906427]}]},{"allowed_amount":3819.54,"providers":[{"billed_charge":4455.00,"npi":[1255562567]}]},{"allowed_amount":5916.68,"providers":[{"billed_charge":6977.00,"npi":[1649910712]}]},{"allowed_amount":369.63,"providers":[{"billed_charge":582.00,"npi":[1700906427]}]}]},{"tin":{"type":"ein","value":"473524701"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":1189.77,"providers":[{"billed_charge":2592.00,"npi":[1801783261]}]},{"allowed_amount":215.69,"providers":[{"billed_charge":432.00,"npi":[1629955638]}]},{"allowed_amount":826.47,"providers":[{"billed_charge":1728.00,"npi":[1669252656]}]},{"allowed_amount":419.10,"providers":[{"billed_charge":864.00,"npi":[1932093671]}]},{"allowed_amount":505.54,"providers":[{"billed_charge":1080.00,"npi":[1932093671]}]},{"allowed_amount":493.81,"providers":[{"billed_charge":1080.00,"npi":[1558194795]}]}]},{"tin":{"type":"ein","value":"626000101"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":643.05,"providers":[{"billed_charge":1145.00,"npi":[1780048785]}]}]},{"tin":{"type":"ein","value":"582190420"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":951.84,"providers":[{"billed_charge":1160.00,"npi":[1417178187]}]}]},{"tin":{"type":"ein","value":"900809664"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1319.10,"providers":[{"billed_charge":2900.00,"npi":[1952453615]}]}]},{"tin":{"type":"ein","value":"453767772"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":620.60,"providers":[{"billed_charge":680.00,"npi":[1467834499]}]}]},{"tin":{"type":"ein","value":"924026234"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1586.08,"providers":[{"billed_charge":3744.00,"npi":[1164006615]}]}]},{"tin":{"type":"ein","value":"453765471"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":1909.22,"providers":[{"billed_charge":4001.00,"npi":[1831776764]}]}]},{"tin":{"type":"ein","value":"581896468"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4905.76,"providers":[{"billed_charge":7420.34,"npi":[1598949547]}]}]},{"tin":{"type":"ein","value":"581973570"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2314.92,"providers":[{"billed_charge":4752.00,"npi":[1518726538]}]},{"allowed_amount":1213.60,"providers":[{"billed_charge":2488.00,"npi":[1669016747]}]}]},{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":19981.00,"providers":[{"billed_charge":52340.60,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"810760527"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2307.33,"providers":[{"billed_charge":10285.60,"npi":[1073698999]}]}]},{"tin":{"type":"ein","value":"562444568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":734.50,"providers":[{"billed_charge":1032.00,"npi":[1346420494]}]}]},{"tin":{"type":"ein","value":"580903829"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":571.48,"providers":[{"billed_charge":1960.00,"npi":[1053095547]}]},{"allowed_amount":142.87,"providers":[{"billed_charge":490.00,"npi":[1053095547]}]}]},{"tin":{"type":"ein","value":"455266876"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2552.44,"providers":[{"billed_charge":5021.64,"npi":[1992787428]}]}]},{"tin":{"type":"ein","value":"922245588"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":642.48,"providers":[{"billed_charge":972.00,"npi":[1730288424]}]}]},{"tin":{"type":"ein","value":"586002491"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":618.68,"providers":[{"billed_charge":1215.32,"npi":[1801025424]}]}]},{"tin":{"type":"ein","value":"582477056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":725.45,"providers":[{"billed_charge":925.00,"npi":[1053383406]}]}]},{"tin":{"type":"ein","value":"582109306"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":6498.69,"providers":[{"billed_charge":15540.01,"npi":[1275577520]}]},{"allowed_amount":247.52,"providers":[{"billed_charge":698.52,"npi":[1427561752]}]}]},{"tin":{"type":"ein","value":"582041471"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3620.11,"providers":[{"billed_charge":5000.00,"npi":[1598949166]}]}]},{"tin":{"type":"ein","value":"800058224"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1846.74,"providers":[{"billed_charge":2520.00,"npi":[1861486094]}]}]},{"tin":{"type":"ein","value":"870836466"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5435.42,"providers":[{"billed_charge":5684.00,"npi":[1033189469]}]}]},{"tin":{"type":"ein","value":"581322279"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":274.34,"providers":[{"billed_charge":350.00,"npi":[1881432714]}]}]},{"tin":{"type":"ein","value":"820709593"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":873.42,"providers":[{"billed_charge":2800.00,"npi":[1134703705]}]}]},{"tin":{"type":"ein","value":"471461454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7971.66,"providers":[{"billed_charge":16616.00,"npi":[1760708580]}]}]},{"tin":{"type":"ein","value":"263380986"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":9305.80,"providers":[{"billed_charge":12324.00,"npi":[1114936531]}]}]},{"tin":{"type":"ein","value":"30417049"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":1278.39,"providers":[{"billed_charge":1883.00,"npi":[1568910461]}]},{"allowed_amount":2368.73,"providers":[{"billed_charge":2959.00,"npi":[1346225919]}]},{"allowed_amount":895.17,"providers":[{"billed_charge":1345.00,"npi":[1336424522]}]},{"allowed_amount":6788.26,"providers":[{"billed_charge":8608.00,"npi":[1336132679]}]}]},{"tin":{"type":"ein","value":"453766969"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7460.21,"providers":[{"billed_charge":15750.00,"npi":[1053536177]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":364.32,"providers":[{"billed_charge":754.00,"npi":[1093391997]}]},{"allowed_amount":5100.48,"providers":[{"billed_charge":10556.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":6840.36,"providers":[{"billed_charge":11880.00,"npi":[1790281723]}]},{"allowed_amount":1700.43,"providers":[{"billed_charge":2970.00,"npi":[1770831588]}]},{"allowed_amount":4700.79,"providers":[{"billed_charge":8370.00,"npi":[1295969228]}]},{"allowed_amount":8238.21,"providers":[{"billed_charge":17010.00,"npi":[1194545632]}]},{"allowed_amount":3187.73,"providers":[{"billed_charge":5670.00,"npi":[1023670148]}]},{"allowed_amount":743.65,"providers":[{"billed_charge":1350.00,"npi":[1023670148]}]},{"allowed_amount":2618.57,"providers":[{"billed_charge":4590.00,"npi":[1578145983]}]},{"allowed_amount":2444.08,"providers":[{"billed_charge":4320.00,"npi":[1912167578]}]},{"allowed_amount":310.34,"providers":[{"billed_charge":540.00,"npi":[1558342071,1023670148]}]}]},{"tin":{"type":"ein","value":"271428070"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":285.56,"providers":[{"billed_charge":490.00,"npi":[1295387751]}]},{"allowed_amount":1820.40,"providers":[{"billed_charge":3675.00,"npi":[1174301386]}]},{"allowed_amount":121.36,"providers":[{"billed_charge":245.00,"npi":[1174301386]}]}]},{"tin":{"type":"ein","value":"582489235"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11581.47,"providers":[{"billed_charge":20140.00,"npi":[1144384827]}]}]},{"tin":{"type":"ein","value":"581874521"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1055.28,"providers":[{"billed_charge":2000.00,"npi":[1548258924]}]}]},{"tin":{"type":"ein","value":"581380450"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2346.83,"providers":[{"billed_charge":2850.00,"npi":[1144203779]}]},{"allowed_amount":385.11,"providers":[{"billed_charge":450.00,"npi":[1417907973]}]}]},{"tin":{"type":"ein","value":"582471834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3906.98,"providers":[{"billed_charge":6250.00,"npi":[1043203011]}]}]},{"tin":{"type":"ein","value":"581974299"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2037.88,"providers":[{"billed_charge":2860.00,"npi":[1215472360]}]}]},{"tin":{"type":"ein","value":"205778734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":154.67,"providers":[{"billed_charge":180.00,"npi":[1710418959]}]}]},{"tin":{"type":"ein","value":"992262156"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":7160.91,"providers":[{"billed_charge":16245.00,"npi":[1457400251]}]},{"allowed_amount":1130.67,"providers":[{"billed_charge":2565.00,"npi":[1457400251]}]}]},{"tin":{"type":"ein","value":"581719867"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":29949.00,"providers":[{"billed_charge":48840.00,"npi":[1669728697]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3046.67,"providers":[{"billed_charge":5875.00,"npi":[1225021678]}]}]},{"tin":{"type":"ein","value":"581973324"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":885.32,"providers":[{"billed_charge":1200.00,"npi":[1447847298]}]}]},{"tin":{"type":"ein","value":"463285783"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":375.88,"providers":[{"billed_charge":480.00,"npi":[1770909236]}]}]},{"tin":{"type":"ein","value":"582545719"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8404.80,"providers":[{"billed_charge":8580.00,"npi":[1063515815]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3643.27,"providers":[{"billed_charge":11600.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":3254.68,"providers":[{"billed_charge":7852.00,"npi":[1467005629]}]},{"allowed_amount":1262.23,"providers":[{"billed_charge":3020.00,"npi":[1467005629]}]},{"allowed_amount":4496.03,"providers":[{"billed_charge":10570.00,"npi":[1932521440]}]},{"allowed_amount":4256.12,"providers":[{"billed_charge":10268.00,"npi":[1619226834]}]},{"allowed_amount":3880.58,"providers":[{"billed_charge":9362.00,"npi":[1154742542]}]},{"allowed_amount":4882.02,"providers":[{"billed_charge":11778.00,"npi":[1255082814]}]},{"allowed_amount":2399.28,"providers":[{"billed_charge":5738.00,"npi":[1437408093]}]},{"allowed_amount":6738.82,"providers":[{"billed_charge":15704.00,"npi":[1619226834]}]},{"allowed_amount":625.90,"providers":[{"billed_charge":1510.00,"npi":[1013687920]}]},{"allowed_amount":876.26,"providers":[{"billed_charge":2114.00,"npi":[1477092856]}]},{"allowed_amount":2545.32,"providers":[{"billed_charge":6040.00,"npi":[1255082814]}]},{"allowed_amount":6467.62,"providers":[{"billed_charge":15402.00,"npi":[1427290071]}]},{"allowed_amount":7385.62,"providers":[{"billed_charge":17818.00,"npi":[1427290071]}]},{"allowed_amount":13769.80,"providers":[{"billed_charge":33220.00,"npi":[1912338633]}]},{"allowed_amount":5414.01,"providers":[{"billed_charge":12684.00,"npi":[1154742542]}]},{"allowed_amount":1877.70,"providers":[{"billed_charge":4530.00,"npi":[1437408093]}]},{"allowed_amount":751.08,"providers":[{"billed_charge":1812.00,"npi":[1780321182]}]},{"allowed_amount":500.72,"providers":[{"billed_charge":1208.00,"npi":[1629395033]}]},{"allowed_amount":771.94,"providers":[{"billed_charge":1812.00,"npi":[1780321182]}]},{"allowed_amount":4788.13,"providers":[{"billed_charge":11476.00,"npi":[1194388967]}]},{"allowed_amount":2128.06,"providers":[{"billed_charge":5134.00,"npi":[1275128613]}]},{"allowed_amount":2691.36,"providers":[{"billed_charge":6342.00,"npi":[1831816032]}]},{"allowed_amount":4756.84,"providers":[{"billed_charge":11476.00,"npi":[1932521440]}]},{"allowed_amount":1794.24,"providers":[{"billed_charge":4228.00,"npi":[1275128613]}]},{"allowed_amount":4130.94,"providers":[{"billed_charge":9966.00,"npi":[1831816032]}]},{"allowed_amount":3755.40,"providers":[{"billed_charge":9060.00,"npi":[1780076182]}]},{"allowed_amount":6717.98,"providers":[{"billed_charge":16006.00,"npi":[1912338633]}]},{"allowed_amount":761.51,"providers":[{"billed_charge":1812.00,"npi":[1477092856]}]},{"allowed_amount":10640.30,"providers":[{"billed_charge":25670.00,"npi":[1194388967]}]},{"allowed_amount":250.36,"providers":[{"billed_charge":604.00,"npi":[1336775550]}]},{"allowed_amount":375.54,"providers":[{"billed_charge":906.00,"npi":[1336775550,1629395033,1013687920]}]},{"allowed_amount":3108.62,"providers":[{"billed_charge":7248.00,"npi":[1780076182]}]}]},{"tin":{"type":"ein","value":"272020394"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2996.76,"providers":[{"billed_charge":3512.00,"npi":[1609051218]}]},{"allowed_amount":908.28,"providers":[{"billed_charge":1004.00,"npi":[1528239738]}]},{"allowed_amount":220.90,"providers":[{"billed_charge":251.00,"npi":[1528239738]}]}]},{"tin":{"type":"ein","value":"990909070"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1398.08,"providers":[{"billed_charge":3300.00,"npi":[1447536081]}]},{"allowed_amount":8842.36,"providers":[{"billed_charge":21000.00,"npi":[1538557061]}]},{"allowed_amount":6468.52,"providers":[{"billed_charge":15600.00,"npi":[1285971796]}]},{"allowed_amount":4811.56,"providers":[{"billed_charge":11400.00,"npi":[1487374005]}]},{"allowed_amount":1751.64,"providers":[{"billed_charge":4200.00,"npi":[1801517446]}]},{"allowed_amount":1002.44,"providers":[{"billed_charge":2400.00,"npi":[1841502978]}]},{"allowed_amount":2664.28,"providers":[{"billed_charge":6300.00,"npi":[1689209819]}]},{"allowed_amount":3170.76,"providers":[{"billed_charge":7500.00,"npi":[1861125312]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4444.28,"providers":[{"billed_charge":17157.00,"npi":[1073175923]}]},{"allowed_amount":2064.13,"providers":[{"billed_charge":7980.00,"npi":[1851010466]}]},{"allowed_amount":1766.11,"providers":[{"billed_charge":5187.00,"npi":[1194007971]}]},{"allowed_amount":3013.94,"providers":[{"billed_charge":9975.00,"npi":[1184964025]}]}]},{"tin":{"type":"ein","value":"811319493"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2691.27,"providers":[{"billed_charge":3768.00,"npi":[1598052094]}]},{"allowed_amount":233.24,"providers":[{"billed_charge":314.00,"npi":[1518971944,1598052094]}]}]},{"tin":{"type":"ein","value":"830350178"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":186.02,"providers":[{"billed_charge":260.00,"npi":[1033229661]}]},{"allowed_amount":279.03,"providers":[{"billed_charge":390.00,"npi":[1033229661]}]}]},{"tin":{"type":"ein","value":"844000208"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":312.84,"providers":[{"billed_charge":1032.00,"npi":[1356984728]}]},{"allowed_amount":1362.05,"providers":[{"billed_charge":3870.00,"npi":[1396060174]}]},{"allowed_amount":383.60,"providers":[{"billed_charge":1290.00,"npi":[1356984728]}]}]},{"tin":{"type":"ein","value":"273211617"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":1049.08,"providers":[{"billed_charge":1890.00,"npi":[1487858650]}]},{"allowed_amount":1749.80,"providers":[{"billed_charge":3150.00,"npi":[1487858650]}]}]},{"tin":{"type":"ein","value":"814874949"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4207.72,"providers":[{"billed_charge":8651.00,"npi":[1871138685]}]}]},{"tin":{"type":"ein","value":"581233448"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":19501.04,"providers":[{"billed_charge":28179.00,"npi":[1124064316]}]}]},{"tin":{"type":"ein","value":"843707279"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3476.70,"providers":[{"billed_charge":6116.00,"npi":[1386698231]}]},{"allowed_amount":800.22,"providers":[{"billed_charge":1680.00,"npi":[1083071898]}]},{"allowed_amount":571.48,"providers":[{"billed_charge":1120.00,"npi":[1083071898]}]}]},{"tin":{"type":"ein","value":"465679478"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":7637.99,"providers":[{"billed_charge":13213.20,"npi":[1538843792]}]}]},{"tin":{"type":"ein","value":"821447166"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6810.68,"providers":[{"billed_charge":18112.32,"npi":[1336956564]}]}]},{"tin":{"type":"ein","value":"580949770"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":480.08,"providers":[{"billed_charge":490.00,"npi":[1558354506]}]}]},{"tin":{"type":"ein","value":"453191160"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1693.26,"providers":[{"billed_charge":2240.00,"npi":[1881889277]}]},{"allowed_amount":1663.08,"providers":[{"billed_charge":4160.00,"npi":[1235411547]}]}]},{"tin":{"type":"ein","value":"472413464"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":907.82,"providers":[{"billed_charge":2975.00,"npi":[1144218157]}]}]},{"tin":{"type":"ein","value":"300466706"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":620.68,"providers":[{"billed_charge":1112.00,"npi":[1942707591]}]}]},{"tin":{"type":"ein","value":"452621912"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9868.44,"providers":[{"billed_charge":17082.00,"npi":[1770731713]}]}]},{"tin":{"type":"ein","value":"273818647"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":141.15,"providers":[{"billed_charge":311.00,"npi":[1548074099]}]}]},{"tin":{"type":"ein","value":"954112121"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":226.12,"providers":[{"billed_charge":776.00,"npi":[1972761328]}]},{"allowed_amount":124.03,"providers":[{"billed_charge":388.00,"npi":[1548260508]}]},{"allowed_amount":11631.24,"providers":[{"billed_charge":37636.00,"npi":[1548260508]}]},{"allowed_amount":3879.10,"providers":[{"billed_charge":12416.00,"npi":[1972761328]}]},{"allowed_amount":1905.64,"providers":[{"billed_charge":6208.00,"npi":[1548260508]}]}]},{"tin":{"type":"ein","value":"581131002"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1005.04,"providers":[{"billed_charge":2200.00,"npi":[1144041062]}]}]},{"tin":{"type":"ein","value":"586000373"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":503.52,"providers":[{"billed_charge":533.12,"npi":[1598051724]}]}]},{"tin":{"type":"ein","value":"582207881"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":4928.33,"providers":[{"billed_charge":5796.00,"npi":[1598293326]}]},{"allowed_amount":466.48,"providers":[{"billed_charge":552.00,"npi":[1598293326]}]}]},{"tin":{"type":"ein","value":"475546265"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1256.30,"providers":[{"billed_charge":3060.00,"npi":[1912944455]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15000.00,"providers":[{"billed_charge":15000.