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14232.58, "providers": [{ "billed_charge": 66234.00, "npi": [1871989780] } ] }, { "allowed_amount": 85.87, "providers": [{ "billed_charge": 399.00, "npi": [1124067798] } ] } ] }, { "tin": { "type": "ein", "value": "760193812" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 12932.02, "providers": [{ "billed_charge": 27930.00, "npi": [1477823813] } ] }, { "allowed_amount": 19587.74, "providers": [{ "billed_charge": 43680.00, "npi": [1356359384] } ] }, { "allowed_amount": 3176.73, "providers": [{ "billed_charge": 7560.00, "npi": [1407857832] } ] }, { "allowed_amount": 7760.27, "providers": [{ "billed_charge": 14700.00, "npi": [1790959427] } ] }, { "allowed_amount": 20005.92, "providers": [{ "billed_charge": 40530.00, "npi": [1578550745] } ] } ] }, { "tin": { "type": "ein", "value": "824337061" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 1624.00, "providers": [{ "billed_charge": 6240.00, "npi": 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"payments": [{ "allowed_amount": 1256.25, "providers": [{ "billed_charge": 7125.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10653.00, "providers": [{ "billed_charge": 89294.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 291524.69, "providers": [{ "billed_charge": 4531010.29, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1913.10, "providers": [{ "billed_charge": 6977.24, "npi": [1730617523] } ] } ] } ] }, { "name": "RENAL FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80069", "description": "RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN 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{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3044.86, "providers": [{ "billed_charge": 18269.16, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "364568253" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 155.35, "providers": [{ "billed_charge": 500.00, "npi": [1023269313] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3231.28, "providers": [{ "billed_charge": 12925.12, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1802.06, "providers": [{ "billed_charge": 8700.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "830973361" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10284.17, "providers": [{ "billed_charge": 82273.36, "npi": [1447814272] } ] } ] }, { "tin": { "type": "ein", "value": "471489220" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 372.84, "providers": [{ "billed_charge": 1864.20, "npi": [1861895500] } ] } ] }, { "tin": { "type": "ein", "value": "461242694" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 411.42, "providers": [{ "billed_charge": 675.00, "npi": [1134559685] } ] } ] }, { "tin": { "type": "ein", "value": "464460776" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.07, "providers": [{ "billed_charge": 600.00, "npi": [1235665175] } ] } ] }, { "tin": { "type": "ein", "value": "472177895" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.98, "providers": [{ "billed_charge": 1838.52, "npi": [1477925188] } ] } ] }, { "tin": { "type": "ein", "value": "800686939" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 994.24, "providers": [{ "billed_charge": 2176.00, "npi": [1699045674] } ] } ] }, { "tin": { "type": "ein", "value": "611803788" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1553.50, "providers": [{ "billed_charge": 6000.00, "npi": [1053841023] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 683.54, "providers": [{ "billed_charge": 2734.16, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1054.02, "providers": [{ "billed_charge": 4800.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", 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103.85, "npi": [1234567893] } ] } ] } ] }, { "name": "BENZODIAZEPINES1-12", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80346", "description": "BENZODIAZEPINES; 1-12", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.11, "providers": [{ "billed_charge": 883.44, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 603.38, "providers": [{ "billed_charge": 3546.40, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 274.27, "providers": [{ "billed_charge": 745.44, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.34, "providers": [{ "billed_charge": 108.18, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 726.52, "providers": [{ "billed_charge": 2906.06, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREENING BUPRENORPHINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80348", "description": "BUPRENORPHINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.96, "providers": [{ "billed_charge": 883.44, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 348.10, "providers": [{ "billed_charge": 918.24, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": 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] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.01, "providers": [{ "billed_charge": 162.27, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 164.09, "providers": [{ "billed_charge": 656.23, "npi": [1234567893] } ] } ] } ] }, { "name": "GABAPENTIN, NON-BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80355", "description": "GABAPENTIN, NON-BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.18, "providers": [{ "billed_charge": 495.72, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 269.71, "providers": [{ "billed_charge": 1425.60, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 243.62, "providers": [{ "billed_charge": 784.30, "npi": [1982091617] } ] } ] } ] }, { "name": "HEROIN METABOLITE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80356", "description": "HEROIN METABOLITE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.11, "providers": [{ "billed_charge": 858.60, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.03, "providers": [{ "billed_charge": 392.15, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.05, "providers": [{ "billed_charge": 165.24, "npi": [1609565100] } ] } ] } ] }, { "name": "KETAMINE AND NORKETAMINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80357", "description": "KETAMINE AND NORKETAMINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.18, "providers": [{ "billed_charge": 664.20, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.99, "providers": [{ "billed_charge": 1425.60, "npi": [1164017422] } ] } ] } ] }, { "name": "DRUG SCREENING METHADONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80358", "description": "METHADONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": 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"providers": [{ "billed_charge": 546.48, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 232.07, "providers": [{ "billed_charge": 546.84, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 88.43, "providers": [{ "billed_charge": 268.97, "npi": [1609565100] } ] } ] } ] }, { "name": "METHYLPHENIDATE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80360", "description": "METHYLPHENIDATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.85, "providers": [{ "billed_charge": 154.69, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": 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"billed_charge": 40.16, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1912.32, "providers": [{ "billed_charge": 11926.70, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 245.43, "providers": [{ "billed_charge": 1128.00, "npi": [1174172845] } ] } ] } ] }, { "name": "OCCULT BLOOD FECES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82270", "description": "BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; FECES, CONSECUTIVE COLLECTED SPECIM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65.10, "providers": [{ "billed_charge": 3658.00, "npi": [1234567893] } ] } ] } ] }, { "name": 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["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.00, "providers": [{ "billed_charge": 495.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6512.00, "providers": [{ "billed_charge": 54595.20, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 331283.29, "providers": [{ "billed_charge": 3969116.31, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.49, "providers": [{ "billed_charge": 74.00, "npi": [1730617523] } ] }, { "allowed_amount": 2385.21, "providers": [{ "billed_charge": 9398.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF CALCIUM", "billing_code_type": "CPT", 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"service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.21, "providers": [{ "billed_charge": 2842.27, "npi": [1234567893] } ] } ] } ] }, { "name": "TOTAL CORTISOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82533", "description": "CORTISOL; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.60, "providers": [{ "billed_charge": 524.63, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.50, "providers": [{ "billed_charge": 165.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.95, "providers": [{ "billed_charge": 529.75, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.30, "providers": [{ "billed_charge": 65.20, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 163.00, "providers": [{ "billed_charge": 420.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.15, "providers": [{ "billed_charge": 68.34, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5238.96, "providers": [{ "billed_charge": 66131.02, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 609.60, "providers": [{ "billed_charge": 2904.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 199.80, "providers": [{ "billed_charge": 733.50, "npi": [1730617523] } ] } ] } ] }, { "name": "COL CHROMOTOGRAPHY QUAL/QUAN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82542", "description": "COLUMN CHROMATOGRAPHY, INCLUDES MASS SPECTROMETRY, IF PERFORMED (EG, HPLC, LC, LC/MS, LC/MS-MS, GC, ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 420.03, "providers": [{ "billed_charge": 7637.78, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF CK (CPK)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82550", "description": "CREATINE KINASE (CK), (CPK); 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"professional", "payments": [{ "allowed_amount": 251.68, "providers": [{ "billed_charge": 1050.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF CPK IN BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82552", "description": "CREATINE KINASE (CK), (CPK); ISOENZYMES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 205.73, "providers": [{ "billed_charge": 2011.41, "npi": [1234567893] } ] } ] } ] }, { "name": "CREATINE, MB FRACTION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82553", "description": "CREATINE KINASE (CK), (CPK); MB FRACTION ONLY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.06, "providers": [{ "billed_charge": 479.46, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF CREATININE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82565", "description": "CREATININE; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.44, "providers": [{ "billed_charge": 142.21, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5210.74, "providers": [{ "billed_charge": 12005.03, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1177.53, "providers": [{ "billed_charge": 24777.60, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.93, "providers": [{ "billed_charge": 279.72, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.50, "providers": [{ "billed_charge": 250.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 520.59, "providers": [{ "billed_charge": 4359.69, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "852076634" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 149.58, "providers": [{ "billed_charge": 279.72, "npi": [1619568367] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32995.65, "providers": [{ "billed_charge": 731317.78, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.60, "providers": [{ "billed_charge": 64.75, "npi": [1730617523] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2554.68, "providers": [{ "billed_charge": 28673.55, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.30, "providers": [{ "billed_charge": 150.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 595.66, "providers": [{ "billed_charge": 1191.32, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 754.00, "providers": [{ "billed_charge": 3770.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 124.41, "providers": [{ "billed_charge": 693.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.32, "providers": [{ "billed_charge": 241.28, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 233.74, "providers": [{ "billed_charge": 589.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 784.16, "providers": [{ "billed_charge": 3046.16, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2035.80, "providers": [{ "billed_charge": 17058.60, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65945.10, "providers": [{ "billed_charge": 869165.62, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 625.96, "providers": [{ "billed_charge": 2584.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 615.60, "providers": [{ "billed_charge": 2216.76, "npi": [1730617523] } ] }, { "allowed_amount": 10.26, "providers": [{ "billed_charge": 37.70, "npi": [1730617523] } ] } ] } ] }, { "name": "CYSTATIN C", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82610", "description": "CYSTATIN C", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1272.68, "providers": [{ "billed_charge": 21996.81, "npi": [1234567893] } ] } ] } ] }, { "name": "DEHYDROEPIANDROSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82626", "description": "DEHYDROEPIANDROSTERONE (DHEA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 446.10, "providers": [{ "billed_charge": 5675.72, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 820.48, "providers": [{ "billed_charge": 2950.00, "npi": [1174172845] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 494.08, "providers": [{ "billed_charge": 5076.93, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.65, "providers": [{ "billed_charge": 220.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 144.56, "providers": [{ "billed_charge": 722.54, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 244.64, "providers": [{ "billed_charge": 616.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.56, "providers": [{ "billed_charge": 32.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44.48, "providers": [{ "billed_charge": 372.84, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8416.94, "providers": [{ "billed_charge": 119249.69, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.13, "providers": [{ "billed_charge": 55.58, "npi": [1730617523] } ] }, { "allowed_amount": 257.21, "providers": [{ "billed_charge": 944.86, "npi": [1730617523] } ] } ] } ] }, { "name": "DIHYDROTESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82642", "description": "DIHYDROTESTOSTERONE (DHT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.05, "providers": [{ "billed_charge": 323.75, "npi": [1234567893] } ] } ] } ] }, { "name": "VIT D 1 25-DIHYDROXY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82652", "description": "VITAMIN D; 1, 25 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"999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 711.57, "providers": [{ "billed_charge": 12549.59, "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1319.20, "providers": [{ "billed_charge": 12993.76, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.04, "providers": [{ "billed_charge": 224.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.40, "providers": [{ "billed_charge": 1397.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 321.31, "providers": [{ "billed_charge": 805.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 474.98, "providers": [{ "billed_charge": 1732.28, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.95, "providers": [{ "billed_charge": 195.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.40, "providers": [{ "billed_charge": 1860.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1313.18, "providers": [{ "billed_charge": 11009.28, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29154.78, "providers": [{ "billed_charge": 357209.08, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 894.20, "providers": [{ "billed_charge": 3416.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.01, "providers": [{ "billed_charge": 69.85, "npi": [1730617523] } ] }, { "allowed_amount": 342.18, "providers": [{ "billed_charge": 1257.30, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF ESTROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82672", "description": "ESTROGENS; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2895.33, "providers": [{ "billed_charge": 36718.32, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ESTRONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82679", "description": "ESTRONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.33, "providers": [{ "billed_charge": 99.80, "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1268.98, "providers": [{ "billed_charge": 10925.28, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 395.56, "providers": [{ "billed_charge": 790.54, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 252.34, "providers": [{ "billed_charge": 1260.96, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 156.86, "providers": [{ "billed_charge": 414.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.56, "providers": [{ "billed_charge": 218.08, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.82, "providers": [{ "billed_charge": 27.26, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 88.66, "providers": [{ "billed_charge": 455.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 545.60, "providers": [{ "billed_charge": 4567.20, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51368.09, "providers": [{ "billed_charge": 585766.21, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 415.46, "providers": [{ "billed_charge": 1485.