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"920249500"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":466.48,"providers":[{"billed_charge":1400.00,"npi":[1497928600]}]}]},{"tin":{"type":"ein","value":"832867658"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":439.92,"providers":[{"billed_charge":637.24,"npi":[1598395592]}]},{"allowed_amount":505.65,"providers":[{"billed_charge":796.55,"npi":[1861909251]}]}]},{"tin":{"type":"ein","value":"582175978"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7073.68,"providers":[{"billed_charge":16060.00,"npi":[1114107810]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99215","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"463285783"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1649.70,"providers":[{"billed_charge":2040.00,"npi":[1770909236]}]}]},{"tin":{"type":"ein","value":"582109771"},"service_code":["02","53"],"billing_class":"professional","payments":[{"allowed_amount":272.55,"providers":[{"billed_charge":1080.00,"npi":[1407219314]}]},{"allowed_amount":582.93,"providers":[{"billed_charge":1800.00,"npi":[1841675667]}]},{"allowed_amount":1861.93,"providers":[{"billed_charge":9080.00,"npi":[1932908969]}]},{"allowed_amount":83.48,"providers":[{"billed_charge":360.00,"npi":[1841675667]}]},{"allowed_amount":1323.22,"providers":[{"billed_charge":3960.00,"npi":[1407219314]}]},{"allowed_amount":262.09,"providers":[{"billed_charge":910.00,"npi":[1932908969]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":526.92,"providers":[{"billed_charge":1275.00,"npi":[1780076182,1932521440]}]}]},{"tin":{"type":"ein","value":"586002922"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":886.12,"providers":[{"billed_charge":2800.00,"npi":[1184964025]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":648.10,"providers":[{"billed_charge":1086.00,"npi":[1023670148]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99222","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":165.22,"providers":[{"billed_charge":281.00,"npi":[1245729631]}]},{"allowed_amount":330.44,"providers":[{"billed_charge":562.00,"npi":[1689092330]}]},{"allowed_amount":495.66,"providers":[{"billed_charge":832.00,"npi":[1689092330]}]}]},{"tin":{"type":"ein","value":"270671865"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":14241.25,"providers":[{"billed_charge":32200.00,"npi":[1306881362]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99223","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"300891469"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2747.47,"providers":[{"billed_charge":9000.00,"npi":[1366447187]}]},{"allowed_amount":4593.03,"providers":[{"billed_charge":15000.00,"npi":[1710140132]}]}]},{"tin":{"type":"ein","value":"582538212"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1111.96,"providers":[{"billed_charge":3060.00,"npi":[1245069517]}]},{"allowed_amount":743.14,"providers":[{"billed_charge":2040.00,"npi":[1245069517]}]}]},{"tin":{"type":"ein","value":"30572112"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":953.92,"providers":[{"billed_charge":2360.00,"npi":[1215934898]}]}]},{"tin":{"type":"ein","value":"582569828"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1223.42,"providers":[{"billed_charge":2781.44,"npi":[1770859209]}]},{"allowed_amount":624.78,"providers":[{"billed_charge":1390.72,"npi":[1932849833]}]},{"allowed_amount":2432.06,"providers":[{"billed_charge":5562.88,"npi":[1770859209]}]},{"allowed_amount":937.17,"providers":[{"billed_charge":2086.08,"npi":[1932849833]}]}]},{"tin":{"type":"ein","value":"812782599"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3717.35,"providers":[{"billed_charge":5270.00,"npi":[1568548790]}]},{"allowed_amount":440.38,"providers":[{"billed_charge":620.00,"npi":[1902303993]}]}]},{"tin":{"type":"ein","value":"453667307"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3319.76,"providers":[{"billed_charge":6840.00,"npi":[1932319613]}]}]},{"tin":{"type":"ein","value":"270671865"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":7527.06,"providers":[{"billed_charge":14615.00,"npi":[1306881362]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1321.14,"providers":[{"billed_charge":4212.00,"npi":[1467832600]}]},{"allowed_amount":220.19,"providers":[{"billed_charge":702.00,"npi":[1467832600]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99231","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"204802901"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1530.30,"providers":[{"billed_charge":3420.00,"npi":[1043664998]}]},{"allowed_amount":1691.86,"providers":[{"billed_charge":3780.00,"npi":[1114308475]}]}]},{"tin":{"type":"ein","value":"582203198"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":387.40,"providers":[{"billed_charge":570.00,"npi":[1104387760]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":249.00,"providers":[{"billed_charge":552.00,"npi":[1073790622]}]},{"allowed_amount":498.00,"providers":[{"billed_charge":1104.00,"npi":[1861847840]}]},{"allowed_amount":62.25,"providers":[{"billed_charge":138.00,"npi":[1073790622]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99232","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"582470727"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":460.86,"providers":[{"billed_charge":900.00,"npi":[1952301830]}]}]},{"tin":{"type":"ein","value":"454611727"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1990.29,"providers":[{"billed_charge":3477.00,"npi":[1922758234]}]}]},{"tin":{"type":"ein","value":"201190794"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":100.49,"providers":[{"billed_charge":209.00,"npi":[1023506854]}]},{"allowed_amount":301.47,"providers":[{"billed_charge":627.00,"npi":[1083845572]}]}]},{"tin":{"type":"ein","value":"30572112"},"service_code":["61","21"],"billing_class":"professional","payments":[{"allowed_amount":111.66,"providers":[{"billed_charge":210.00,"npi":[1215934898]}]},{"allowed_amount":37447.66,"providers":[{"billed_charge":75390.00,"npi":[1215934898]}]}]},{"tin":{"type":"ein","value":"233044978"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2500.95,"providers":[{"billed_charge":4000.00,"npi":[1386902856]}]}]},{"tin":{"type":"ein","value":"582602452"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":676.28,"providers":[{"billed_charge":1028.00,"npi":[1598273377]}]}]},{"tin":{"type":"ein","value":"582494310"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2731.12,"providers":[{"billed_charge":12600.00,"npi":[1043379928]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1277.18,"providers":[{"billed_charge":3604.00,"npi":[1528297884]}]},{"allowed_amount":678.41,"providers":[{"billed_charge":2041.00,"npi":[1457978660]}]},{"allowed_amount":1896.80,"providers":[{"billed_charge":4942.00,"npi":[1649388133]}]},{"allowed_amount":1205.88,"providers":[{"billed_charge":3036.00,"npi":[1962596585]}]},{"allowed_amount":256.26,"providers":[{"billed_charge":759.00,"npi":[1174939227,1912376468]}]},{"allowed_amount":301.47,"providers":[{"billed_charge":759.00,"npi":[1477753267]}]}]},{"tin":{"type":"ein","value":"260532745"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1042.16,"providers":[{"billed_charge":2016.00,"npi":[1871530303]}]}]},{"tin":{"type":"ein","value":"204802901"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":974.97,"providers":[{"billed_charge":1680.00,"npi":[1114308475]}]},{"allowed_amount":326.45,"providers":[{"billed_charge":560.00,"npi":[1043664998]}]}]},{"tin":{"type":"ein","value":"862092864"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":74.44,"providers":[{"billed_charge":124.89,"npi":[1508867904]}]}]},{"tin":{"type":"ein","value":"205106086"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":135.95,"providers":[{"billed_charge":238.00,"npi":[1558740050]}]}]},{"tin":{"type":"ein","value":"582538212"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1345.48,"providers":[{"billed_charge":3840.00,"npi":[1245069517]}]}]},{"tin":{"type":"ein","value":"461921294"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":3449.14,"providers":[{"billed_charge":11000.00,"npi":[1003697103]}]},{"allowed_amount":4170.71,"providers":[{"billed_charge":13400.00,"npi":[1700359072]}]}]},{"tin":{"type":"ein","value":"874461181"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5272.00,"providers":[{"billed_charge":38000.00,"npi":[1831548536]}]}]},{"tin":{"type":"ein","value":"821487099"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":2220.38,"providers":[{"billed_charge":2900.00,"npi":[1447693056]}]}]},{"tin":{"type":"ein","value":"752999825"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":279.20,"providers":[{"billed_charge":720.00,"npi":[1396083481]}]}]},{"tin":{"type":"ein","value":"582569828"},"service_code":["61","21"],"billing_class":"professional","payments":[{"allowed_amount":280.82,"providers":[{"billed_charge":634.40,"npi":[1598992208]}]},{"allowed_amount":270.50,"providers":[{"billed_charge":634.40,"npi":[1598992208]}]},{"allowed_amount":1265.89,"providers":[{"billed_charge":2854.80,"npi":[1730444282]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":2720.97,"providers":[{"billed_charge":4641.00,"npi":[1710414974]}]},{"allowed_amount":1555.83,"providers":[{"billed_charge":2652.00,"npi":[1982164547]}]},{"allowed_amount":129.46,"providers":[{"billed_charge":221.00,"npi":[1508422072]}]},{"allowed_amount":1165.14,"providers":[{"billed_charge":1989.00,"npi":[1043896848]}]},{"allowed_amount":3624.88,"providers":[{"billed_charge":6188.00,"npi":[1427579085]}]},{"allowed_amount":388.38,"providers":[{"billed_charge":663.00,"npi":[1508422072,1699413112,1255613758]}]},{"allowed_amount":906.22,"providers":[{"billed_charge":1547.00,"npi":[1285194506]}]},{"allowed_amount":524.77,"providers":[{"billed_charge":884.00,"npi":[1134149735]}]},{"allowed_amount":647.30,"providers":[{"billed_charge":1105.00,"npi":[1427579085]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":201.00,"providers":[{"billed_charge":345.00,"npi":[1205368222]}]},{"allowed_amount":194.73,"providers":[{"billed_charge":352.00,"npi":[1205368222]}]},{"allowed_amount":395.73,"providers":[{"billed_charge":697.00,"npi":[1316383565]}]}]},{"tin":{"type":"ein","value":"270671865"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":2841.59,"providers":[{"billed_charge":9145.00,"npi":[1306881362]}]}]},{"tin":{"type":"ein","value":"352498003"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2304.05,"providers":[{"billed_charge":4464.00,"npi":[1851586747]}]},{"allowed_amount":1265.48,"providers":[{"billed_charge":2448.00,"npi":[1396083481]}]}]},{"tin":{"type":"ein","value":"881114400"},"service_code":["61"],"billing_class":"professional","payments":[{"allowed_amount":294.17,"providers":[{"billed_charge":612.00,"npi":[1356591499]}]}]},{"tin":{"type":"ein","value":"472503442"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":508.60,"providers":[{"billed_charge":1281.00,"npi":[1225520679]}]}]},{"tin":{"type":"ein","value":"273284636"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1059.04,"providers":[{"billed_charge":1875.00,"npi":[1972674190]}]},{"allowed_amount":1957.73,"providers":[{"billed_charge":3500.00,"npi":[1043250079]}]}]},{"tin":{"type":"ein","value":"582234927"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2530.96,"providers":[{"billed_charge":9350.00,"npi":[1417017799]}]}]},{"tin":{"type":"ein","value":"205291426"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":637.48,"providers":[{"billed_charge":1170.00,"npi":[1013135623]}]}]},{"tin":{"type":"ein","value":"203566888"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":569.43,"providers":[{"billed_charge":2658.00,"npi":[1922640531]}]},{"allowed_amount":822.51,"providers":[{"billed_charge":3796.00,"npi":[1881108520]}]},{"allowed_amount":885.78,"providers":[{"billed_charge":4118.00,"npi":[1427507243]}]},{"allowed_amount":189.81,"providers":[{"billed_charge":906.00,"npi":[1669164182]}]},{"allowed_amount":372.20,"providers":[{"billed_charge":1250.00,"npi":[1598883928]}]},{"allowed_amount":695.97,"providers":[{"billed_charge":3227.00,"npi":[1790488104]}]},{"allowed_amount":74.44,"providers":[{"billed_charge":292.00,"npi":[1144633660]}]}]},{"tin":{"type":"ein","value":"272004035"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":511.94,"providers":[{"billed_charge":1050.00,"npi":[1043302037]}]}]},{"tin":{"type":"ein","value":"581627802"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":388.38,"providers":[{"billed_charge":663.00,"npi":[1932336617]}]}]},{"tin":{"type":"ein","value":"460881518"},"service_code":["61","21"],"billing_class":"professional","payments":[{"allowed_amount":893.28,"providers":[{"billed_charge":2100.00,"npi":[1700896156]}]},{"allowed_amount":521.08,"providers":[{"billed_charge":1225.00,"npi":[1700896156]}]}]},{"tin":{"type":"ein","value":"581651447"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":422.70,"providers":[{"billed_charge":924.00,"npi":[1700266418]}]},{"allowed_amount":362.53,"providers":[{"billed_charge":770.00,"npi":[1760480727]}]}]},{"tin":{"type":"ein","value":"582651479"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3670.33,"providers":[{"billed_charge":7200.00,"npi":[1770858953]}]}]},{"tin":{"type":"ein","value":"204168057"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1321.36,"providers":[{"billed_charge":2699.64,"npi":[1104288927]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99233","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"454611727"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1287.04,"providers":[{"billed_charge":2064.00,"npi":[1922758234]}]},{"allowed_amount":160.88,"providers":[{"billed_charge":258.00,"npi":[1922758234]}]}]},{"tin":{"type":"ein","value":"201190794"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":3579.60,"providers":[{"billed_charge":5448.00,"npi":[1023506854]}]},{"allowed_amount":8607.86,"providers":[{"billed_charge":13166.00,"npi":[1841877917]}]},{"allowed_amount":3564.48,"providers":[{"billed_charge":5448.00,"npi":[1528645629]}]},{"allowed_amount":5215.84,"providers":[{"billed_charge":7945.00,"npi":[1083845572]}]},{"allowed_amount":146.00,"providers":[{"billed_charge":227.00,"npi":[1083845572]}]}]},{"tin":{"type":"ein","value":"582030692"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":194.75,"providers":[{"billed_charge":463.00,"npi":[1578022620,1619293354]}]}]},{"tin":{"type":"ein","value":"821505834"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":2366.73,"providers":[{"billed_charge":3000.00,"npi":[1225144140]}]}]},{"tin":{"type":"ein","value":"922193137"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":227.14,"providers":[{"billed_charge":572.00,"npi":[1376787788]}]}]},{"tin":{"type":"ein","value":"200401785"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":322.55,"providers":[{"billed_charge":2154.00,"npi":[1033642822]}]},{"allowed_amount":3260.03,"providers":[{"billed_charge":20822.00,"npi":[1164911376]}]},{"allowed_amount":519.43,"providers":[{"billed_charge":3590.00,"npi":[1902303720]}]}]},{"tin":{"type":"ein","value":"850791745"},"service_code":["61"],"billing_class":"professional","payments":[{"allowed_amount":5955.25,"providers":[{"billed_charge":10800.00,"npi":[1982199634]}]}]},{"tin":{"type":"ein","value":"272812143"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":998.55,"providers":[{"billed_charge":2025.00,"npi":[1821184540]}]}]},{"tin":{"type":"ein","value":"812782599"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":11760.80,"providers":[{"billed_charge":15010.00,"npi":[1093721243]}]},{"allowed_amount":1044.68,"providers":[{"billed_charge":1330.00,"npi":[1568548790]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":127.32,"providers":[{"billed_charge":364.00,"npi":[1285878165]}]},{"allowed_amount":1273.20,"providers":[{"billed_charge":3640.00,"npi":[1093259731]}]},{"allowed_amount":1145.88,"providers":[{"billed_charge":3276.00,"npi":[1285878165]}]},{"allowed_amount":295.78,"providers":[{"billed_charge":808.00,"npi":[1528297884]}]}]},{"tin":{"type":"ein","value":"581627802"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":114.47,"providers":[{"billed_charge":318.00,"npi":[1366637241]}]},{"allowed_amount":2576.61,"providers":[{"billed_charge":5406.00,"npi":[1366637241]}]}]},{"tin":{"type":"ein","value":"204600494"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":450.54,"providers":[{"billed_charge":1000.00,"npi":[1487273017]}]}]},{"tin":{"type":"ein","value":"460881518"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":110.95,"providers":[{"billed_charge":225.00,"npi":[1700896156]}]}]},{"tin":{"type":"ein","value":"300891469"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3489.85,"providers":[{"billed_charge":11200.00,"npi":[1104092048]}]}]},{"tin":{"type":"ein","value":"201970681"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3621.44,"providers":[{"billed_charge":9600.00,"npi":[1235101072]}]}]},{"tin":{"type":"ein","value":"363966745"},"service_code":["02","21"],"billing_class":"professional","payments":[{"allowed_amount":823.64,"providers":[{"billed_charge":1400.00,"npi":[1497919450]}]},{"allowed_amount":2736.43,"providers":[{"billed_charge":4800.00,"npi":[1497919450]}]}]},{"tin":{"type":"ein","value":"272582397"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5513.51,"providers":[{"billed_charge":28200.00,"npi":[1306000211]}]}]},{"tin":{"type":"ein","value":"582569828"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":2062.77,"providers":[{"billed_charge":4771.20,"npi":[1447754510]}]},{"allowed_amount":631.05,"providers":[{"billed_charge":1431.36,"npi":[1255836680]}]},{"allowed_amount":207.79,"providers":[{"billed_charge":477.12,"npi":[1548901697]}]},{"allowed_amount":850.12,"providers":[{"billed_charge":1908.48,"npi":[1548901697]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2714.60,"providers":[{"billed_charge":5088.00,"npi":[1013476357]}]},{"allowed_amount":2340.47,"providers":[{"billed_charge":3816.00,"npi":[1477948040]}]},{"allowed_amount":782.47,"providers":[{"billed_charge":1272.00,"npi":[1700364494]}]},{"allowed_amount":194.75,"providers":[{"billed_charge":318.00,"npi":[1699302547,1124475595]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99238","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS","allowed_amounts":[{"tin":{"type":"ein","value":"203854156"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":600.24,"providers":[{"billed_charge":880.00,"npi":[1144413733]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99239","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"201190794"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":144.54,"providers":[{"billed_charge":355.00,"npi":[1083845572]}]}]},{"tin":{"type":"ein","value":"461921294"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":361.77,"providers":[{"billed_charge":1060.00,"npi":[1700359072]}]}]},{"tin":{"type":"ein","value":"812782599"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1299.45,"providers":[{"billed_charge":1800.00,"npi":[1093721243]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99283","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"581795715"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1153.05,"providers":[{"billed_charge":26604.00,"npi":[1457091274]}]}]},{"tin":{"type":"ein","value":"208550713"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":71.18,"providers":[{"billed_charge":718.94,"npi":[1013658574]}]}]},{"tin":{"type":"ein","value":"621696734"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":294.78,"providers":[{"billed_charge":2592.00,"npi":[1922045681]}]}]},{"tin":{"type":"ein","value":"820945402"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":466.61,"providers":[{"billed_charge":2028.32,"npi":[1386373082]}]}]},{"tin":{"type":"ein","value":"811855329"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":252.72,"providers":[{"billed_charge":3150.00,"npi":[1376092247]}]}]},{"tin":{"type":"ein","value":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":7922.05,"providers":[{"billed_charge":19219.00,"npi":[1578937702]}]},{"allowed_amount":255.55,"providers":[{"billed_charge":631.00,"npi":[1104326271]},{"billed_charge":613.00,"npi":[1205994985,1720055643]}]},{"allowed_amount":511.10,"providers":[{"billed_charge":1226.00,"npi":[1770713919]}]},{"allowed_amount":4599.90,"providers":[{"billed_charge":11232.00,"npi":[1871091694]}]}]},{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":234.40,"providers":[{"billed_charge":2572.00,"npi":[1336103910]}]},{"allowed_amount":3776.88,"providers":[{"billed_charge":32839.00,"npi":[1053393892]}]},{"allowed_amount":2962.75,"providers":[{"billed_charge":26454.00,"npi":[1083921274]}]},{"allowed_amount":2957.88,"providers":[{"billed_charge":26797.00,"npi":[1043575178]}]},{"allowed_amount":3935.83,"providers":[{"billed_charge":30369.00,"npi":[1013957844]}]},{"allowed_amount":2709.54,"providers":[{"billed_charge":24008.00,"npi":[1316214687]}]}]},{"tin":{"type":"ein","value":"841888261"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2401.74,"providers":[{"billed_charge":6282.00,"npi":[1215945969]}]},{"allowed_amount":266.86,"providers":[{"billed_charge":586.00,"npi":[1578910378]}]}]},{"tin":{"type":"ein","value":"752850785"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":205.39,"providers":[{"billed_charge":1142.00,"npi":[1346384773]}]}]},{"tin":{"type":"ein","value":"472478680"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1666.98,"providers":[{"billed_charge":6196.00,"npi":[1225520679]}]}]},{"tin":{"type":"ein","value":"843393326"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":891.90,"providers":[{"billed_charge":9450.00,"npi":[1104804491]}]}]},{"tin":{"type":"ein","value":"352504339"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":527.04,"providers":[{"billed_charge":3850.00,"npi":[1780325571]}]}]},{"tin":{"type":"ein","value":"811558273"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":7048.20,"providers":[{"billed_charge":92211.00,"npi":[1134869217]}]}]},{"tin":{"type":"ein","value":"991100562"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":406.85,"providers":[{"billed_charge":2050.00,"npi":[1275646739]}]}]},{"tin":{"type":"ein","value":"205411209"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":626.40,"providers":[{"billed_charge":3266.00,"npi":[1124420856]}]},{"allowed_amount":732.34,"providers":[{"billed_charge":3852.00,"npi":[1265491294]}]},{"allowed_amount":876.96,"providers":[{"billed_charge":4438.00,"npi":[1336224153]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1875.20,"providers":[{"billed_charge":3184.00,"npi":[1699033449]}]}]},{"tin":{"type":"ein","value":"473041726"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1489.89,"providers":[{"billed_charge":5610.00,"npi":[1952497760]}]},{"allowed_amount":350.05,"providers":[{"billed_charge":1172.00,"npi":[1356304844]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99284","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"621795045"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4344.00,"providers":[{"billed_charge":12070.00,"npi":[1033206784]}]},{"allowed_amount":3909.60,"providers":[{"billed_charge":10134.00,"npi":[1871938266]}]},{"allowed_amount":868.80,"providers":[{"billed_charge":2414.00,"npi":[1821376476]}]},{"allowed_amount":1303.20,"providers":[{"billed_charge":3378.00,"npi":[1538943311]}]},{"allowed_amount":434.40,"providers":[{"billed_charge":1126.00,"npi":[1457871949]}]}]},{"tin":{"type":"ein","value":"582030692"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":402.42,"providers":[{"billed_charge":1080.00,"npi":[1336602754]}]},{"allowed_amount":2799.14,"providers":[{"billed_charge":7560.00,"npi":[1003221482]}]},{"allowed_amount":2998.57,"providers":[{"billed_charge":8100.00,"npi":[1598028094]}]},{"allowed_amount":1599.00,"providers":[{"billed_charge":4320.00,"npi":[1265896591]}]},{"allowed_amount":3596.86,"providers":[{"billed_charge":9720.00,"npi":[1811239130]}]},{"allowed_amount":3589.74,"providers":[{"billed_charge":9720.00,"npi":[1659661080]}]},{"allowed_amount":5990.02,"providers":[{"billed_charge":16200.00,"npi":[1538471339]}]},{"allowed_amount":598.29,"providers":[{"billed_charge":1620.00,"npi":[1952346207,1538503081]}]}]},{"tin":{"type":"ein","value":"272268928"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":254.04,"providers":[{"billed_charge":1534.00,"npi":[1346875564]}]},{"allowed_amount":762.12,"providers":[{"billed_charge":4602.00,"npi":[1689899684]}]}]},{"tin":{"type":"ein","value":"352504339"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1050.70,"providers":[{"billed_charge":4816.00,"npi":[1780325571]}]}]},{"tin":{"type":"ein","value":"621130266"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5212.80,"providers":[{"billed_charge":13614.00,"npi":[1033571799]}]},{"allowed_amount":3040.80,"providers":[{"billed_charge":8449.00,"npi":[1023117272]}]},{"allowed_amount":6516.00,"providers":[{"billed_charge":17230.00,"npi":[1427404409]}]},{"allowed_amount":2172.00,"providers":[{"billed_charge":5698.00,"npi":[1073831871]},{"billed_charge":6035.00,"npi":[1154061539]}]},{"allowed_amount":868.80,"providers":[{"billed_charge":2252.00,"npi":[1902162381]}]},{"allowed_amount":9991.20,"providers":[{"billed_charge":26238.00,"npi":[1497763163]}]},{"allowed_amount":3475.20,"providers":[{"billed_charge":9042.00,"npi":[1275552440]}]},{"allowed_amount":1737.60,"providers":[{"billed_charge":4640.00,"npi":[1538943311]},{"billed_charge":4572.00,"npi":[1598021867]}]},{"allowed_amount":434.40,"providers":[{"billed_charge":1126.00,"npi":[1598942146]},{"billed_charge":1160.00,"npi":[1609221282]}]}]},{"tin":{"type":"ein","value":"650203499"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":14161.28,"providers":[{"billed_charge":35753.00,"npi":[1740968312]}]},{"allowed_amount":4867.94,"providers":[{"billed_charge":12221.00,"npi":[1750069373]}]},{"allowed_amount":14335.20,"providers":[{"billed_charge":53625.00,"npi":[1144914912]}]},{"allowed_amount":3982.86,"providers":[{"billed_charge":10038.00,"npi":[1194581900]}]},{"allowed_amount":2212.70,"providers":[{"billed_charge":5606.00,"npi":[1184374464,1265507511]},{"billed_charge":5573.00,"npi":[1558982496]}]},{"allowed_amount":11728.80,"providers":[{"billed_charge":43875.00,"npi":[1619051455]}]},{"allowed_amount":442.54,"providers":[{"billed_charge":1108.00,"npi":[1952889446,1447888300]}]},{"allowed_amount":5310.48,"providers":[{"billed_charge":13395.00,"npi":[1720866122]}]},{"allowed_amount":9122.40,"providers":[{"billed_charge":34125.00,"npi":[1396570594]}]},{"allowed_amount":6195.56,"providers":[{"billed_charge":15578.00,"npi":[1003495623]}]},{"allowed_amount":10620.96,"providers":[{"billed_charge":26790.00,"npi":[1124741632]}]},{"allowed_amount":4425.40,"providers":[{"billed_charge":11113.00,"npi":[1275943961]}]},{"allowed_amount":885.08,"providers":[{"billed_charge":2249.00,"npi":[1891534657]}]},{"allowed_amount":1770.16,"providers":[{"billed_charge":4432.00,"npi":[1275154114]}]}]},{"tin":{"type":"ein","value":"811558273"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":6605.04,"providers":[{"billed_charge":40119.00,"npi":[1134869217]}]}]},{"tin":{"type":"ein","value":"20762608"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":215.91,"providers":[{"billed_charge":1280.00,"npi":[1164845731]}]}]},{"tin":{"type":"ein","value":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5212.80,"providers":[{"billed_charge":13542.00,"npi":[1417325259]},{"billed_charge":13440.00,"npi":[1932660933]},{"billed_charge":13610.00,"npi":[1184738528]},{"billed_charge":13474.00,"npi":[1285083519]}]},{"allowed_amount":2172.00,"providers":[{"billed_charge":5668.00,"npi":[1104342294]},{"billed_charge":5702.00,"npi":[1588014468]}]},{"allowed_amount":26932.80,"providers":[{"billed_charge":70256.00,"npi":[1376265314]}]},{"allowed_amount":8253.60,"providers":[{"billed_charge":21518.00,"npi":[1568495596]},{"billed_charge":21351.00,"npi":[1174244396]}]},{"allowed_amount":23457.60,"providers":[{"billed_charge":60820.00,"npi":[1831431428]}]},{"allowed_amount":15204.00,"providers":[{"billed_charge":39574.00,"npi":[1902878804]}]},{"allowed_amount":9556.80,"providers":[{"billed_charge":24980.00,"npi":[1124050141,1992976773]},{"billed_charge":24844.00,"npi":[1831725704]}]},{"allowed_amount":20851.20,"providers":[{"billed_charge":54576.00,"npi":[1487141222]}]},{"allowed_amount":13211.28,"providers":[{"billed_charge":34992.00,"npi":[1003443615]}]},{"allowed_amount":23892.00,"providers":[{"billed_charge":62280.00,"npi":[1235657412]}]},{"allowed_amount":23466.42,"providers":[{"billed_charge":61126.00,"npi":[1720055643]}]},{"allowed_amount":14335.20,"providers":[{"billed_charge":37334.00,"npi":[1740728823]}]},{"allowed_amount":35629.62,"providers":[{"billed_charge":92520.00,"npi":[1205994985]}]},{"allowed_amount":5647.20,"providers":[{"billed_charge":14730.00,"npi":[1740255389]}]},{"allowed_amount":1303.20,"providers":[{"billed_charge":3462.00,"npi":[1508491812]},{"billed_charge":3428.00,"npi":[1629607809,1164059473]}]},{"allowed_amount":2655.24,"providers":[{"billed_charge":6072.00,"npi":[1962136515]},{"billed_charge":7374.00,"npi":[1407418098]}]},{"allowed_amount":7080.64,"providers":[{"billed_charge":19472.00,"npi":[1083104350]}]},{"allowed_amount":6532.28,"providers":[{"billed_charge":16710.00,"npi":[1023219342]}]},{"allowed_amount":4778.40,"providers":[{"billed_charge":12422.00,"npi":[1730861840]},{"billed_charge":12456.00,"npi":[1043418924]}]},{"allowed_amount":3909.60,"providers":[{"billed_charge":10318.00,"npi":[1124689856,1669105953]},{"billed_charge":10250.00,"npi":[1841399961]},{"billed_charge":10284.00,"npi":[1992933329]},{"billed_charge":10182.00,"npi":[1972173748]}]},{"allowed_amount":11063.50,"providers":[{"billed_charge":30725.00,"npi":[1396077756]}]},{"allowed_amount":11294.40,"providers":[{"billed_charge":29256.00,"npi":[1740355346]}]},{"allowed_amount":6516.00,"providers":[{"billed_charge":17038.00,"npi":[1033776372]},{"billed_charge":16803.00,"npi":[1902631955]},{"billed_charge":16970.00,"npi":[1003338237]}]},{"allowed_amount":35620.80,"providers":[{"billed_charge":92758.00,"npi":[1578937702]}]},{"allowed_amount":33883.20,"providers":[{"billed_charge":88176.00,"npi":[1770713919]}]},{"allowed_amount":39964.80,"providers":[{"billed_charge":104332.00,"npi":[1871091694]}]},{"allowed_amount":7819.20,"providers":[{"billed_charge":20296.00,"npi":[1457971970,1063751212]}]},{"allowed_amount":30842.40,"providers":[{"billed_charge":80200.00,"npi":[1962667915]}]},{"allowed_amount":18244.80,"providers":[{"billed_charge":47414.00,"npi":[1740209154]}]},{"allowed_amount":28236.00,"providers":[{"billed_charge":73718.00,"npi":[1629278486]},{"billed_charge":73446.00,"npi":[1104326271]}]},{"allowed_amount":1327.62,"providers":[{"billed_charge":3111.00,"npi":[1962088328]}]},{"allowed_amount":14769.60,"providers":[{"billed_charge":38080.00,"npi":[1124737366]}]},{"allowed_amount":885.08,"providers":[{"billed_charge":2458.00,"npi":[1629014030,1023114774]},{"billed_charge":2044.00,"npi":[1194953638]}]},{"allowed_amount":6081.60,"providers":[{"billed_charge":16020.00,"npi":[1174229579]},{"billed_charge":15986.00,"npi":[1922688696]},{"billed_charge":15782.00,"npi":[1952938466]},{"billed_charge":16156.00,"npi":[1548961279]}]},{"allowed_amount":3040.80,"providers":[{"billed_charge":8010.00,"npi":[1023657871]},{"billed_charge":7874.00,"npi":[1316390099]}]},{"allowed_amount":7384.80,"providers":[{"billed_charge":19244.00,"npi":[1932571676]},{"billed_charge":19210.00,"npi":[1871506915]}]},{"allowed_amount":4344.00,"providers":[{"billed_charge":11200.00,"npi":[1306960216]}]},{"allowed_amount":39090.61,"providers":[{"billed_charge":101582.00,"npi":[1891309357]}]},{"allowed_amount":868.80,"providers":[{"billed_charge":2274.00,"npi":[1457769218]},{"billed_charge":2240.00,"npi":[1760455455]},{"billed_charge":2073.00,"npi":[1235335365]}]},{"allowed_amount":442.54,"providers":[{"billed_charge":1007.00,"npi":[1861073959,1518493519]},{"billed_charge":1037.00,"npi":[1831725829,1396725453]},{"billed_charge":1229.00,"npi":[1962402461,1366566762]}]},{"allowed_amount":1737.60,"providers":[{"billed_charge":4480.00,"npi":[1942267554]}]},{"allowed_amount":434.40,"providers":[{"billed_charge":1120.00,"npi":[1790363638,1184005910,1982327730]}]},{"allowed_amount":2606.40,"providers":[{"billed_charge":6720.00,"npi":[1518263284]},{"billed_charge":6822.00,"npi":[1306037486]},{"billed_charge":6754.00,"npi":[1154704823,1700876695,1851404354]}]},{"allowed_amount":13900.80,"providers":[{"billed_charge":36282.00,"npi":[1427568229]}]},{"allowed_amount":12597.60,"providers":[{"billed_charge":32285.00,"npi":[1124490255]}]},{"allowed_amount":3097.78,"providers":[{"billed_charge":7079.00,"npi":[1205935343]}]},{"allowed_amount":1770.16,"providers":[{"billed_charge":4028.00,"npi":[1407114291]}]},{"allowed_amount":3475.20,"providers":[{"billed_charge":8861.00,"npi":[1922131382]}]},{"allowed_amount":9991.20,"providers":[{"billed_charge":26032.00,"npi":[1346788122]}]}]},{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3290.90,"providers":[{"billed_charge":11538.00,"npi":[1083921274]}]},{"allowed_amount":202.99,"providers":[{"billed_charge":962.00,"npi":[1043575178]}]},{"allowed_amount":601.85,"providers":[{"billed_charge":2798.00,"npi":[1053393892]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":402.42,"providers":[{"billed_charge":732.00,"npi":[1962905737]}]},{"allowed_amount":1599.00,"providers":[{"billed_charge":2928.00,"npi":[1477970424]}]},{"allowed_amount":2197.29,"providers":[{"billed_charge":4026.00,"npi":[1154345700]}]},{"allowed_amount":1196.58,"providers":[{"billed_charge":2196.00,"npi":[1114101417]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99285","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"621795045"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1902.03,"providers":[{"billed_charge":4881.00,"npi":[1497786974]}]},{"allowed_amount":8876.14,"providers":[{"billed_charge":24416.00,"npi":[1033206784]}]}]},{"tin":{"type":"ein","value":"581795715"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":167.60,"providers":[{"billed_charge":1758.00,"npi":[1457091274]}]}]},{"tin":{"type":"ein","value":"272268928"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":9601.80,"providers":[{"billed_charge":59110.00,"npi":[1689899684]}]}]},{"tin":{"type":"ein","value":"582030692"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1155.52,"providers":[{"billed_charge":3148.00,"npi":[1437232188,1336602754,1811239130]}]},{"allowed_amount":577.76,"providers":[{"billed_charge":1574.00,"npi":[1538471339]}]},{"allowed_amount":1733.28,"providers":[{"billed_charge":4722.00,"npi":[1598028094]}]},{"allowed_amount":288.88,"providers":[{"billed_charge":787.00,"npi":[1952346207]}]}]},{"tin":{"type":"ein","value":"621130266"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":13948.22,"providers":[{"billed_charge":35826.00,"npi":[1255755575]}]},{"allowed_amount":3804.06,"providers":[{"billed_charge":9666.00,"npi":[1023472065]}]},{"allowed_amount":3170.05,"providers":[{"billed_charge":8103.00,"npi":[1396179446]}]},{"allowed_amount":9510.15,"providers":[{"billed_charge":26160.00,"npi":[1336584291]}]},{"allowed_amount":12046.19,"providers":[{"billed_charge":30669.00,"npi":[1780209049]}]},{"allowed_amount":17752.28,"providers":[{"billed_charge":44964.00,"npi":[1902162381]}]},{"allowed_amount":5706.09,"providers":[{"billed_charge":14643.00,"npi":[1699138719]}]},{"allowed_amount":13314.21,"providers":[{"billed_charge":33915.00,"npi":[1598942146]},{"billed_charge":36624.00,"npi":[1154061539]}]},{"allowed_amount":634.01,"providers":[{"billed_charge":1744.00,"npi":[1154770279]}]},{"allowed_amount":4438.07,"providers":[{"billed_charge":11421.00,"npi":[1396756680,1558536987]}]},{"allowed_amount":21556.34,"providers":[{"billed_charge":54894.00,"npi":[1033571799]}]},{"allowed_amount":6974.11,"providers":[{"billed_charge":19184.00,"npi":[1023117272]}]},{"allowed_amount":8242.13,"providers":[{"billed_charge":21027.00,"npi":[1265493779]},{"billed_charge":20991.00,"npi":[1427404409]}]},{"allowed_amount":2536.04,"providers":[{"billed_charge":6540.00,"npi":[1144751637]}]},{"allowed_amount":15216.24,"providers":[{"billed_charge":38856.00,"npi":[1497763163]}]},{"allowed_amount":8876.14,"providers":[{"billed_charge":22722.00,"npi":[1598021867]}]}]},{"tin":{"type":"ein","value":"650203499"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2581.24,"providers":[{"billed_charge":6552.00,"npi":[1003221771]}]},{"allowed_amount":5162.48,"providers":[{"billed_charge":13202.00,"npi":[1558086397,1184374464]}]},{"allowed_amount":1935.93,"providers