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 231.75, "providers": [{ "billed_charge": 852.00, "npi": [1730617523] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1092.47, "providers": [{ "billed_charge": 12005.28, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 42.55, "providers": [{ "billed_charge": 145.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 396.90, "providers": [{ "billed_charge": 793.80, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 389.55, "providers": [{ "billed_charge": 1947.75, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 169.05, "providers": [{ "billed_charge": 437.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 507.15, "providers": [{ "billed_charge": 1940.40, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.40, "providers": [{ "billed_charge": 117.60, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.68, "providers": [{ "billed_charge": 520.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1587.60, "providers": [{ "billed_charge": 13309.92, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41930.79, "providers": [{ "billed_charge": 533588.11, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 570.55, "providers": [{ "billed_charge": 2516.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.01, "providers": [{ "billed_charge": 36.75, "npi": [1730617523] } ] }, { "allowed_amount": 190.19, "providers": [{ "billed_charge": 683.55, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID, RBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82747", "description": "FOLIC ACID; RBC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 742.33, "providers": [{ "billed_charge": 10946.88, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY IGA/IGD/IGG/IGM EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82784", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4300.27, "providers": [{ "billed_charge": 53695.76, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF IGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82785", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2676.39, "providers": [{ "billed_charge": 30118.24, "npi": [1234567893] } ] } ] } ] }, { "name": "IGG 1 2 3 OR 4 EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82787", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.95, "providers": [{ "billed_charge": 966.98, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY, GLUCOSE, BLOOD QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82947", "description": "GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.16, "providers": [{ "billed_charge": 280.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.71, "providers": [{ "billed_charge": 205.62, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.34, "providers": [{ "billed_charge": 1100.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3905.50, "providers": [{ "billed_charge": 10199.96, "npi": [1234567893] } ] } ] } ] }, { "name": "REAGENT STRIP/BLOOD GLUCOSE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82948", "description": "GLUCOSE; BLOOD, REAGENT STRIP", "allowed_amounts": [{ "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.40, "providers": [{ "billed_charge": 1400.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 115.56, "providers": [{ "billed_charge": 270.00, "npi": [1669082723] } ] }, { "allowed_amount": 151.94, "providers": [{ "billed_charge": 355.00, "npi": [1538526702] } ] }, { "allowed_amount": 192.60, "providers": [{ "billed_charge": 450.00, "npi": [1003273731] } ] } ] } ] }, { "name": "GLUCOSE TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82950", "description": "GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.14, "providers": [{ "billed_charge": 48.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1498.41, "providers": [{ "billed_charge": 18600.97, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE TOLERANCE TEST (GTT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82951", "description": "GLUCOSE; TOLERANCE TEST (GTT), 3 SPECIMENS (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 823.90, "providers": [{ "billed_charge": 9406.78, "npi": [1234567893] } ] } ] } ] }, { "name": "GTT-ADDED SAMPLES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82952", "description": "GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 211.43, "providers": [{ "billed_charge": 2192.68, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF G6PD ENZYME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82955", "description": "GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 267.24, "providers": [{ "billed_charge": 3523.76, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE BLOOD TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82962", "description": "GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752354465" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.70, "providers": [{ "billed_charge": 199.00, "npi": [1144282989] } ] }, { "allowed_amount": 2.10, "providers": [{ "billed_charge": 7.00, "npi": [1144282989] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.64, "providers": [{ "billed_charge": 15.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.52, "providers": [{ "billed_charge": 56.00, "npi": [1326017872] } ] }, { "allowed_amount": 73.92, "providers": [{ "billed_charge": 176.00, "npi": [1326017872] } ] }, { "allowed_amount": 105.60, "providers": [{ "billed_charge": 352.00, "npi": [1265493688] } ] }, { "allowed_amount": 2.40, "providers": [{ "billed_charge": 8.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.84, "providers": [{ "billed_charge": 90.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.20, "providers": [{ "billed_charge": 30.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GGT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82977", "description": "GLUTAMYLTRANSFERASE, GAMMA (GGT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 205.00, "providers": [{ "billed_charge": 1317.49, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.60, "providers": [{ "billed_charge": 189.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 72.00, "providers": [{ "billed_charge": 603.60, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7373.38, "providers": [{ "billed_charge": 55148.61, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 347.20, "providers": [{ "billed_charge": 1488.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (FSH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83001", "description": "GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1110.26, "providers": [{ "billed_charge": 11613.54, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.65, "providers": [{ "billed_charge": 37.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 185.80, "providers": [{ "billed_charge": 929.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.25, "providers": [{ "billed_charge": 130.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.51, "providers": [{ "billed_charge": 706.04, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 232.25, "providers": [{ "billed_charge": 1550.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1347.05, "providers": [{ "billed_charge": 11296.95, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22536.74, "providers": [{ "billed_charge": 264038.93, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 940.68, "providers": [{ "billed_charge": 4042.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.65, "providers": [{ "billed_charge": 46.45, "npi": [1730617523] } ] }, { "allowed_amount": 113.85, "providers": [{ "billed_charge": 399.47, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (LH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83002", "description": "GONADOTROPIN; LUTEINIZING HORMONE (LH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 617.28, "providers": [{ "billed_charge": 6499.67, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.40, "providers": [{ "billed_charge": 148.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 148.16, "providers": [{ "billed_charge": 740.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.15, "providers": [{ "billed_charge": 130.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.78, "providers": [{ "billed_charge": 186.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1268.62, "providers": [{ "billed_charge": 10636.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18506.43, "providers": [{ "billed_charge": 214484.75, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 903.18, "providers": [{ "billed_charge": 3948.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 226.80, "providers": [{ "billed_charge": 814.88, "npi": [1730617523] } ] }, { "allowed_amount": 12.60, "providers": [{ "billed_charge": 46.30, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY, GROWTH HORMONE (HGH)", "billing_code_type": "CPT", "billing_code_type_version": 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GLYCOSYLATED (A1C)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6227.76, "providers": [{ "billed_charge": 71302.55, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 607.50, "providers": [{ "billed_charge": 1213.75, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.56, "providers": [{ "billed_charge": 480.00, "npi": [1184250524] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.94, "providers": [{ "billed_charge": 563.18, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 213.84, "providers": [{ "billed_charge": 572.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 510.30, "providers": [{ "billed_charge": 2625.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.66, "providers": [{ "billed_charge": 4650.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.22, "providers": [{ "billed_charge": 405.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "743001674" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 180.00, "npi": [1972819589] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1234.44, "providers": [{ "billed_charge": 11430.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 462.82, "providers": [{ "billed_charge": 1780.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.32, "providers": [{ "billed_charge": 528.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 222.00, "npi": [1982050241] } ] }, { "allowed_amount": 34.02, "providers": [{ "billed_charge": 518.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 476.28, "providers": [{ "billed_charge": 2379.44, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 901.53, "providers": [{ "billed_charge": 4452.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7430.94, "providers": [{ "billed_charge": 62199.72, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 116.64, "providers": [{ "billed_charge": 768.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "751414940" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 126.36, "providers": [{ "billed_charge": 494.00, "npi": [1578897765] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 196046.07, "providers": [{ "billed_charge": 2648373.59, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 107.38, "providers": [{ "billed_charge": 650.00, "npi": [1003273731] } ] }, { "allowed_amount": 128.03, "providers": [{ "billed_charge": 775.00, "npi": [1669082723] } ] }, { "allowed_amount": 181.72, "providers": [{ "billed_charge": 1100.00, "npi": [1538526702] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1070.82, "providers": [{ "billed_charge": 3894.52, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF B HEXOSAMINIDASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83080", "description": "B-HEXOSAMINIDASE, EACH ASSAY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.63, "providers": [{ "billed_charge": 160.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF HOMOCYSTINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83090", "description": "HOMOCYSTEINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.75, "providers": [{ "billed_charge": 6498.50, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.64, "providers": [{ "billed_charge": 360.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE 17-D", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83498", "description": "HYDROXYPROGESTERONE, 17-D", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3763.86, "providers": [{ "billed_charge": 35036.76, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83516", "description": "IMMUNOASSAY FOR ANALYTE OTH THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 201.87, "providers": [{ "billed_charge": 6860.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3470.44, "providers": [{ "billed_charge": 83165.53, "npi": [1234567893] } ] } ] } ] }, { "name": "RIA NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83519", "description": "IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.20, "providers": [{ "billed_charge": 1831.72, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY QUANT NOS NONAB", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83520", "description": "IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": 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"840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 262.02, "providers": [{ "billed_charge": 3572.35, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36.84, "providers": [{ "billed_charge": 115.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.12, "providers": [{ "billed_charge": 315.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.60, "providers": [{ "billed_charge": 114.30, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 652.08, "providers": [{ "billed_charge": 5465.16, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6512.38, "providers": [{ "billed_charge": 78742.04, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 857.81, "providers": [{ "billed_charge": 3174.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.04, "providers": [{ "billed_charge": 480.15, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF INSULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83527", "description": "INSULIN; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.18, "providers": [{ "billed_charge": 1355.34, "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 562.78, "providers": [{ "billed_charge": 3315.34, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 220.32, "providers": [{ "billed_charge": 439.96, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39.69, "providers": [{ "billed_charge": 702.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 288.36, "providers": [{ "billed_charge": 1440.02, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.52, "providers": [{ "billed_charge": 207.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.36, "providers": [{ "billed_charge": 280.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.56, "providers": [{ "billed_charge": 245.86, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 301.32, "providers": [{ "billed_charge": 2524.95, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.40, "providers": [{ "billed_charge": 200.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22036.36, "providers": [{ "billed_charge": 204310.37, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 208.20, "providers": [{ "billed_charge": 855.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.61, "providers": [{ "billed_charge": 339.78, "npi": [1730617523] } ] }, { "allowed_amount": 22.05, "providers": [{ "billed_charge": 80.90, "npi": [1730617523] } ] } ] } ] }, { "name": "IRON BINDING TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83550", "description": "IRON BINDING CAPACITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 564.51, "providers": [{ "billed_charge": 4413.37, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.51, "providers": [{ "billed_charge": 253.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24455.14, "providers": [{ "billed_charge": 251973.59, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 89.25, "providers": [{ "billed_charge": 327.75, "npi": [1730617523] } ] } ] } ] }, { "name": "LACTATE (LD) (LDH) ENZYME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83615", "description": "LACTATE DEHYDROGENASE (LD), (LDH);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.78, "providers": [{ "billed_charge": 124.31, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.55, "providers": [{ "billed_charge": 60.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.65, "providers": [{ "billed_charge": 150.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.42, "providers": [{ "billed_charge": 168.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4167.74, "providers": [{ "billed_charge": 24282.60, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 290.84, "providers": [{ "billed_charge": 1209.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LDH ENZYMES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83625", "description": "LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.92, "providers": [{ "billed_charge": 1398.64, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LEAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83655", "description": "LEAD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1580.07, "providers": [{ "billed_charge": 21047.94, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LIPASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83690", "description": "LIPASE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.24, "providers": [{ "billed_charge": 497.97, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3937.54, "providers": [{ "billed_charge": 69964.78, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 281.85, "providers": [{ "billed_charge": 1125.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN(A)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83695", "description": "LIPOPROTEIN (A)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 486.88, "providers": [{ "billed_charge": 4080.