":[{"billed_charge":4963.00,"npi":[1275943961]}]},{"allowed_amount":6453.10,"providers":[{"billed_charge":16429.00,"npi":[1730768789]},{"billed_charge":16478.00,"npi":[1891439469]}]},{"allowed_amount":3170.05,"providers":[{"billed_charge":9840.00,"npi":[1144914912]}]},{"allowed_amount":8389.03,"providers":[{"billed_charge":21392.00,"npi":[1902548241]}]},{"allowed_amount":10970.27,"providers":[{"billed_charge":27993.00,"npi":[1134700651]},{"billed_charge":28042.00,"npi":[1922749290]}]},{"allowed_amount":4517.17,"providers":[{"billed_charge":11613.00,"npi":[1467194142]}]},{"allowed_amount":11615.58,"providers":[{"billed_charge":29925.00,"npi":[1184201428]}]},{"allowed_amount":645.31,"providers":[{"billed_charge":1638.00,"npi":[1659838696]}]},{"allowed_amount":7743.72,"providers":[{"billed_charge":19803.00,"npi":[1447888300]}]},{"allowed_amount":10144.16,"providers":[{"billed_charge":31488.00,"npi":[1619051455]}]},{"allowed_amount":4438.07,"providers":[{"billed_charge":13776.00,"npi":[1124330345]}]},{"allowed_amount":14582.23,"providers":[{"billed_charge":45264.00,"npi":[1396570594]}]},{"allowed_amount":21295.23,"providers":[{"billed_charge":54495.00,"npi":[1003495623]}]}]},{"tin":{"type":"ein","value":"811558273"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":11817.60,"providers":[{"billed_charge":72824.00,"npi":[1134869217]}]}]},{"tin":{"type":"ein","value":"581920755"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1442.64,"providers":[{"billed_charge":11600.00,"npi":[1063663698]}]}]},{"tin":{"type":"ein","value":"20762608"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1843.60,"providers":[{"billed_charge":9350.00,"npi":[1275929663]}]}]},{"tin":{"type":"ein","value":"650691102"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5162.48,"providers":[{"billed_charge":11880.00,"npi":[1407435936]}]},{"allowed_amount":3226.55,"providers":[{"billed_charge":7403.00,"npi":[1831725829]}]},{"allowed_amount":27896.44,"providers":[{"billed_charge":73100.00,"npi":[1871506915]}]},{"allowed_amount":3170.05,"providers":[{"billed_charge":8400.00,"npi":[1932571676]},{"billed_charge":8350.00,"npi":[1417325259]},{"billed_charge":8250.00,"npi":[1508491812]}]},{"allowed_amount":6453.10,"providers":[{"billed_charge":14806.00,"npi":[1962088328]}]},{"allowed_amount":12680.20,"providers":[{"billed_charge":33400.00,"npi":[1841399961]}]},{"allowed_amount":4517.17,"providers":[{"billed_charge":10373.00,"npi":[1518493519]},{"billed_charge":10285.00,"npi":[1083107460]}]},{"allowed_amount":24739.95,"providers":[{"billed_charge":65050.00,"npi":[1033776372]}]},{"allowed_amount":24092.38,"providers":[{"billed_charge":63350.00,"npi":[1770713919]}]},{"allowed_amount":20301.88,"providers":[{"billed_charge":53250.00,"npi":[1902878804]}]},{"allowed_amount":5807.79,"providers":[{"billed_charge":13211.00,"npi":[1205935343]},{"billed_charge":16119.00,"npi":[1891925566]}]},{"allowed_amount":7608.12,"providers":[{"billed_charge":20050.00,"npi":[1588014468]},{"billed_charge":20250.00,"npi":[1578937702]}]},{"allowed_amount":6974.11,"providers":[{"billed_charge":18350.00,"npi":[1871091694,1043418924]}]},{"allowed_amount":19020.30,"providers":[{"billed_charge":50450.00,"npi":[1023657871]}]},{"allowed_amount":10778.17,"providers":[{"billed_charge":28350.00,"npi":[1992976773]},{"billed_charge":27978.00,"npi":[1760455455]},{"billed_charge":28250.00,"npi":[1205994985]},{"billed_charge":28150.00,"npi":[1184738528]}]},{"allowed_amount":44380.70,"providers":[{"billed_charge":116500.00,"npi":[1003443615]}]},{"allowed_amount":8876.14,"providers":[{"billed_charge":23100.00,"npi":[1306960216]},{"billed_charge":23400.00,"npi":[1487141222]}]},{"allowed_amount":12906.20,"providers":[{"billed_charge":29480.00,"npi":[1902573520]},{"billed_charge":35820.00,"npi":[1114668415]}]},{"allowed_amount":15250.14,"providers":[{"billed_charge":39489.00,"npi":[1023219342]}]},{"allowed_amount":12046.19,"providers":[{"billed_charge":31650.00,"npi":[1376265314]},{"billed_charge":31800.00,"npi":[1427568229]}]},{"allowed_amount":36786.14,"providers":[{"billed_charge":96700.00,"npi":[1831725704]}]},{"allowed_amount":11412.18,"providers":[{"billed_charge":30000.00,"npi":[1720055643]},{"billed_charge":30200.00,"npi":[1669105953]}]},{"allowed_amount":5719.65,"providers":[{"billed_charge":14950.00,"npi":[1316390099]}]},{"allowed_amount":634.01,"providers":[{"billed_charge":1389.00,"npi":[1235335365]},{"billed_charge":1700.00,"npi":[1124689856]},{"billed_charge":1650.00,"npi":[1467594218,1063751212]}]},{"allowed_amount":15850.25,"providers":[{"billed_charge":41700.00,"npi":[1235657412]}]},{"allowed_amount":29798.47,"providers":[{"billed_charge":78450.00,"npi":[1235794488]}]},{"allowed_amount":21556.34,"providers":[{"billed_charge":56700.00,"npi":[1124050141]}]},{"allowed_amount":19654.31,"providers":[{"billed_charge":51600.00,"npi":[1891309357]}]},{"allowed_amount":15216.24,"providers":[{"billed_charge":40150.00,"npi":[1104326271]}]},{"allowed_amount":3310.23,"providers":[{"billed_charge":9900.00,"npi":[1174244396]}]},{"allowed_amount":3804.06,"providers":[{"billed_charge":9789.00,"npi":[1922131382]},{"billed_charge":10100.00,"npi":[1457769218]},{"billed_charge":9689.00,"npi":[1346788122]}]},{"allowed_amount":9679.65,"providers":[{"billed_charge":22253.00,"npi":[1861073959]}]},{"allowed_amount":9034.34,"providers":[{"billed_charge":20834.00,"npi":[1013657089]}]},{"allowed_amount":3871.86,"providers":[{"billed_charge":10746.00,"npi":[1083104350]}]},{"allowed_amount":11615.58,"providers":[{"billed_charge":26378.00,"npi":[1790148385]}]},{"allowed_amount":5706.09,"providers":[{"billed_charge":15100.00,"npi":[1922688696]},{"billed_charge":15300.00,"npi":[1548961279]}]},{"allowed_amount":28530.45,"providers":[{"billed_charge":74800.00,"npi":[1891361408]},{"billed_charge":75200.00,"npi":[1962667915]}]},{"allowed_amount":4438.07,"providers":[{"billed_charge":11650.00,"npi":[1023292562]},{"billed_charge":11750.00,"npi":[1003338237,1902631955,1154704823]}]},{"allowed_amount":1268.02,"providers":[{"billed_charge":3350.00,"npi":[1417169574]},{"billed_charge":3300.00,"npi":[1124737366,1508090366]}]},{"allowed_amount":2536.04,"providers":[{"billed_charge":6600.00,"npi":[1124490255]},{"billed_charge":6750.00,"npi":[1780571794]}]},{"allowed_amount":34236.54,"providers":[{"billed_charge":89850.00,"npi":[1285083519]}]},{"allowed_amount":8389.03,"providers":[{"billed_charge":19195.00,"npi":[1871097816]}]},{"allowed_amount":645.31,"providers":[{"billed_charge":1463.00,"npi":[1902484611,1851735138]}]},{"allowed_amount":33602.53,"providers":[{"billed_charge":88300.00,"npi":[1740728823]}]},{"allowed_amount":1290.62,"providers":[{"billed_charge":3582.00,"npi":[1962402461,1629023924]},{"billed_charge":2970.00,"npi":[1902077357]}]},{"allowed_amount":6340.10,"providers":[{"billed_charge":16600.00,"npi":[1831431428]},{"billed_charge":16750.00,"npi":[1457971970]}]},{"allowed_amount":5072.08,"providers":[{"billed_charge":13350.00,"npi":[1851404354]},{"billed_charge":12778.00,"npi":[1598343998]},{"billed_charge":13400.00,"npi":[1083843296,1740209154]}]},{"allowed_amount":46916.74,"providers":[{"billed_charge":123050.00,"npi":[1629278486]}]},{"allowed_amount":10144.16,"providers":[{"billed_charge":26750.00,"npi":[1740355346]}]},{"allowed_amount":31700.50,"providers":[{"billed_charge":83350.00,"npi":[1578149621]}]},{"allowed_amount":8242.13,"providers":[{"billed_charge":21550.00,"npi":[1568495596]},{"billed_charge":21600.00,"npi":[1790363638]}]}]},{"tin":{"type":"ein","value":"271369141"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3765.74,"providers":[{"billed_charge":17234.00,"npi":[1053393892]}]},{"allowed_amount":2893.95,"providers":[{"billed_charge":12989.00,"npi":[1043575178]}]},{"allowed_amount":3789.81,"providers":[{"billed_charge":17363.00,"npi":[1013957844]}]},{"allowed_amount":1743.58,"providers":[{"billed_charge":7974.00,"npi":[1083921274]}]},{"allowed_amount":288.88,"providers":[{"billed_charge":1286.00,"npi":[1316214687]}]}]},{"tin":{"type":"ein","value":"581537752"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":325.75,"providers":[{"billed_charge":531.00,"npi":[1396030268]}]},{"allowed_amount":577.76,"providers":[{"billed_charge":1062.00,"npi":[1013963917]}]},{"allowed_amount":1733.28,"providers":[{"billed_charge":3186.00,"npi":[1508127093]}]},{"allowed_amount":288.88,"providers":[{"billed_charge":531.00,"npi":[1942406483]}]}]}]},{"name":"CRITICAL CARE, FIRST HOUR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99291","description":"CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJURED PATIENT; FIRST ","allowed_amounts":[{"tin":{"type":"ein","value":"581627802"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":207.41,"providers":[{"billed_charge":704.00,"npi":[1689052136]}]}]},{"tin":{"type":"ein","value":"582307485"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":231.94,"providers":[{"billed_charge":992.00,"npi":[1487417739]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99307","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"204168057"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":988.30,"providers":[{"billed_charge":2062.34,"npi":[1285675488]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99308","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"273763093"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":874.12,"providers":[{"billed_charge":2274.46,"npi":[1053572347]}]},{"allowed_amount":201.72,"providers":[{"billed_charge":540.46,"npi":[1053572347]}]}]},{"tin":{"type":"ein","value":"921195375"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":1395.38,"providers":[{"billed_charge":2616.00,"npi":[1093294522]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99309","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"993812081"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":802.00,"providers":[{"billed_charge":1038.48,"npi":[1649432733]}]},{"allowed_amount":110.52,"providers":[{"billed_charge":129.81,"npi":[1649432733]}]}]},{"tin":{"type":"ein","value":"814630461"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":673.93,"providers":[{"billed_charge":1255.00,"npi":[1407601685]}]},{"allowed_amount":374.26,"providers":[{"billed_charge":753.00,"npi":[1952712788]}]},{"allowed_amount":478.88,"providers":[{"billed_charge":1004.00,"npi":[1265291900]}]},{"allowed_amount":528.32,"providers":[{"billed_charge":1004.00,"npi":[1407601685]}]}]},{"tin":{"type":"ein","value":"333264278"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":7105.69,"providers":[{"billed_charge":41456.83,"npi":[1588285639]}]},{"allowed_amount":1993.40,"providers":[{"billed_charge":9970.63,"npi":[1598384224]}]},{"allowed_amount":271.72,"providers":[{"billed_charge":1574.31,"npi":[1548159353]}]},{"allowed_amount":3161.32,"providers":[{"billed_charge":18891.72,"npi":[1760054795]}]}]},{"tin":{"type":"ein","value":"845000210"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":2467.51,"providers":[{"billed_charge":12594.48,"npi":[1245087667]}]},{"allowed_amount":202.16,"providers":[{"billed_charge":1049.54,"npi":[1396577938]}]}]},{"tin":{"type":"ein","value":"843937974"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":816.86,"providers":[{"billed_charge":2277.00,"npi":[1922683887]}]},{"allowed_amount":355.50,"providers":[{"billed_charge":1012.00,"npi":[1922683887]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99310","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"814630461"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":188.75,"providers":[{"billed_charge":359.00,"npi":[1700424496]}]},{"allowed_amount":566.25,"providers":[{"billed_charge":1077.00,"npi":[1700424496]}]}]}]},{"name":"PREV VISIT EST AGE 18-39","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99395","description":"PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF AN INDIVIDUAL INCL AN AGE ","allowed_amounts":[{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2768.40,"providers":[{"billed_charge":6921.00,"npi":[1093391997]}]}]}]},{"name":"PREV VISIT EST AGE 40-64","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99396","description":"PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF AN INDIVIDUAL INCL AN AGE ","allowed_amounts":[{"tin":{"type":"ein","value":"205870972"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":1232.62,"providers":[{"billed_charge":3130.00,"npi":[1285325282]}]}]},{"tin":{"type":"ein","value":"453766969"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":136.00,"providers":[{"billed_charge":340.00,"npi":[1053536177]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2455.28,"providers":[{"billed_charge":2800.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"582640568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":254.84,"providers":[{"billed_charge":476.90,"npi":[1306860101]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2460.80,"providers":[{"billed_charge":6152.00,"npi":[1093391997]}]}]}]},{"name":"BEHAV CHNG SMOKING 3-10 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99406","description":"SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT; INTERMEDIATE, GREATER THAN 3 MINUTES UP TO 10 MI","allowed_amounts":[{"tin":{"type":"ein","value":"581335405"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":81.52,"providers":[{"billed_charge":120.00,"npi":[1811874696]}]}]}]},{"name":"PROLNG OFF/OP E/M EA 15 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99417","description":"PROLONGED OFFICE/OUTPATIENT E/M SVC EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"472221436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":289.00,"providers":[{"billed_charge":592.00,"npi":[1023670148]}]}]}]},{"name":"Under Prolonged Service With or Without Direct Patient Contact on the Date of an Evaluation and Management Service","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99418","description":"Under Prolonged Service With or Without Direct Patient Contact on the Date of an Evaluation and Management Service","allowed_amounts":[{"tin":{"type":"ein","value":"300891469"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1324.24,"providers":[{"billed_charge":3200.00,"npi":[1710140132]}]}]}]},{"name":"REM PHYSIOL MNTR 20 MIN MO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99457","description":"REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH","allowed_amounts":[{"tin":{"type":"ein","value":"581874521"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1460.44,"providers":[{"billed_charge":4400.00,"npi":[1548258924]}]}]},{"tin":{"type":"ein","value":"874134822"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":459.88,"providers":[{"billed_charge":1323.00,"npi":[1124089784]}]}]}]},{"name":"REM PHYSIOL MNTR EA ADDL 20","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99458","description":"REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO","allowed_amounts":[{"tin":{"type":"ein","value":"581874521"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1986.31,"providers":[{"billed_charge":5424.12,"npi":[1548258924]}]}]},{"tin":{"type":"ein","value":"874134822"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1408.95,"providers":[{"billed_charge":4200.00,"npi":[1124089784]}]}]}]},{"name":"Under Other Evaluation and Management Services","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99459","description":"Under Other Evaluation and Management Services","allowed_amounts":[{"tin":{"type":"ein","value":"581187683"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":39.42,"providers":[{"billed_charge":100.00,"npi":[1568481539]}]}]}]},{"name":"SAME DAY NB DISCHARGE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99463","description":"INITIAL HOSPITAL OR BIRTHING CENTER CARE, PER DAY, FOR EVALUATION AND MANAGEMENT OF NORMAL NEWBORN I","allowed_amounts":[{"tin":{"type":"ein","value":"201188965"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":706.39,"providers":[{"billed_charge":1735.00,"npi":[1215944863]}]}]}]},{"name":"CARE MGMT SVC BHVL HLTH COND","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99484","description":"CARE MANAGEMENT SERVICES FOR BEHAVIORAL HEALTH CONDITIONS, AT LEAST 20 MINUTES OF CLINICAL STAFF TIM","allowed_amounts":[{"tin":{"type":"ein","value":"822639811"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":699.41,"providers":[{"billed_charge":1449.00,"npi":[1962430892]}]}]}]},{"name":"CMPLX CHRON CARE W/O PT VSIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99487","description":"COMPLEX CHRONIC CARE MANAGEMENT SERVICES, W THE FOLLOWING REQUIRED ELEMENTS: MULTIPLE (TWO OR MORE) ","allowed_amounts":[{"tin":{"type":"ein","value":"814630461"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":1720.65,"providers":[{"billed_charge":3201.00,"npi":[1952712788]}]}]}]},{"name":"CHRON CARE MGMT SRVC 20 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99490","description":"CHRONIC CARE MANAGEMENT SERVICES, AT LEAST 