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4271.76, "providers": [{ "billed_charge": 63784.86, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY LIPOPROTEIN PLA2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83698", "description": "LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 (LP-PLA2)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 361.27, "providers": [{ "billed_charge": 749.32, "npi": [1234567893] } ] } ] } ] }, { "name": "LIPOPROTEIN BLD QUAN PART", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83704", "description": "LIPOPROTEIN, BLOOD; QUANTITATION OF LIPOPROTEIN PARTICLE NUMBER(S) (EG, BY NUCLEAR MAGNETIC RESONANC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1279.89, "providers": [{ "billed_charge": 8386.29, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83718", "description": "LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 57.40, "providers": [{ "billed_charge": 266.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF BLOOD LIPOPROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83721", "description": "LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 225.12, "providers": [{ "billed_charge": 2616.39, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 126.00, "providers": [{ "billed_charge": 441.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF MAGNESIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83735", "description": "MAGNESIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.24, "providers": [{ "billed_charge": 676.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 158.10, "providers": [{ "billed_charge": 1352.67, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.80, "providers": [{ "billed_charge": 65.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 211.05, "providers": [{ "billed_charge": 422.10, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.70, "providers": [{ "billed_charge": 1038.50, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.40, "providers": [{ "billed_charge": 78.00, "npi": [1265493688] } ] }, { "allowed_amount": 5.46, "providers": [{ "billed_charge": 13.00, "npi": [1326017872] } ] }, { "allowed_amount": 16.75, "providers": [{ "billed_charge": 195.00, "npi": [1265493688] } ] }, { "allowed_amount": 21.84, "providers": [{ "billed_charge": 52.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.05, "providers": [{ "billed_charge": 207.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 103.85, "providers": [{ "billed_charge": 620.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.55, "providers": [{ "billed_charge": 365.04, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9466.17, "providers": [{ "billed_charge": 123923.94, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.75, "providers": [{ "billed_charge": 45.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF METANEPHRINES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83835", "description": "METANEPHRINES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 156.34, "providers": [{ "billed_charge": 4355.62, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF NATRIURETIC PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83880", "description": "NATRIURETIC PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14275.65, "providers": [{ "billed_charge": 133844.64, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1085.13, "providers": [{ "billed_charge": 2226.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY, NEPHELOMETRY NOT SPEC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83883", "description": "NEPHELOMETRY, EACH ANALYTE NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 309.52, "providers": [{ "billed_charge": 2713.41, "npi": [1234567893] } ] } ] } ] }, { "name": "ORGANIC ACID SINGLE QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83921", "description": "ORGANIC ACID, SINGLE, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 923.40, "providers": [{ "billed_charge": 21439.03, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PARATHORMONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83970", "description": "PARATHORMONE (PARATHYROID HORMONE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 206.40, "providers": [{ "billed_charge": 1032.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.84, "providers": [{ "billed_charge": 1038.06, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21671.97, "providers": [{ "billed_charge": 202616.15, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1479.16, "providers": [{ "billed_charge": 3850.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 449.44, "providers": [{ "billed_charge": 1609.92, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY FOR PHENCYCLIDINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83992", "description": "PHENCYCLIDINE (PCP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 321.30, "providers": [{ "billed_charge": 907.20, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 172.77, "providers": [{ "billed_charge": 322.71, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.00, "providers": [{ "billed_charge": 207.66, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.19, "providers": [{ "billed_charge": 204.73, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 633.53, "providers": [{ "billed_charge": 16179.48, "npi": [1234567893] } ] } ] } ] }, { "name": "ANESTH, SURG LOWER ABDOMEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "840", "description": "ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHERWISE SPEC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "742569713" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 20533.23, "providers": [{ "billed_charge": 66160.00, "npi": [1063041523] } ] }, { "allowed_amount": 2345.85, "providers": [{ "billed_charge": 7660.00, "npi": [1063041523] } ] } ] }, { "tin": { "type": "ein", "value": "760482007" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 3101.31, "providers": [{ "billed_charge": 15925.00, "npi": [1689872228] } ] } ] } ] }, { "name": "ASSAY ALKALINE PHOSPHATASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84075", "description": "PHOSPHATASE, ALKALINE;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 68.41, "providers": [{ "billed_charge": 99.22, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4754.08, "providers": [{ "billed_charge": 6127.38, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY ALKALINE PHOSPHATASES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84080", "description": "PHOSPHATASE, ALKALINE; ISOENZYMES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 239.98, "providers": [{ "billed_charge": 2331.05, "npi": [1234567893] } ] } ] } ] }, { "name": "CAPD/COMPOSIT", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "841", "description": "CONT AMBULATORY PERITONEAL DIALYSIS - CAPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 89291.88, "providers": [{ "billed_charge": 730603.00, "npi": [1234567893] } ] }, { "allowed_amount": 11580.89, "providers": [{ "billed_charge": 113243.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PHOSPHORUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84100", "description": "PHOSPHORUS INORGANIC (PHOSPHATE);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.54, "providers": [{ "billed_charge": 261.21, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.15, "providers": [{ "billed_charge": 45.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.07, "providers": [{ "billed_charge": 513.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.40, "providers": [{ "billed_charge": 18.00, "npi": [1265493688] } ] }, { "allowed_amount": 13.50, "providers": [{ "billed_charge": 45.00, "npi": [1265493688] } ] }, { "allowed_amount": 4.74, "providers": [{ "billed_charge": 62.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4042.53, "providers": [{ "billed_charge": 18557.06, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.85, "providers": [{ "billed_charge": 55.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.23, "providers": [{ "billed_charge": 11.85, "npi": [1730617523] } ] }, { "allowed_amount": 48.45, "providers": [{ "billed_charge": 168.27, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF SERUM POTASSIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84132", "description": "POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.44, "providers": [{ "billed_charge": 52.03, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4099.89, "providers": [{ "billed_charge": 8315.74, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF URINE POTASSIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84133", "description": "POTASSIUM; URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.84, "providers": [{ "billed_charge": 25.37, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PREALBUMIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84134", "description": "PREALBUMIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 224.44, "providers": [{ "billed_charge": 3036.17, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 405.72, "providers": [{ "billed_charge": 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"billing_class": "professional", "payments": [{ "allowed_amount": 2517.45, "providers": [{ "billed_charge": 21106.80, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48819.94, "providers": [{ "billed_charge": 585305.14, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 915.33, "providers": [{ "billed_charge": 3315.