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"471461454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1960.78,"providers":[{"billed_charge":2550.00,"npi":[1760708580]}]}]},{"tin":{"type":"ein","value":"331166863"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1190.00,"providers":[{"billed_charge":1190.00,"npi":[1790707925]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7085.58,"providers":[{"billed_charge":7710.72,"npi":[1588827513]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"621623714"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":138.13,"providers":[{"billed_charge":524.78,"npi":[1366487944]}]}]},{"tin":{"type":"ein","value":"263941348"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33548.16,"providers":[{"billed_charge":57917.76,"npi":[1407294028]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":113280.93,"providers":[{"billed_charge":123565.80,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"576000356"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":188.52,"providers":[{"billed_charge":471.30,"npi":[1871530667]}]}]},{"tin":{"type":"ein","value":"823526081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6946.71,"providers":[{"billed_charge":12863.90,"npi":[1750854279]}]}]},{"tin":{"type":"ein","value":"586011374"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1027.50,"providers":[{"billed_charge":1517.60,"npi":[1134291842]}]}]},{"tin":{"type":"ein","value":"586000802"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26010.90,"providers":[{"billed_charge":42324.00,"npi":[1073683603]}]}]},{"tin":{"type":"ein","value":"453801631"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":15103.14,"providers":[{"billed_charge":31916.00,"npi":[1205112752]}]}]},{"tin":{"type":"ein","value":"586000904"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1964.58,"providers":[{"billed_charge":3263.75,"npi":[1699778530]}]}]},{"tin":{"type":"ein","value":"452393528"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":449517.96,"providers":[{"billed_charge":1853639.25,"npi":[1639462476]}]}]},{"tin":{"type":"ein","value":"753106281"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9607.53,"providers":[{"billed_charge":17073.49,"npi":[1407872153]}]}]},{"tin":{"type":"ein","value":"586000906"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1255.74,"providers":[{"billed_charge":1618.80,"npi":[1790846665]}]}]},{"tin":{"type":"ein","value":"581608892"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":80490.38,"providers":[{"billed_charge":591774.70,"npi":[1538211081]}]}]},{"tin":{"type":"ein","value":"586000908"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":968.34,"providers":[{"billed_charge":1367.60,"npi":[1962444141]}]}]},{"tin":{"type":"ein","value":"820945402"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12707.29,"providers":[{"billed_charge":38491.91,"npi":[1992238430]}]}]},{"tin":{"type":"ein","value":"464991734"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7186.09,"providers":[{"billed_charge":14684.00,"npi":[1588084578]}]}]},{"tin":{"type":"ein","value":"843523020"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13306.38,"providers":[{"billed_charge":36110.00,"npi":[1518588250]}]}]},{"tin":{"type":"ein","value":"596000773"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":45.75,"providers":[{"billed_charge":85.00,"npi":[1033215348]}]}]},{"tin":{"type":"ein","value":"586000873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11432.05,"providers":[{"billed_charge":24626.90,"npi":[1326001108]}]}]},{"tin":{"type":"ein","value":"586000511"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":596.73,"providers":[{"billed_charge":1172.93,"npi":[1952679748]}]}]},{"tin":{"type":"ein","value":"586000910"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7811.37,"providers":[{"billed_charge":8869.50,"npi":[1659435303]}]}]},{"tin":{"type":"ein","value":"586000911"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1453.32,"providers":[{"billed_charge":2988.00,"npi":[1396788097]}]}]},{"tin":{"type":"ein","value":"586000878"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2592.87,"providers":[{"billed_charge":4025.25,"npi":[1750471272]}]}]},{"tin":{"type":"ein","value":"581313603"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12846.66,"providers":[{"billed_charge":33069.40,"npi":[1295760304]}]}]},{"tin":{"type":"ein","value":"586000913"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5875.92,"providers":[{"billed_charge":14689.80,"npi":[1871665174]}]}]},{"tin":{"type":"ein","value":"586000817"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10387.47,"providers":[{"billed_charge":14974.20,"npi":[1972608644]}]}]},{"tin":{"type":"ein","value":"586000818"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8509.35,"providers":[{"billed_charge":15157.68,"npi":[1548329899]}]}]},{"tin":{"type":"ein","value":"261706720"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":87801.73,"providers":[{"billed_charge":90070.60,"npi":[1295113868]}]}]},{"tin":{"type":"ein","value":"834547536"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":21414.60,"providers":[{"billed_charge":34498.50,"npi":[1043875586]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":129496.96,"providers":[{"billed_charge":471870.83,"npi":[1326630153]}]}]},{"tin":{"type":"ein","value":"366005820"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1057.65,"providers":[{"billed_charge":2185.00,"npi":[1376554592]}]}]},{"tin":{"type":"ein","value":"831214083"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":689.34,"providers":[{"billed_charge":2368.00,"npi":[1437778883]}]}]},{"tin":{"type":"ein","value":"586002562"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4012.59,"providers":[{"billed_charge":5872.50,"npi":[1255315800]}]}]},{"tin":{"type":"ein","value":"586010502"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9143.10,"providers":[{"billed_charge":14748.00,"npi":[1942310800]}]}]},{"tin":{"type":"ein","value":"586000783"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4762.20,"providers":[{"billed_charge":6216.00,"npi":[1225193048]}]}]},{"tin":{"type":"ein","value":"586004467"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":41394.23,"providers":[{"billed_charge":88653.42,"npi":[1558141671]}]}]},{"tin":{"type":"ein","value":"586000785"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":27.90,"providers":[{"billed_charge":49.50,"npi":[1912086612]}]}]},{"tin":{"type":"ein","value":"586000821"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13380.82,"providers":[{"billed_charge":21801.00,"npi":[1417931049]}]}]},{"tin":{"type":"ein","value":"631225058"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":65.43,"providers":[{"billed_charge":225.00,"npi":[1821037755]}]}]},{"tin":{"type":"ein","value":"586000789"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13143.56,"providers":[{"billed_charge":19791.80,"npi":[1013025642]}]}]},{"tin":{"type":"ein","value":"720701964"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6059.19,"providers":[{"billed_charge":6080.67,"npi":[1316943566]}]}]},{"tin":{"type":"ein","value":"586000822"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3664.26,"providers":[{"billed_charge":5715.90,"npi":[1477542983]}]}]},{"tin":{"type":"ein","value":"586000823"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23851.76,"providers":[{"billed_charge":74286.40,"npi":[1962591966]}]}]},{"tin":{"type":"ein","value":"582465552"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1337.68,"providers":[{"billed_charge":7827.00,"npi":[1891782595]}]}]},{"tin":{"type":"ein","value":"823991191"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1061.40,"providers":[{"billed_charge":1488.00,"npi":[1316455173]}]}]},{"tin":{"type":"ein","value":"586000826"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3739.76,"providers":[{"billed_charge":5717.60,"npi":[1790880474]}]}]},{"tin":{"type":"ein","value":"596000708"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2093.58,"providers":[{"billed_charge":4163.16,"npi":[1215047675]}]}]},{"tin":{"type":"ein","value":"450600978"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":42671.25,"providers":[{"billed_charge":135914.72,"npi":[1275823122]}]}]},{"tin":{"type":"ein","value":"586000809"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10782.24,"providers":[{"billed_charge":12914.00,"npi":[1225436033]}]}]},{"tin":{"type":"ein","value":"453827742"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18732.93,"providers":[{"billed_charge":60420.00,"npi":[1225305964]}]}]},{"tin":{"type":"ein","value":"850900440"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1738.50,"providers":[{"billed_charge":2280.00,"npi":[1205430212]}]}]},{"tin":{"type":"ein","value":"832156832"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1789.54,"providers":[{"billed_charge":4473.88,"npi":[1770059800]}]}]},{"tin":{"type":"ein","value":"586000890"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8411.74,"providers":[{"billed_charge":9908.80,"npi":[1033256060]}]}]},{"tin":{"type":"ein","value":"586000891"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4988.31,"providers":[{"billed_charge":5210.04,"npi":[1588664452]}]}]},{"tin":{"type":"ein","value":"586000893"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12786.54,"providers":[{"billed_charge":20589.00,"npi":[1780668608]}]}]},{"tin":{"type":"ein","value":"586000894"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10410.37,"providers":[{"billed_charge":16512.25,"npi":[1356447536]}]}]},{"tin":{"type":"ein","value":"586000895"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7186.79,"providers":[{"billed_charge":10601.53,"npi":[1548432834]}]}]},{"tin":{"type":"ein","value":"581036407"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":48336.51,"providers":[{"billed_charge":196474.65,"npi":[1962452870]}]}]},{"tin":{"type":"ein","value":"586000898"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7688.88,"providers":[{"billed_charge":12796.80,"npi":[1043390677]}]}]},{"tin":{"type":"ein","value":"582469468"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2937.96,"providers":[{"billed_charge":4705.50,"npi":[1326036161]}]}]},{"tin":{"type":"ein","value":"586000778"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5321.28,"providers":[{"billed_charge":8526.00,"npi":[1780644617]}]}]},{"tin":{"type":"ein","value":"581097948"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17437.28,"providers":[{"billed_charge":18888.00,"npi":[1730133471]}]}]},{"tin":{"type":"ein","value":"582363827"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":32701.68,"providers":[{"billed_charge":102693.20,"npi":[1164445391]}]}]},{"tin":{"type":"ein","value":"586000839"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4998.30,"providers":[{"billed_charge":10336.00,"npi":[1881780799]}]}]},{"tin":{"type":"ein","value":"582605844"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":35502.93,"providers":[{"billed_charge":127101.43,"npi":[1699769158]}]},{"allowed_amount":1705.73,"providers":[{"billed_charge":10090.80,"npi":[1720300379]}]}]},{"tin":{"type":"ein","value":"586002461"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3873.03,"providers":[{"billed_charge":6737.60,"npi":[1760055396]}]}]},{"tin":{"type":"ein","value":"275404756"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":36469.44,"providers":[{"billed_charge":71813.40,"npi":[1447530787]}]}]},{"tin":{"type":"ein","value":"331880865"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":667.95,"providers":[{"billed_charge":731.00,"npi":[1962273532]}]}]},{"tin":{"type":"ein","value":"586001497"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1185.96,"providers":[{"billed_charge":1792.00,"npi":[1952411886]}]}]},{"tin":{"type":"ein","value":"586000840"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9935.46,"providers":[{"billed_charge":15451.20,"npi":[1700877016]}]}]},{"tin":{"type":"ein","value":"586002987"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17732.22,"providers":[{"billed_charge":33524.75,"npi":[1780969964]}]}]},{"tin":{"type":"ein","value":"586000841"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":643.56,"providers":[{"billed_charge":1115.48,"npi":[1871681361]}]}]},{"tin":{"type":"ein","value":"586000842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":22721.31,"providers":[{"billed_charge":31991.05,"npi":[1952363301]}]}]},{"tin":{"type":"ein","value":"586000845"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7434.90,"providers":[{"billed_charge":16020.00,"npi":[1982755138]}]}]},{"tin":{"type":"ein","value":"586000829"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4672.38,"providers":[{"billed_charge":6510.40,"npi":[1184614208]}]}]},{"tin":{"type":"ein","value":"824030857"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":137258.58,"providers":[{"billed_charge":625518.60,"npi":[1730697335]}]}]},{"tin":{"type":"ein","value":"582164513"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9921.24,"providers":[{"billed_charge":32940.00,"npi":[1821141821]}]}]},{"tin":{"type":"ein","value":"273447343"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":512.40,"providers":[{"billed_charge":668.40,"npi":[1417257890]}]}]},{"tin":{"type":"ein","value":"581651002"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16776.27,"providers":[{"billed_charge":48789.00,"npi":[1134156045]}]}]},{"tin":{"type":"ein","value":"586000790"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11960.49,"providers":[{"billed_charge":12793.30,"npi":[1699855049]}]}]},{"tin":{"type":"ein","value":"586009406"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33164.01,"providers":[{"billed_charge":83007.00,"npi":[1962593541]}]}]},{"tin":{"type":"ein","value":"746001164"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":685.56,"providers":[{"billed_charge":685.56,"npi":[1447375282]}]}]},{"tin":{"type":"ein","value":"586012659"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6951.57,"providers":[{"billed_charge":11316.00,"npi":[1942386289]}]}]},{"tin":{"type":"ein","value":"586000430"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4119.39,"providers":[{"billed_charge":5575.00,"npi":[1851381156]}]}]},{"tin":{"type":"ein","value":"586000793"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5235.16,"providers":[{"billed_charge":7833.00,"npi":[1295708303]}]}]},{"tin":{"type":"ein","value":"586000799"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":14017.20,"providers":[{"billed_charge":22920.00,"npi":[1801972625]}]}]},{"tin":{"type":"ein","value":"586000833"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6478.26,"providers":[{"billed_charge":10444.50,"npi":[1881861300]}]}]},{"tin":{"type":"ein","value":"586000834"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2559.42,"providers":[{"billed_charge":4137.00,"npi":[1992715908]}]}]},{"tin":{"type":"ein","value":"586000835"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30833.10,"providers":[{"billed_charge":50310.00,"npi":[1316052566]}]}]},{"tin":{"type":"ein","value":"582149691"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8615.70,"providers":[{"billed_charge":22889.50,"npi":[1568772689]}]},{"allowed_amount":92.40,"providers":[{"billed_charge":232.50,"npi":[1609325018]}]},{"allowed_amount":4947.84,"providers":[{"billed_charge":13253.50,"npi":[1821308941]}]},{"allowed_amount":6848.67,"providers":[{"billed_charge":18490.00,"npi":[1720398845]}]}]},{"tin":{"type":"ein","value":"586000836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2170.92,"providers":[{"billed_charge":2832.00,"npi":[1992734867]}]}]},{"tin":{"type":"ein","value":"990611768"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":57156.39,"providers":[{"billed_charge":123976.00,"npi":[1003788852]}]}]},{"tin":{"type":"ein","value":"822125340"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4870.26,"providers":[{"billed_charge":6819.80,"npi":[1255859179]}]}]},{"tin":{"type":"ein","value":"586012329"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10200.00,"providers":[{"billed_charge":16485.00,"npi":[1538239132]}]}]},{"tin":{"type":"ein","value":"453755569"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":567.84,"providers":[{"billed_charge":928.50,"npi":[1538438288]}]}]},{"tin":{"type":"ein","value":"581425000"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11103.88,"providers":[{"billed_charge":20135.06,"npi":[1669867487]}]}]},{"tin":{"type":"ein","value":"596000344"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1065.72,"providers":[{"billed_charge":1160.00,"npi":[1356341531]}]}]},{"tin":{"type":"ein","value":"586000863"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12739.32,"providers":[{"billed_charge":16588.80,"npi":[1720176340]}]}]},{"tin":{"type":"ein","value":"586002921"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9685.62,"providers":[{"billed_charge":12538.80,"npi":[1952319360]}]}]},{"tin":{"type":"ein","value":"586000865"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4927.44,"providers":[{"billed_charge":8014.50,"npi":[1962487942]}]}]},{"tin":{"type":"ein","value":"453639743"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":66390.99,"providers":[{"billed_charge":215546.20,"npi":[1477830164]}]}]},{"tin":{"type":"ein","value":"586000902"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4332.48,"providers":[{"billed_charge":7432.00,"npi":[1265439137]}]}]},{"tin":{"type":"ein","value":"581923254"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9939.84,"providers":[{"billed_charge":40674.06,"npi":[1730156266]}]}]},{"tin":{"type":"ein","value":"824692084"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25409.13,"providers":[{"billed_charge":41415.00,"npi":[1346744943]}]}]},{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":191533.42,"providers":[{"billed_charge":589871.89,"npi":[1164966164]}]}]},{"tin":{"type":"ein","value":"726000969"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":210.00,"providers":[{"billed_charge":210.00,"npi":[1982671202]}]}]},{"tin":{"type":"ein","value":"454301492"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18044.14,"providers":[{"billed_charge":59454.20,"npi":[1962768440]}]}]},{"tin":{"type":"ein","value":"581282570"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":47347.32,"providers":[{"billed_charge":246239.53,"npi":[1396950770]}]}]},{"tin":{"type":"ein","value":"311836178"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":314167.02,"providers":[{"billed_charge":1448625.14,"npi":[1821028945]}]}]},{"tin":{"type":"ein","value":"272030893"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4016.85,"providers":[{"billed_charge":6582.00,"npi":[1497075279]}]}]},{"tin":{"type":"ein","value":"586003047"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5757.03,"providers":[{"billed_charge":7480.80,"npi":[1932260007]}]}]},{"tin":{"type":"ein","value":"474231144"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1007.94,"providers":[{"billed_charge":1272.00,"npi":[1710353636]}]}]},{"tin":{"type":"ein","value":"582285820"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":102.63,"providers":[{"billed_charge":130.80,"npi":[1285780577]}]}]},{"tin":{"type":"ein","value":"934415873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34197.57,"providers":[{"billed_charge":81613.40,"npi":[1518732643]}]}]},{"tin":{"type":"ein","value":"461615070"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12718.47,"providers":[{"billed_charge":34221.25,"npi":[1215368634]}]}]},{"tin":{"type":"ein","value":"134339107"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1072.81,"providers":[{"billed_charge":1247.76,"npi":[1073615407]}]}]},{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":132318.87,"providers":[{"billed_charge":455881.04,"npi":[1982674636]}]}]},{"tin":{"type":"ein","value":"586000853"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":24675.42,"providers":[{"billed_charge":39954.00,"npi":[1902890205]}]}]},{"tin":{"type":"ein","value":"586000854"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1371.81,"providers":[{"billed_charge":2093.00,"npi":[1194762450]}]}]},{"tin":{"type":"ein","value":"626000636"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2454.99,"providers":[{"billed_charge":7480.00,"npi":[1194797761]}]}]},{"tin":{"type":"ein","value":"586000858"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8470.54,"providers":[{"billed_charge":11791.00,"npi":[1093811275]}]}]},{"tin":{"type":"ein","value":"586000859"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":808.62,"providers":[{"billed_charge":922.95,"npi":[1316154222]}]}]}]},{"name":"AMB SVC ALS NON ER TRSPRT L1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0426","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NONEMERGENCY TRANSPORT, LEVEL 1 (ALS 1)","allowed_amounts":[{"tin":{"type":"ein","value":"934415873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2846.97,"providers":[{"billed_charge":9540.00,"npi":[1518732643]}]}]},{"tin":{"type":"ein","value":"581425000"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4109.47,"providers":[{"billed_charge":11334.30,"npi":[1669867487]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19283.75,"providers":[{"billed_charge":22800.00,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1374.45,"providers":[{"billed_charge":7800.00,"npi":[1982674636]}]}]},{"tin":{"type":"ein","value":"581282570"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1576.01,"providers":[{"billed_charge":18043.75,"npi":[1396950770]}]}]},{"tin":{"type":"ein","value":"311836178"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12665.00,"providers":[{"billed_charge":147260.00,"npi":[1821028945]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"582363827"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":51582.74,"providers":[{"billed_charge":287312.50,"npi":[1164445391]}]}]},{"tin":{"type":"ein","value":"586000839"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9511.62,"providers":[{"billed_charge":19000.00,"npi":[1881780799]}]}]},{"tin":{"type":"ein","value":"263941348"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":79809.40,"providers":[{"billed_charge":175100.00,"npi":[1407294028]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":175875.00,"providers":[{"billed_charge":175875.00,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"582605844"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":189006.72,"providers":[{"billed_charge":745997.43,"npi":[1699769158]}]}]},{"tin":{"type":"ein","value":"275404756"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13442.46,"providers":[{"billed_charge":24300.00,"npi":[1447530787]}]}]},{"tin":{"type":"ein","value":"586002461"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16594.94,"providers":[{"billed_charge":31020.00,"npi":[1760055396]}]}]},{"tin":{"type":"ein","value":"586002987"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8548.31,"providers":[{"billed_charge":15300.00,"npi":[1780969964]}]}]},{"tin":{"type":"ein","value":"586000841"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":509.78,"providers":[{"billed_charge":905.45,"npi":[1871681361]}]}]},{"tin":{"type":"ein","value":"586000842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23866.16,"providers":[{"billed_charge":48400.00,"npi":[1952363301]}]}]},{"tin":{"type":"ein","value":"586011374"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1503.75,"providers":[{"billed_charge":1725.00,"npi":[1134291842]}]}]},{"tin":{"type":"ein","value":"586000845"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20185.30,"providers":[{"billed_charge":42000.00,"npi":[1982755138]}]}]},{"tin":{"type":"ein","value":"586000802"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":81326.10,"providers":[{"billed_charge":225000.00,"npi":[1073683603]}]}]},{"tin":{"type":"ein","value":"586000829"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12070.59,"providers":[{"billed_charge":26280.00,"npi":[1184614208]}]}]},{"tin":{"type":"ein","value":"753106281"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25140.87,"providers":[{"billed_charge":45483.32,"npi":[1407872153]}]}]},{"tin":{"type":"ein","value":"586000906"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10146.77,"providers":[{"billed_charge":11000.00,"npi":[1790846665]}]}]},{"tin":{"type":"ein","value":"824030857"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":241920.97,"providers":[{"billed_charge":1013916.00,"npi":[1730697335]}]}]},{"tin":{"type":"ein","value":"581608892"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":357578.30,"providers":[{"billed_charge":1738693.00,"npi":[1538211081]}]}]},{"tin":{"type":"ein","value":"586000908"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1002.50,"providers":[{"billed_charge":1160.00,"npi":[1962444141]}]}]},{"tin":{"type":"ein","value":"582164513"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23423.66,"providers":[{"billed_charge":98859.80,"npi":[1821141821]}]}]},{"tin":{"type":"ein","value":"581651002"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25999.36,"providers":[{"billed_charge":89728.00,"npi":[1134156045]}]}]},{"tin":{"type":"ein","value":"586000790"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6543.31,"providers":[{"billed_charge":7800.00,"npi":[1699855049]}]}]},{"tin":{"type":"ein","value":"586009406"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":38866.85,"providers":[{"billed_charge":77000.00,"npi":[1962593541]}]}]},{"tin":{"type":"ein","value":"586012659"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6442.45,"providers":[{"billed_charge":10389.50,"npi":[1942386289]}]}]},{"tin":{"type":"ein","value":"586000430"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13026.48,"providers":[{"billed_charge":14300.00,"npi":[1851381156]}]}]},{"tin":{"type":"ein","value":"586000793"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1002.50,"providers":[{"billed_charge":1400.00,"npi":[1295708303]}]}]},{"tin":{"type":"ein","value":"586000873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26742.14,"providers":[{"billed_charge":60009.13,"npi":[1326001108]}]}]},{"tin":{"type":"ein","value":"586000799"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":40088.30,"providers":[{"billed_charge":66600.00,"npi":[1801972625]}]}]},{"tin":{"type":"ein","value":"586000910"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12084.12,"providers":[{"billed_charge":13525.44,"npi":[1659435303]}]}]},{"tin":{"type":"ein","value":"586000833"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6570.37,"providers":[{"billed_charge":7800.00,"npi":[1881861300]}]}]},{"tin":{"type":"ein","value":"586000834"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1530.81,"providers":[{"billed_charge":2700.00,"npi":[1992715908]}]}]},{"tin":{"type":"ein","value":"586000878"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1002.50,"providers":[{"billed_charge":1800.00,"npi":[1750471272]}]}]},{"tin":{"type":"ein","value":"586000835"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":150214.92,"providers":[{"billed_charge":269100.00,"npi":[1316052566]}]}]},{"tin":{"type":"ein","value":"581313603"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":109597.22,"providers":[{"billed_charge":443794.84,"npi":[1295760304]}]}]},{"tin":{"type":"ein","value":"582149691"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17638.46,"providers":[{"billed_charge":52000.00,"npi":[1568772689]}]}]},{"tin":{"type":"ein","value":"586000836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18486.66,"providers":[{"billed_charge":28675.00,"npi":[1992734867]}]}]},{"tin":{"type":"ein","value":"586000817"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":52481.70,"providers":[{"billed_charge":68250.00,"npi":[1972608644]}]}]},{"tin":{"type":"ein","value":"586000818"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23308.51,"providers":[{"billed_charge":50537.60,"npi":[1548329899]}]}]},{"tin":{"type":"ein","value":"261706720"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18553.66,"providers":[{"billed_charge":62900.00,"npi":[1295113868]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":380197.96,"providers":[{"billed_charge":1264896.14,"npi":[1326630153]}]}]},{"tin":{"type":"ein","value":"366005820"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13205.08,"providers":[{"billed_charge":70500.00,"npi":[1376554592]}]}]},{"tin":{"type":"ein","value":"586012329"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4037.06,"providers":[{"billed_charge":13313.28,"npi":[1538239132]}]}]},{"tin":{"type":"ein","value":"586002562"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7068.25,"providers":[{"billed_charge":10400.00,"npi":[1255315800]}]}]},{"tin":{"type":"ein","value":"586010502"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10146.77,"providers":[{"billed_charge":16000.00,"npi":[1942310800]}]}]},{"tin":{"type":"ein","value":"581425000"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3984.44,"providers":[{"billed_charge":7325.87,"npi":[1669867487]}]}]},{"tin":{"type":"ein","value":"586000783"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20498.98,"providers":[{"billed_charge":33599.50,"npi":[1225193048]}]}]},{"tin":{"type":"ein","value":"586004467"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":134840.00,"providers":[{"billed_charge":239490.00,"npi":[1558141671]}]}]},{"tin":{"type":"ein","value":"596000344"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2088.37,"providers":[{"billed_charge":2540.00,"npi":[1356341531]}]}]},{"tin":{"type":"ein","value":"586002921"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12543.50,"providers":[{"billed_charge":15000.00,"npi":[1952319360]}]}]},{"tin":{"type":"ein","value":"586000863"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":496.38,"providers":[{"billed_charge":650.00,"npi":[1720176340]}]}]},{"tin":{"type":"ein","value":"586000821"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6512.16,"providers":[{"billed_charge":10479.52,"npi":[1417931049]}]}]},{"tin":{"type":"ein","value":"586000865"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4480.82,"providers":[{"billed_charge":7200.00,"npi":[1962487942]}]}]},{"tin":{"type":"ein","value":"720701964"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":14795.00,"providers":[{"billed_charge":16049.00,"npi":[1316943566]}]}]},{"tin":{"type":"ein","value":"586000789"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23314.57,"providers":[{"billed_charge":27600.00,"npi":[1013025642]}]}]},{"tin":{"type":"ein","value":"582465552"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":403.06,"providers":[{"billed_charge":1866.00,"npi":[1891782595]}]}]},{"tin":{"type":"ein","value":"586000823"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":35778.17,"providers":[{"billed_charge":74195.00,"npi":[1962591966]}]}]},{"tin":{"type":"ein","value":"453639743"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":320471.56,"providers":[{"billed_charge":996546.00,"npi":[1477830164]}]}]},{"tin":{"type":"ein","value":"586000902"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8808.62,"providers":[{"billed_charge":13600.00,"npi":[1265439137]}]}]},{"tin":{"type":"ein","value":"581923254"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":91470.49,"providers":[{"billed_charge":394093.55,"npi":[1730156266]}]}]},{"tin":{"type":"ein","value":"586000826"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":28327.36,"providers":[{"billed_charge":42900.00,"npi":[1790880474]}]}]},{"tin":{"type":"ein","value":"450600978"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":15213.39,"providers":[{"billed_charge":77948.83,"npi":[1275823122]}]}]},{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1090985.56,"providers":[{"billed_charge":3513679.23,"npi":[1164966164]}]}]},{"tin":{"type":"ein","value":"596000708"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7818.99,"providers":[{"billed_charge":15516.00,"npi":[1215047675]}]}]},{"tin":{"type":"ein","value":"586000809"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":54896.60,"providers":[{"billed_charge":88000.00,"npi":[1225436033]}]}]},{"tin":{"type":"ein","value":"581282570"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":168644.49,"providers":[{"billed_charge":1111147.74,"npi":[1396950770]}]}]},{"tin":{"type":"ein","value":"311836178"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":271526.71,"providers":[{"billed_charge":1824557.54,"npi":[1821028945]}]}]},{"tin":{"type":"ein","value":"586003047"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16018.16,"providers":[{"billed_charge":22400.00,"npi":[1932260007]}]}]},{"tin":{"type":"ein","value":"832156832"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8664.40,"providers":[{"billed_charge":21661.00,"npi":[1770059800]}]}]},{"tin":{"type":"ein","value":"586000890"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4064.12,"providers":[{"billed_charge":4400.00,"npi":[1033256060]}]}]},{"tin":{"type":"ein","value":"586000893"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":27223.32,"providers":[{"billed_charge":42800.00,"npi":[1780668608]}]}]},{"tin":{"type":"ein","value":"586000894"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":84224.51,"providers":[{"billed_charge":157700.00,"npi":[1356447536]}]}]},{"tin":{"type":"ein","value":"586000895"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7586.40,"providers":[{"billed_charge":8646.45,"npi":[1548432834]}]}]},{"tin":{"type":"ein","value":"581036407"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":209559.15,"providers":[{"billed_charge":899371.63,"npi":[1962452870]}]}]},{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":390434.36,"providers":[{"billed_charge":1361613.14,"npi":[1982674636]}]}]},{"tin":{"type":"ein","value":"586000853"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":52427.66,"providers":[{"billed_charge":71200.00,"npi":[1902890205]}]}]},{"tin":{"type":"ein","value":"586000898"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8575.37,"providers":[{"billed_charge":12750.00,"npi":[1043390677]}]}]},{"tin":{"type":"ein","value":"582469468"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10052.06,"providers":[{"billed_charge":22888.00,"npi":[1326036161]}]}]},{"tin":{"type":"ein","value":"586000778"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3535.81,"providers":[{"billed_charge":5950.00,"npi":[1780644617]}]}]},{"tin":{"type":"ein","value":"626000636"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23931.00,"providers":[{"billed_charge":88620.00,"npi":[1194797761]}]}]},{"tin":{"type":"ein","value":"586000858"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7599.93,"providers":[{"billed_charge":15300.00,"npi":[1093811275]}]}]},{"tin":{"type":"ein","value":"581097948"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":99449.62,"providers":[{"billed_charge":179100.00,"npi":[1730133471]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0428","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NONEMERGENCY