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.57, "providers": [{ "billed_charge": 64.53, "npi": [1730617523] } ] }, { "allowed_amount": 404.11, "providers": [{ "billed_charge": 1432.57, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN B-1", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84425", "description": "THIAMINE (VITAMIN B-1)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.72, "providers": [{ "billed_charge": 270.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1549.09, "providers": [{ "billed_charge": 19741.46, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF THYROGLOBULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84432", "description": "THYROGLOBULIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.70, "providers": [{ "billed_charge": 5202.69, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 522.83, "providers": [{ "billed_charge": 2046.00, "npi": [1174172845] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 357.75, "providers": [{ "billed_charge": 3548.20, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14819.92, "providers": [{ "billed_charge": 174906.91, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF FREE THYROXINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84439", "description": "THYROXINE; FREE", 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"payments": [{ "allowed_amount": 798.20, "providers": [{ "billed_charge": 2895.42, "npi": [1730617523] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9511.05, "providers": [{ "billed_charge": 98494.01, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 915.60, "providers": [{ "billed_charge": 1881.60, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.80, "providers": [{ "billed_charge": 199.20, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 294.00, "providers": [{ "billed_charge": 735.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.40, "providers": [{ "billed_charge": 705.60, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 285.60, "providers": [{ "billed_charge": 850.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 731.20, "providers": [{ "billed_charge": 2856.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.20, "providers": [{ "billed_charge": 151.20, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1323.00, "providers": [{ "billed_charge": 7560.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.20, "providers": [{ "billed_charge": 2688.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6333.60, "providers": [{ "billed_charge": 53089.14, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 162511.19, "providers": [{ "billed_charge": 1847681.62, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 286.00, "providers": [{ "billed_charge": 1050.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF TSI GLOBULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84445", "description": "THYROID STIMULATING IMMUNE GLOBULINS (TSI)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 288.83, "providers": [{ "billed_charge": 2975.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4231.75, "providers": [{ "billed_charge": 58545.57, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN E", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84446", "description": "TOCOPHEROL ALPHA (VITAMIN E)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.68, "providers": [{ "billed_charge": 1106.96, "npi": [1234567893] } ] } ] } ] }, { "name": "TRANSFERASE (AST) (SGOT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84450", "description": "TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.92, "providers": [{ "billed_charge": 97.60, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5042.61, "providers": [{ "billed_charge": 8733.64, "npi": [1234567893] } ] } ] } ] }, { "name": "ALANINE AMINO (ALT) (SGPT)", 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"billing_code": "84478", "description": "TRIGLYCERIDES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 135.69, "providers": [{ "billed_charge": 1429.27, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF THYROID (T3 OR T4)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84479", "description": "THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 269.40, "providers": [{ "billed_charge": 2694.86, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11784.00, "providers": [{ "billed_charge": 143388.08, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY, TRIIODOTHYRONINE (T3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84480", "description": "TRIIODOTHYRONINE T3; TOTAL (TT-3)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 452.64, "providers": [{ "billed_charge": 5822.01, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16176.49, "providers": [{ "billed_charge": 222042.94, "npi": [1234567893] } ] } ] } ] }, { "name": "FREE ASSAY (FT-3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84481", "description": "TRIIODOTHYRONINE T3; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 858.48, "providers": [{ "billed_charge": 15835.15, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.59, "providers": [{ "billed_charge": 170.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 440.44, "providers": [{ "billed_charge": 880.88, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.17, "providers": [{ "billed_charge": 186.34, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 821.59, "providers": [{ "billed_charge": 4107.95, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 194.81, "providers": [{ "billed_charge": 506.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 440.44, "providers": [{ "billed_charge": 1660.12, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 338.80, "providers": [{ "billed_charge": 2840.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33753.15, "providers": [{ "billed_charge": 760398.29, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 728.66, "providers": [{ "billed_charge": 2720.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 588.03, "providers": [{ "billed_charge": 2109.03, "npi": [1730617523] } ] } ] } ] }, { "name": "T3 REVERSE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84482", "description": "TRIIODOTHYRONINE T3; REVERSE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 328.16, "providers": [{ "billed_charge": 10089.72, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TROPONIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84484", "description": "TROPONIN, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 683.02, "providers": [{ "billed_charge": 12657.72, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF UREA NITROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84520", "description": "UREA NITROGEN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.91, "providers": [{ "billed_charge": 88.34, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4259.67, "providers": [{ "billed_charge": 5888.12, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF BLOOD/URIC ACID", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84550", "description": "URIC ACID; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 283.44, "providers": [{ "billed_charge": 2702.31, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.40, "providers": [{ "billed_charge": 45.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.08, "providers": [{ "billed_charge": 90.40, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.43, "providers": [{ "billed_charge": 88.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.52, "providers": [{ "billed_charge": 20.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.24, "providers": [{ "billed_charge": 144.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 361.60, "providers": [{ "billed_charge": 3028.80, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11081.29, "providers": [{ "billed_charge": 135104.24, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "371925902" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.00, "providers": [{ "billed_charge": 22.00, "npi": [1144367426] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 128.52, "providers": [{ "billed_charge": 583.