TRANSPORT, (BLS)","allowed_amounts":[{"tin":{"type":"ein","value":"582363827"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":797.87,"providers":[{"billed_charge":5250.00,"npi":[1164445391]}]}]},{"tin":{"type":"ein","value":"261706720"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5267.36,"providers":[{"billed_charge":30000.00,"npi":[1295113868]}]}]},{"tin":{"type":"ein","value":"582605844"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2313.24,"providers":[{"billed_charge":38804.48,"npi":[1720300379]}]},{"allowed_amount":15088.04,"providers":[{"billed_charge":122324.00,"npi":[1699769158]}]}]},{"tin":{"type":"ein","value":"275404756"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13690.90,"providers":[{"billed_charge":26100.00,"npi":[1447530787]}]}]},{"tin":{"type":"ein","value":"331880865"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1047.57,"providers":[{"billed_charge":1600.00,"npi":[1962273532]}]}]},{"tin":{"type":"ein","value":"822125340"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":527.64,"providers":[{"billed_charge":1200.00,"npi":[1255859179]}]}]},{"tin":{"type":"ein","value":"823526081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":48683.42,"providers":[{"billed_charge":76500.00,"npi":[1750854279]}]}]},{"tin":{"type":"ein","value":"453639743"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9164.93,"providers":[{"billed_charge":43058.75,"npi":[1477830164]}]}]},{"tin":{"type":"ein","value":"823991191"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9405.00,"providers":[{"billed_charge":22461.84,"npi":[1316455173]}]}]},{"tin":{"type":"ein","value":"824692084"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":14940.67,"providers":[{"billed_charge":85500.00,"npi":[1346744943]}]}]},{"tin":{"type":"ein","value":"453801631"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":59907.74,"providers":[{"billed_charge":135000.00,"npi":[1205112752]}]}]},{"tin":{"type":"ein","value":"452393528"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":22046.18,"providers":[{"billed_charge":175500.00,"npi":[1639462476]}]}]},{"tin":{"type":"ein","value":"824030857"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17133.00,"providers":[{"billed_charge":76636.00,"npi":[1730697335]}]}]},{"tin":{"type":"ein","value":"581608892"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9468.54,"providers":[{"billed_charge":61857.00,"npi":[1538211081]}]}]},{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":51488.51,"providers":[{"billed_charge":171950.00,"npi":[1164966164]}]}]},{"tin":{"type":"ein","value":"450600978"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":791.46,"providers":[{"billed_charge":7500.00,"npi":[1275823122]}]}]},{"tin":{"type":"ein","value":"453827742"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7460.08,"providers":[{"billed_charge":47600.00,"npi":[1225305964]}]}]},{"tin":{"type":"ein","value":"273447343"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2555.64,"providers":[{"billed_charge":3825.00,"npi":[1417257890]}]}]},{"tin":{"type":"ein","value":"850900440"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7666.92,"providers":[{"billed_charge":12150.00,"npi":[1205430212]}]}]},{"tin":{"type":"ein","value":"581282570"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8939.74,"providers":[{"billed_charge":119088.75,"npi":[1396950770]}]}]},{"tin":{"type":"ein","value":"311836178"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":89143.78,"providers":[{"billed_charge":1233800.00,"npi":[1821028945]}]}]},{"tin":{"type":"ein","value":"464991734"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23736.89,"providers":[{"billed_charge":52800.00,"npi":[1588084578]}]}]},{"tin":{"type":"ein","value":"934415873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9715.67,"providers":[{"billed_charge":30340.00,"npi":[1518732643]}]}]},{"tin":{"type":"ein","value":"582285820"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":293.50,"providers":[{"billed_charge":1000.00,"npi":[1285780577]}]}]},{"tin":{"type":"ein","value":"843523020"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34041.52,"providers":[{"billed_charge":80240.00,"npi":[1518588250]}]}]},{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":65720.77,"providers":[{"billed_charge":401662.67,"npi":[1982674636]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0429","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"582363827"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26467.33,"providers":[{"billed_charge":174375.00,"npi":[1164445391]}]}]},{"tin":{"type":"ein","value":"263941348"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":148844.10,"providers":[{"billed_charge":282850.00,"npi":[1407294028]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33824.00,"providers":[{"billed_charge":37500.00,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"275404756"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9252.62,"providers":[{"billed_charge":15540.00,"npi":[1447530787]}]}]},{"tin":{"type":"ein","value":"586002461"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2530.62,"providers":[{"billed_charge":4794.00,"npi":[1760055396]}]}]},{"tin":{"type":"ein","value":"586000840"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19599.00,"providers":[{"billed_charge":20700.00,"npi":[1700877016]}]}]},{"tin":{"type":"ein","value":"586002987"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":24595.80,"providers":[{"billed_charge":42050.00,"npi":[1780969964]}]}]},{"tin":{"type":"ein","value":"586000842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":103606.14,"providers":[{"billed_charge":202500.00,"npi":[1952363301]}]}]},{"tin":{"type":"ein","value":"586000802"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":62998.54,"providers":[{"billed_charge":151800.00,"npi":[1073683603]}]}]},{"tin":{"type":"ein","value":"452393528"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":251943.64,"providers":[{"billed_charge":1353787.50,"npi":[1639462476]}]}]},{"tin":{"type":"ein","value":"824030857"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":137141.30,"providers":[{"billed_charge":584025.00,"npi":[1730697335]}]}]},{"tin":{"type":"ein","value":"581608892"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":147725.43,"providers":[{"billed_charge":745235.00,"npi":[1538211081]}]}]},{"tin":{"type":"ein","value":"820945402"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7198.50,"providers":[{"billed_charge":22122.78,"npi":[1992238430]}]}]},{"tin":{"type":"ein","value":"581651002"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":27825.54,"providers":[{"billed_charge":94644.00,"npi":[1134156045]}]}]},{"tin":{"type":"ein","value":"586000790"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3810.30,"providers":[{"billed_charge":4950.00,"npi":[1699855049]}]}]},{"tin":{"type":"ein","value":"586000430"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13104.95,"providers":[{"billed_charge":13950.00,"npi":[1851381156]}]}]},{"tin":{"type":"ein","value":"586000873"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7232.70,"providers":[{"billed_charge":15212.68,"npi":[1326001108]}]}]},{"tin":{"type":"ein","value":"586000799"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20567.38,"providers":[{"billed_charge":36000.00,"npi":[1801972625]}]}]},{"tin":{"type":"ein","value":"586000833"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11008.80,"providers":[{"billed_charge":14300.00,"npi":[1881861300]}]}]},{"tin":{"type":"ein","value":"586000878"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1688.40,"providers":[{"billed_charge":3200.00,"npi":[1750471272]}]}]},{"tin":{"type":"ein","value":"586000835"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":50374.16,"providers":[{"billed_charge":107250.00,"npi":[1316052566]}]}]},{"tin":{"type":"ein","value":"586000913"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10350.00,"providers":[{"billed_charge":25875.00,"npi":[1871665174]}]}]},{"tin":{"type":"ein","value":"582149691"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2555.40,"providers":[{"billed_charge":8500.00,"npi":[1821308941]}]}]},{"tin":{"type":"ein","value":"586000817"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":75353.95,"providers":[{"billed_charge":93975.00,"npi":[1972608644]}]}]},{"tin":{"type":"ein","value":"586000818"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":40680.42,"providers":[{"billed_charge":84830.20,"npi":[1548329899]}]}]},{"tin":{"type":"ein","value":"261706720"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":35767.73,"providers":[{"billed_charge":127500.00,"npi":[1295113868]}]}]},{"tin":{"type":"ein","value":"834547536"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1688.40,"providers":[{"billed_charge":7200.00,"npi":[1043875586]}]}]},{"tin":{"type":"ein","value":"990611768"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":45406.94,"providers":[{"billed_charge":285689.25,"npi":[1003788852]}]}]},{"tin":{"type":"ein","value":"582149128"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":291158.61,"providers":[{"billed_charge":929615.84,"npi":[1326630153]}]}]},{"tin":{"type":"ein","value":"586002562"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7754.30,"providers":[{"billed_charge":11900.00,"npi":[1255315800]}]}]},{"tin":{"type":"ein","value":"586012329"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7632.00,"providers":[{"billed_charge":25225.20,"npi":[1538239132]}]}]},{"tin":{"type":"ein","value":"586010502"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":422.10,"providers":[{"billed_charge":700.00,"npi":[1942310800]}]}]},{"tin":{"type":"ein","value":"586004467"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":143550.06,"providers":[{"billed_charge":251596.00,"npi":[1558141671]}]}]},{"tin":{"type":"ein","value":"586002921"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":429.29,"providers":[{"billed_charge":500.00,"npi":[1952319360]}]}]},{"tin":{"type":"ein","value":"586000863"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17657.94,"providers":[{"billed_charge":23100.00,"npi":[1720176340]}]}]},{"tin":{"type":"ein","value":"586000821"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3427.50,"providers":[{"billed_charge":5515.60,"npi":[1417931049]}]}]},{"tin":{"type":"ein","value":"586000789"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":40806.60,"providers":[{"billed_charge":52800.00,"npi":[1013025642]}]}]},{"tin":{"type":"ein","value":"586000822"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8095.49,"providers":[{"billed_charge":9500.00,"npi":[1477542983]}]}]},{"tin":{"type":"ein","value":"586000823"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1711.20,"providers":[{"billed_charge":3520.00,"npi":[1962591966]}]}]},{"tin":{"type":"ein","value":"453639743"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":84923.06,"providers":[{"billed_charge":273454.50,"npi":[1477830164]}]}]},{"tin":{"type":"ein","value":"586000902"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4175.37,"providers":[{"billed_charge":6300.00,"npi":[1265439137]}]}]},{"tin":{"type":"ein","value":"450600978"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":855.60,"providers":[{"billed_charge":4108.53,"npi":[1275823122]}]}]},{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":387261.78,"providers":[{"billed_charge":1456035.00,"npi":[1164966164]}]}]},{"tin":{"type":"ein","value":"596000708"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2180.85,"providers":[{"billed_charge":4360.00,"npi":[1215047675]}]}]},{"tin":{"type":"ein","value":"586000809"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1265.31,"providers":[{"billed_charge":1800.00,"npi":[1225436033]}]}]},{"tin":{"type":"ein","value":"581282570"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":39619.92,"providers":[{"billed_charge":310190.54,"npi":[1396950770]}]}]},{"tin":{"type":"ein","value":"311836178"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":243402.74,"providers":[{"billed_charge":2118215.70,"npi":[1821028945]}]}]},{"tin":{"type":"ein","value":"586000890"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3000.30,"providers":[{"billed_charge":3150.00,"npi":[1033256060]}]}]},{"tin":{"type":"ein","value":"586000891"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1699.80,"providers":[{"billed_charge":1967.28,"npi":[1588664452]}]}]},{"tin":{"type":"ein","value":"586000893"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":42564.10,"providers":[{"billed_charge":52375.00,"npi":[1780668608]}]}]},{"tin":{"type":"ein","value":"586000894"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":59555.68,"providers":[{"billed_charge":90374.98,"npi":[1356447536]}]}]},{"tin":{"type":"ein","value":"461615070"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6922.19,"providers":[{"billed_charge":25600.00,"npi":[1215368634]}]}]},{"tin":{"type":"ein","value":"586000895"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19188.30,"providers":[{"billed_charge":21843.45,"npi":[1548432834]}]}]},{"tin":{"type":"ein","value":"581036407"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":126626.98,"providers":[{"billed_charge":510080.62,"npi":[1962452870]}]}]},{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":125191.12,"providers":[{"billed_charge":507800.00,"npi":[1982674636]}]}]},{"tin":{"type":"ein","value":"586000853"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20808.30,"providers":[{"billed_charge":28900.00,"npi":[1902890205]}]}]},{"tin":{"type":"ein","value":"586000854"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":429.29,"providers":[{"billed_charge":525.00,"npi":[1194762450]}]}]},{"tin":{"type":"ein","value":"626000636"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1343.48,"providers":[{"billed_charge":4752.00,"npi":[1194797761]}]}]},{"tin":{"type":"ein","value":"581097948"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":94005.83,"providers":[{"billed_charge":156100.00,"npi":[1730133471]}]}]}]},{"name":"AMB SVC AIR TRNSPRT 1 WY ROT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0431","description":"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)","allowed_amounts":[{"tin":{"type":"ein","value":"870533822"},"service_code":["42"],"billing_class":"professional","payments":[{"allowed_amount":340753.64,"providers":[{"billed_charge":515697.42,"npi":[1407855240]}]}]}]},{"name":"ADVNCED LIFE SUPPORT LEVEL 2","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0433","description":"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)","allowed_amounts":[{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16257.66,"providers":[{"billed_charge":37695.00,"npi":[1164966164]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0434","description":"SPECIALTY CARE TRANSPORT (SCT)","allowed_amounts":[{"tin":{"type":"ein","value":"582612884"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6491.16,"providers":[{"billed_charge":22080.38,"npi":[1982674636]}]}]}]},{"name":"ROTARY WING AIR MILEAGE-STAT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0436","description":"ROTARY WING AIR MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"870533822"},"service_code":["42"],"billing_class":"professional","payments":[{"allowed_amount":69397.78,"providers":[{"billed_charge":234605.32,"npi":[1407855240]}]}]}]},{"name":"AMB RSPN&TREATMENT NO TRNSPT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0998","description":"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"814571957"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":22901.84,"providers":[{"billed_charge":57254.60,"npi":[1164966164]}]}]},{"tin":{"type":"ein","value":"581608892"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31216.68,"providers":[{"billed_charge":78041.70,"npi":[1538211081]}]}]},{"tin":{"type":"ein","value":"581036407"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2360.94,"providers":[{"billed_charge":5902.56,"npi":[1962452870]}]}]},{"tin":{"type":"ein","value":"586003081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1980.00,"providers":[{"billed_charge":4950.00,"npi":[1427835891]}]}]}]},{"name":"INFUS SET EXT INSULIN PUMP","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4230","description":"INFUSION SET FOR EXTERNAL INSULIN PUMP, NONNEEDLE CANNULA TYPE","allowed_amounts":[{"tin":{"type":"ein","value":"593271823"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":8776.00,"providers":[{"billed_charge":51996.00,"npi":[1295827780]}]}]}]},{"name":"INFUS SET EXT INSULIN PUMP","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4231","description":"INFUSION SET FOR EXTERNAL INSULIN PUMP, NEEDLE TYPE","allowed_amounts":[{"tin":{"type":"ein","value":"593271823"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":3168.75,"providers":[{"billed_charge":18213.00,"npi":[1295827780]}]}]}]},{"name":"SYRINGE NDLE EXT INSULIN PUM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4232","description":"SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3 CC","allowed_amounts":[{"tin":{"type":"ein","value":"593271823"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":3836.10,"providers":[{"billed_charge":11615.98,"npi":[1295827780]}]}]}]},{"name":"SPLY ALW NONIMPL CGM 1 MO SP=1 UOS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4239","description":"SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":27665.44,"providers":[{"billed_charge":82787.28,"npi":[1234567893]}]}]}]},{"name":"TUBING W/INTGR HEAT ELEM W/P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4604","description":"TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2319.82,"providers":[{"billed_charge":5481.23,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":221.71,"providers":[{"billed_charge":873.38,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":41.54,"providers":[{"billed_charge":100.00,"npi":[1770929622]}]},{"allowed_amount":2658.56,"providers":[{"billed_charge":6400.00,"npi":[1225115686]}]}]}]},{"name":"FULL FCE MASK POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7030","description":"FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1764.00,"providers":[{"billed_charge":4410.01,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":4066.95,"providers":[{"billed_charge":24184.48,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":3049.80,"providers":[{"billed_charge":4810.00,"npi":[1225115686]}]}]}]},{"name":"FCE MASK INTERFCE REPL FULL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7031","description":"FACE MASK INTERFACE, REPLACEMENT FOR FULL FACE MASK, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":5287.48,"providers":[{"billed_charge":23281.18,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2863.30,"providers":[{"billed_charge":4604.82,"npi":[1225115686]}]}]}]},{"name":"CUSHN NASAL MASK INTF REPL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7032","description":"CUSHION FOR USE ON NASAL MASK INTERFACE, REPLACEMENT ONLY, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":158.31,"providers":[{"billed_charge":795.12,"npi":[1234567893]}]}]}]},{"name":"NASL INTERFCE POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7034","description":"NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1437.15,"providers":[{"billed_charge":3295.20,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":374.72,"providers":[{"billed_charge":1921.76,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1901.90,"providers":[{"billed_charge":3250.00,"npi":[1225115686]}]}]}]},{"name":"HEADGEAR USED W/POS ARWAY PR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7035","description":"HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":973.86,"providers":[{"billed_charge":2238.50,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":631.84,"providers":[{"billed_charge":3169.20,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1010.25,"providers":[{"billed_charge":2146.50,"npi":[1225115686]}]}]}]},{"name":"TUBING USED W/POS ARWAY PRES","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7037","description":"TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1062.93,"providers":[{"billed_charge":4408.57,"npi":[1234567893]}]}]}]},{"name":"FLTR DISPBL W/POS ARWAY PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7038","description":"FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":776.18,"providers":[{"billed_charge":1782.42,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":960.02,"providers":[{"billed_charge":4478.92,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1337.99,"providers":[{"billed_charge":2600.94,"npi":[1225115686]}]}]}]},{"name":"WATR