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN A", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84590", "description": "VITAMIN A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.77, "providers": [{ "billed_charge": 1880.37, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN K", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84597", "description": "VITAMIN K", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1153.22, "providers": [{ "billed_charge": 29032.78, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ZINC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84630", "description": "ZINC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 572.51, "providers": [{ "billed_charge": 7694.18, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF C-PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84681", "description": "C-PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1197.15, "providers": [{ "billed_charge": 10029.15, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3143.91, "providers": [{ "billed_charge": 26228.43, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84702", "description": "GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 188.28, "providers": [{ "billed_charge": 2268.00, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.65, "providers": [{ "billed_charge": 250.95, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9759.07, "providers": [{ "billed_charge": 153085.27, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN ASSAY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84703", "description": "GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1077.26, "providers": [{ "billed_charge": 20618.07, "npi": [1234567893] } ] } ] } ] }, { "name": "BL SMEAR W/O DIFF WBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85008", "description": "BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITHOUT MANUAL DIFFERENTIAL WBC COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.36, "providers": [{ "billed_charge": 278.04, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMATOCRIT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85014", "description": "BLOOD COUNT; HEMATOCRIT (HCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.34, "providers": [{ "billed_charge": 203.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 320.26, "providers": [{ "billed_charge": 2971.37, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMOGLOBIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85018", "description": "BLOOD COUNT; HEMOGLOBIN (HGB)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.96, "providers": [{ "billed_charge": 232.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 376.66, "providers": [{ "billed_charge": 3586.44, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLETE CBC W/AUTO DIFF WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.60, "providers": [{ "billed_charge": 330.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4851.00, "providers": [{ "billed_charge": 30367.46, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.56, "providers": [{ "billed_charge": 71.40, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 380.10, "providers": [{ "billed_charge": 1380.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 159.49, "providers": [{ "billed_charge": 955.71, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "751369692" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.78, "providers": [{ "billed_charge": 12.50, "npi": [1700960655] } ] }, { "allowed_amount": 6.25, "providers": [{ "billed_charge": 6.25, "npi": [1700960655] } ] }, { "allowed_amount": 23.34, "providers": [{ "billed_charge": 37.50, "npi": [1700960655] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4380.14, "providers": [{ "billed_charge": 17473.12, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 119686.42, "providers": [{ "billed_charge": 1004506.34, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.67, "providers": [{ "billed_charge": 108.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 322.69, "providers": [{ "billed_charge": 1185.23, "npi": [1730617523] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.85, "providers": [{ "billed_charge": 95.90, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 459.02, "providers": [{ "billed_charge": 932.40, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.30, "providers": [{ "billed_charge": 15.00, "npi": [1326017872] } ] }, { "allowed_amount": 4.50, "providers": [{ "billed_charge": 15.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "760430777" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.89, "providers": [{ "billed_charge": 7.77, "npi": [1780730606] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 248.96, "providers": [{ "billed_charge": 994.56, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.41, "providers": [{ "billed_charge": 2415.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 171.16, "providers": [{ "billed_charge": 440.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 248.96, "providers": [{ "billed_charge": 768.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.89, "providers": [{ "billed_charge": 33.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 241.18, "providers": [{ "billed_charge": 2170.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "710892430" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.72, "providers": [{ "billed_charge": 36.00, "npi": [1154379907] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 42.32, "providers": [{ "billed_charge": 752.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 762.43, "providers": [{ "billed_charge": 3900.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 178.94, "providers": [{ "billed_charge": 1426.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1266.51, "providers": [{ "billed_charge": 1956.00, "npi": [1972519544] } ] } ] } ] }, { "name": "COMPLETE CBC, AUTOMATED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85027", "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 269.40, "providers": [{ "billed_charge": 1947.55, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.56, "providers": [{ "billed_charge": 71.40, "npi": [1821077728] } ] }, { "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.38, "providers": [{ "billed_charge": 39.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.48, "providers": [{ "billed_charge": 40.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.76, "providers": [{ "billed_charge": 650.88, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10981.75, "providers": [{ "billed_charge": 99655.54, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "371925902" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 130.00, "providers": [{ "billed_charge": 270.00, "npi": [1144367426] } ] } ] } ] }, { "name": "AUTOMATED RBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85041", "description": "BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.20, "providers": [{ "billed_charge": 969.97, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED RETICULOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85045", "description": "BLOOD COUNT; RETICULOCYTE, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44.48, "providers": [{ "billed_charge": 470.88, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.72, "providers": [{ "billed_charge": 48.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.00, "providers": [{ "billed_charge": 120.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1580.05, "providers": [{ "billed_charge": 24650.09, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.00, "providers": [{ "billed_charge": 736.00, "npi": [1174172845] } ] } ] } ] }, { "name": "RETICYTE/HGB CONCENTRATE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85046", "description": "BLOOD COUNT; RETICULOCYTES, AUTOMATED, INCLUDING 1 OR MORE CELLULAR PARAMETERS (EG, RETICULOCYTE HEM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.85, "providers": [{ "billed_charge": 300.00, "npi": [1134585946] } ] } ] } ] }, { "name": "AUTOMATED PLATELET COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85049", "description": "BLOOD COUNT; PLATELET, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 292.21, "providers": [{ "billed_charge": 2178.99, "npi": [1234567893] } ] } ] } ] }, { "name": "BLOOD SMEAR INTERPRETATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85060", "description": "BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "746106575" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.09, "providers": [{ "billed_charge": 86.00, "npi": [1598181943] } ] } ] } ] }, { "name": "CCPD/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "851", "description": "CCPD - OUTPT OR HOME - CCPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "750800628" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 23014.40, "providers": [{ "billed_charge": 39680.00, "npi": [1194743013] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 901588.89, "providers": [{ "billed_charge": 7679285.00, "npi": [1234567893] } ] }, { "allowed_amount": 24097.43, "providers": [{ "billed_charge": 235197.