CHAMB HUMDIFIR USED W/P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7046","description":"WATER CHAMBER FOR HUMIDIFIER, USED WITH POSITIVE AIRWAY PRESSURE DEVICE, REPLACEMENT, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":401.08,"providers":[{"billed_charge":1002.33,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":200.42,"providers":[{"billed_charge":1693.72,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":497.33,"providers":[{"billed_charge":959.81,"npi":[1225115686]}]}]}]},{"name":"SENSOR; INVSV INTRSTL GLU MO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A9276","description":"SENSOR; INVASIVE (E.G., SUBCUTANEOUS), DISPOSABLE, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONI","allowed_amounts":[{"tin":{"type":"ein","value":"593271823"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":116383.50,"providers":[{"billed_charge":167662.26,"npi":[1295827780]}]}]}]},{"name":"TC-99M SESTAMIBI DX PER STUD","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A9500","description":"TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE","allowed_amounts":[{"tin":{"type":"ein","value":"994689720"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3857.22,"providers":[{"billed_charge":12720.00,"npi":[1780772731]}]}]}]},{"name":"WALKER FOLD WHEELED ADJUSTBL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0143","description":"WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":100.80,"providers":[{"billed_charge":252.00,"npi":[1184673030]}]}]}]},{"name":"PRTBLE GASEOUS O2 SYS RENTAL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0431","description":"PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, HUMIDIFIE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1223.81,"providers":[{"billed_charge":1750.00,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":168.80,"providers":[{"billed_charge":898.25,"npi":[1234567893]}]}]}]},{"name":"RESP ASST DEVC BI-LEVL PRSS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0470","description":"RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITHOUT BACKUP RATE FEATURE, USED WITH NONI","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2751.63,"providers":[{"billed_charge":8400.00,"npi":[1184673030]}]}]}]},{"name":"HUMDIFIR HEAT USED W/POS ARW","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0562","description":"HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":6424.83,"providers":[{"billed_charge":11280.00,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2224.83,"providers":[{"billed_charge":9489.30,"npi":[1234567893]}]}]}]},{"name":"CONTINUOUS POS AIRWAY PRESSU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0601","description":"CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"421685996"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1913.93,"providers":[{"billed_charge":1913.93,"npi":[1073551446]}]}]},{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":17685.48,"providers":[{"billed_charge":33240.00,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"593154523"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1025.88,"providers":[{"billed_charge":2280.00,"npi":[1558341289]}]}]},{"tin":{"type":"ein","value":"203301086"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":10888.64,"providers":[{"billed_charge":18540.19,"npi":[1245215797]}]}]},{"tin":{"type":"ein","value":"810691481"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1228.89,"providers":[{"billed_charge":4600.00,"npi":[1487104774]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2884.05,"providers":[{"billed_charge":36342.54,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"522439178"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2222.56,"providers":[{"billed_charge":3450.00,"npi":[1225115686]}]}]}]},{"name":"O2 CONC 85%/>02 CONC PRSC FL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E1390","description":"OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCEN","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":9068.42,"providers":[{"billed_charge":15000.00,"npi":[1184673030]}]}]},{"tin":{"type":"ein","value":"593154523"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":5065.55,"providers":[{"billed_charge":14350.00,"npi":[1558341289]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":10946.00,"providers":[{"billed_charge":82962.47,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"581815731"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1999.20,"providers":[{"billed_charge":2550.00,"npi":[1174523765]}]}]}]},{"name":"PORTABLE OXYGEN CONCENTRATOR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E1392","description":"PORTABLE OXYGEN CONCENTRATOR, RENTAL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":889.80,"providers":[{"billed_charge":4360.00,"npi":[1234567893]}]}]}]},{"name":"NEG PRSS WND TX PUMP STATN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E2402","description":"NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE","allowed_amounts":[{"tin":{"type":"ein","value":"742152396"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1023.00,"providers":[{"billed_charge":2407.90,"npi":[1649267857]}]}]}]},{"name":"E-STIM 1/>NOT WND CARE PART","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0283","description":"ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, A","allowed_amounts":[{"tin":{"type":"ein","value":"621488455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":161.56,"providers":[{"billed_charge":868.19,"npi":[1710999099]}]}]}]},{"name":"ANL ALCHL MISUSE SCREN 15MIM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING, 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1019.67,"providers":[{"billed_charge":2132.00,"npi":[1093391997]}]}]}]},{"name":"ANL DEPRSSION SCREENG 15 MIN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0444","description":"ANNUAL DEPRESSION SCREENING, 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1019.67,"providers":[{"billed_charge":2132.00,"npi":[1093391997]}]}]}]},{"name":"COLL V BLD VP/URN SMP CATH I","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0471","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE OR URINE SAMPLE BY CATHETERIZATION FROM AN INDIVIDUAL IN ","allowed_amounts":[{"tin":{"type":"ein","value":"582328865"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":543.41,"providers":[{"billed_charge":980.00,"npi":[1760579825]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 1-7","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"471359076"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3584.72,"providers":[{"billed_charge":12129.58,"npi":[1134538713]}]}]},{"tin":{"type":"ein","value":"464450977"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3290.10,"providers":[{"billed_charge":18308.80,"npi":[1184041949]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24231.48,"providers":[{"billed_charge":217645.86,"npi":[1234567893]}]}]}]},{"name":"Code for Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0545","description":"Code for Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge)","allowed_amounts":[{"tin":{"type":"ein","value":"30572112"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":125.50,"providers":[{"billed_charge":240.00,"npi":[1215934898]}]}]},{"tin":{"type":"ein","value":"201970681"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2005.02,"providers":[{"billed_charge":3055.00,"npi":[1235101072]}]}]},{"tin":{"type":"ein","value":"363966745"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":177.90,"providers":[{"billed_charge":180.00,"npi":[1972910339]}]},{"allowed_amount":44.89,"providers":[{"billed_charge":45.00,"npi":[1497919450]}]}]},{"tin":{"type":"ein","value":"472221436"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":154.53,"providers":[{"billed_charge":324.00,"npi":[1922636000]}]}]}]},{"name":"MED ASST TX METHADONE;WEEKLY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2067","description":"MEDICATION ASSISSTED TX METHADONE; WEEKLY BUNDLE","allowed_amounts":[{"tin":{"type":"ein","value":"822071077"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":5341.98,"providers":[{"billed_charge":5341.98,"npi":[1578125282]}]}]}]},{"name":"VISIT CPLX INHERENT E&M ASSO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2211","description":"VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC","allowed_amounts":[{"tin":{"type":"ein","value":"472597330"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":20.28,"providers":[{"billed_charge":32.00,"npi":[1164543344]}]},{"allowed_amount":230.88,"providers":[{"billed_charge":416.00,"npi":[1164543344]}]}]},{"tin":{"type":"ein","value":"208583725"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.40,"providers":[{"billed_charge":324.00,"npi":[1578690467]}]}]},{"tin":{"type":"ein","value":"581896468"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14.00,"providers":[{"billed_charge":20.00,"npi":[1386602662]}]},{"allowed_amount":607.60,"providers":[{"billed_charge":868.00,"npi":[1598949547]}]}]},{"tin":{"type":"ein","value":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1404.00,"providers":[{"billed_charge":2189.70,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"581590562"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.48,"providers":[{"billed_charge":188.00,"npi":[1093391997]}]}]},{"tin":{"type":"ein","value":"581974299"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":759.28,"providers":[{"billed_charge":950.00,"npi":[1215472360]}]}]},{"tin":{"type":"ein","value":"453072990"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":780.30,"providers":[{"billed_charge":1922.00,"npi":[1649910712]}]}]}]},{"name":"ALCOHL&/RX SRVC; INTENSV OP;","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0015","description":"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"853679775"},"service_code":["57"],"billing_class":"professional","payments":[{"allowed_amount":9450.00,"providers":[{"billed_charge":37800.00,"npi":[1992221717]}]}]}]},{"name":"BHVAL HLTH; SHRTTRM RES DIEM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0018","description":"BEHAVIORAL HEALTH; SHORT-TERM RESIDENTIAL (NONHOSPITAL RESIDENTIAL TREATMENT PROGRAM), WITHOUT ROOM ","allowed_amounts":[{"tin":{"type":"ein","value":"932430642"},"service_code":["55"],"billing_class":"professional","payments":[{"allowed_amount":12585.00,"providers":[{"billed_charge":50340.00,"npi":[1518748391]}]}]}]},{"name":"MENTAL HEALTH ASSESS NON-PHY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0031","description":"MENTAL HEALTH ASSESSMENT, BY NONPHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"200690840"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":937.20,"providers":[{"billed_charge":1304.64,"npi":[1174891774]}]}]}]},{"name":"MENTL HLTH SVC PLAN DVLP NON","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0032","description":"MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NONPHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"582108870"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":156.00,"providers":[{"billed_charge":704.25,"npi":[1508521790]}]}]}]},{"name":"MENTAL HLTH PART HOSP TX <24","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0035","description":"MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"992174368"},"service_code":["57"],"billing_class":"professional","payments":[{"allowed_amount":11100.00,"providers":[{"billed_charge":75000.00,"npi":[1083976971]}]}]}]},{"name":"COMP CMTY SUPPRT SRV PER 15","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H2015","description":"COMPREHENSIVE COMMUNITY SUPPORT SERVICES, PER 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":24.36,"providers":[{"billed_charge":97.44,"npi":[1669456620]}]}]},{"tin":{"type":"ein","value":"200690840"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":1563.16,"providers":[{"billed_charge":2242.00,"npi":[1174891774]}]}]}]},{"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":"453455306"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12.04,"providers":[{"billed_charge":4480.00,"npi":[1770655987]}]}]},{"tin":{"type":"ein","value":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":25.54,"providers":[{"billed_charge":660.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":32.60,"providers":[{"billed_charge":80.00,"npi":[1194953638]}]},{"allowed_amount":37.34,"providers":[{"billed_charge":96.00,"npi":[1073612115]}]},{"allowed_amount":13.56,"providers":[{"billed_charge":34.00,"npi":[1295806495]}]}]},{"tin":{"type":"ein","value":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1.72,"providers":[{"billed_charge":40.00,"npi":[1225021678]}]}]}]},{"name":"INJ BETAMETHASONE AC & PHOS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J0702","description":"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG","allowed_amounts":[{"tin":{"type":"ein","value":"43800503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":36.00,"providers":[{"billed_charge":83.03,"npi":[1558698423]}]}]}]},{"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":"202595343"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1.08,"providers":[{"billed_charge":315.00,"npi":[1225021678]}]}]}]},{"name":"INJ TESTOSTERONE CYPION 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1071","description":"INJECTION, TESTOSTERONE CYPIONATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"582041471"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.00,"providers":[{"billed_charge":250.00,"npi":[1598949166]}]}]}]},{"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":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":66.71,"providers":[{"billed_charge":917.00,"npi":[1902942220]}]}]},{"tin":{"type":"ein","value":"852204789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":22.95,"providers":[{"billed_charge":65.00,"npi":[1194953638]}]},{"allowed_amount":26.55,"providers":[{"billed_charge":75.00,"npi":[1073612115]}]},{"allowed_amount":1.67,"providers":[{"billed_charge":5.00,"npi":[1164166922]}]},{"allowed_amount":12.07,"providers":[{"billed_charge":35.00,"npi":[1295806495]}]}]},{"tin":{"type":"ein","value":"465736753"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":0.08,"providers":[{"billed_charge":15.00,"npi":[1679319875]}]},{"allowed_amount":17.14,"providers":[{"billed_charge":3225.00,"npi":[1053860361]}]},{"allowed_amount":16.07,"providers":[{"billed_charge":2880.00,"npi":[1750179412]}]},{"allowed_amount":32.94,"providers":[{"billed_charge":5910.00,"npi":[1538132857]}]},{"allowed_amount":49.57,"providers":[{"billed_charge":8565.00,"npi":[1144887472]}]},{"allowed_amount":5.50,"providers":[{"billed_charge":960.00,"npi":[1255381950]}]}]}]},{"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":"582076411"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.00,"providers":[{"billed_charge":216.00,"npi":[1902942220]}]}]}]},{"name":"STANDARD WHEELCHAIR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"K0001","description":"STANDARD WHEELCHAIR","allowed_amounts":[{"tin":{"type":"ein","value":"580566121"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2043.77,"providers":[{"billed_charge":1973.00,"npi":[1184673030]}]}]}]},{"name":"PORT GASEOUS O2 SYS RNTL;HOM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"K0738","description":"PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; HOME COMPRESSOR USED TO FILL PORTABLE OXYGEN CYLINDERS; INCL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1831.20,"providers":[{"billed_charge":15993.60,"npi":[1234567893]}]}]}]},{"name":"TRAVL 1 WAY NEC LAB SPEC; AC","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"P9603","description":"TRAVEL ALLOWANCE, ONE WAY IN CONNECTION W MEDICALLY NECESSARY LABORATORY SPECIMEN COLLECTION DRAWN F","allowed_amounts":[{"tin":{"type":"ein","value":"582328865"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":2388.79,"providers":[{"billed_charge":5971.96,"npi":[1760579825]}]},{"allowed_amount":21.02,"providers":[{"billed_charge":52.56,"npi":[1760579825]}]}]}]},{"name":"VERT AXIAL DECOMPRS PER SESS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9090","description":"VERTEBRAL AXIAL DECOMPRESSION, PER SESSION","allowed_amounts":[{"tin":{"type":"ein","value":"582068734"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1200.00,"providers":[{"billed_charge":4000.00,"npi":[1174005284]}]}]}]},{"name":"HOM HLTH AIDE/CNA PROV CARE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9122","description":"HOME HEALTH AIDE OR CERTIFIED NURSE ASSISTANT, PROVIDING CARE IN THE HOME; PER HOUR","allowed_amounts":[{"tin":{"type":"ein","value":"454051201"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1298.50,"providers":[{"billed_charge":1405.88,"npi":[1760754113]}]}]}]},{"name":"HIT IMPLANTED PUMP PAIN MGMT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9328","description":"HOME INFUSION THERAPY, IMPLANTED PUMP PAIN MANAGEMENT INFUSION; ADMINISTRATIVE SERVICES, PROFESSIONA","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":4932.00,"providers":[{"billed_charge":16440.00,"npi":[1234567893]}]}]}]},{"name":"HOME INFUS TX IMMUOTHAPY; PE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9338","description":"HOME INFUSION THERAPY, IMMUNOTHERAPY, ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY SERVICES, CARE ","allowed_amounts":[{"tin":{"type":"ein","value":"20651651"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":160.00,"providers":[{"billed_charge":400.00,"npi":[1982602991]}]}]}]},{"name":"LACTATION CLASS NON-PHYS PRO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9443","description":"LACTATION CLASSES, NONPHYSICIAN PROVIDER, PER SESSION","allowed_amounts":[{"tin":{"type":"ein","value":"850867370"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":786.00,"providers":[{"billed_charge":2100.00,"npi":[1699369124]}]}]}]},{"name":"NURSING ASSESSMENT/EVALUATIO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"T1001","description":"NURSING ASSESSMENT/EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"582109188"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":3450.00,"providers":[{"billed_charge":13800.00,"npi":[1669456620]}]}]}]}]}