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "853224374" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 9414.92, "providers": [{ "billed_charge": 444978.33, "npi": [1609473941] } ] } ] } ] }, { "name": "CLOT FACTOR VIII AHG 1 STAGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85240", "description": "CLOTTING; FACTOR VIII (AHG), 1-STAGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 242.12, "providers": [{ "billed_charge": 5780.28, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW RISTOCTN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85245", "description": "CLOTTING; FACTOR VIII, VW FACTOR, RISTOCETIN COFACTOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 191.32, "providers": [{ "billed_charge": 2998.82, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85246", "description": "CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 229.90, "providers": [{ "billed_charge": 4162.49, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTITHROMBIN III ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85300", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 102.60, "providers": [{ "billed_charge": 3569.08, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT C ACTIVITY", "billing_code_type": "CPT", 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"allowed_amount": 69.51, "providers": [{ "billed_charge": 672.00, "npi": [1699734053] } ] }, { "allowed_amount": 1443.19, "providers": [{ "billed_charge": 13860.00, "npi": [1518254309] } ] }, { "allowed_amount": 471.84, "providers": [{ "billed_charge": 4536.00, "npi": [1518254309] } ] }, { "allowed_amount": 166.71, "providers": [{ "billed_charge": 1596.00, "npi": [1003132663] } ] }, { "allowed_amount": 8.94, "providers": [{ "billed_charge": 84.00, "npi": [1003132663] } ] } ] }, { "tin": { "type": "ein", "value": "760421006" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 319.94, "providers": [{ "billed_charge": 319.94, "npi": [1194929778] } ] }, { "allowed_amount": 18.82, "providers": [{ "billed_charge": 18.82, "npi": [1346207214] } ] } ] } ] }, { "name": "HEXAGNAL PHOSPH PLTLT NEUTRL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85598", "description": "PHOSPHOLIPID NEUTRALIZATION; HEXAGONAL 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"type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4809.48, "providers": [{ "billed_charge": 112912.42, "npi": [1234567893] } ] } ] } ] }, { "name": "RBC SICKLE CELL TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85660", "description": "SICKLING OF RBC, REDUCTION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 469.56, "providers": [{ "billed_charge": 8537.87, "npi": [1234567893] } ] } ] } ] }, { "name": "THROMBOPLASTIN TIME, PARTIAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85730", "description": "THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.21, "providers": [{ "billed_charge": 866.15, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2807.94, "providers": [{ "billed_charge": 45219.82, "npi": [1234567893] } ] } ] } ] }, { "name": "ALLERGEN SPECIFIC IGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86003", "description": "ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16119.49, "providers": [{ "billed_charge": 174810.30, "npi": [1234567893] } ] } ] } ] }, { "name": "ACTIN ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86015", "description": "ACTIN SMOOTH MUSCLE ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1868.56, "providers": [{ "billed_charge": 29408.10, "npi": [1234567893] } ] } ] } ] }, { "name": "WBC ANTIBODY IDENTIFICATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86021", "description": "ANTIBODY IDENTIFICATION; LEUKOCYTE ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 316.05, "providers": [{ "billed_charge": 10285.67, "npi": [1234567893] } ] } ] } ] }, { "name": "ANCA SCREEN EACH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86036", "description": "ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ 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"ANTISTREPTOLYSIN 0; TITER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 547.36, "providers": [{ "billed_charge": 7470.33, "npi": [1234567893] } ] } ] } ] }, { "name": "PHYS BLOOD BANK SERV XMATCH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86077", "description": "BLOOD BANK PHYSICIAN SERVICES; DIFFICULT CROSS MATCH AND/OR EVALUATION OF IRREGULAR ANTIBODY(S), INT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.79, "providers": [{ "billed_charge": 108.75, "npi": [1487652293] } ] }, { "allowed_amount": 228.10, "providers": [{ "billed_charge": 435.00, "npi": [1487652293] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86140", "description": "C-REACTIVE PROTEIN;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 129.24, "providers": [{ "billed_charge": 2442.16, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.80, "providers": [{ "billed_charge": 50.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.62, "providers": [{ "billed_charge": 93.24, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.21, "providers": [{ "billed_charge": 412.11, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7965.31, "providers": [{ "billed_charge": 190498.57, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.84, "providers": [{ "billed_charge": 214.97, "npi": [1730617523] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN, HS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86141", "description": "C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.92, "providers": [{ "billed_charge": 51.80, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 129.60, "providers": [{ "billed_charge": 340.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1211.76, "providers": [{ "billed_charge": 10148.49, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3062.00, "providers": [{ "billed_charge": 36577.30, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 513.60, "providers": [{ "billed_charge": 2160.00, "npi": [1174172845] } ] } ] } ] }, { "name": "BETA-2 GLYCOPROTEIN ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86146", "description": "BETA 2 GLYCOPROTEIN I ANTIBODY, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6671.32, "providers": [{ "billed_charge": 64853.08, "npi": [1234567893] } ] } ] } ] }, { "name": "CARDIOLIPIN ANTIBODY EA IG", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86147", "description": "CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8237.61, "providers": [{ "billed_charge": 65602.28, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLEMENT, ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86160", "description": "COMPLEMENT; ANTIGEN, EACH COMPONENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7537.60, "providers": [{ "billed_charge": 122286.42, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLEMENT, TOTAL (CH50)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86162", "description": "COMPLEMENT; TOTAL HEMOLYTIC (CH50)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36.57, "providers": [{ "billed_charge": 416.94, "npi": [1234567893] } ] } ] } ] }, { "name": "CCP ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86200", "description": "CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6956.66, "providers": [{ "billed_charge": 121204.67, "npi": [1234567893] } ] } ] } ] }, { "name": "DNA ANTIBODY NATIVE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86225", "description": "DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.61, "providers": [{ "billed_charge": 172.80, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4027.04, "providers": [{ "billed_charge": 74382.65, "npi": [1234567893] } ] } ] } ] }, { "name": "EMA EACH IG CLASS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86231", "description": "ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.56, "providers": [{ "billed_charge": 124.12, "npi": [1234567893] } ] } ] } ] }, { "name": "NUCLEAR ANTIGEN ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86235", "description": "EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.49, "providers": [{ "billed_charge": 1127.70, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 45481.58, "providers": [{ "billed_charge": 439288.87, "npi": [1234567893] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86255", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 84.80, "providers": [{ "billed_charge": 84.80, "npi": [1346207214] } ] }, { "allowed_amount": 63.60, "providers": [{ "billed_charge": 63.60, "npi": [1346207214] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1699.70, "providers": [{ "billed_charge": 40855.46, "npi": [1234567893] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, TITER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86256", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.31, "providers": [{ "billed_charge": 1359.26, "npi": [1234567893] } ] } ] } ] }, { "name": "DGP ANTIBODY EACH IG CLASS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86258", "description": "GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 419.82, "providers": [{ "billed_charge": 8612.54, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 15-3", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86300", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4570.48, "providers": [{ "billed_charge": 54448.72, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 19-9", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86301", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1194.72, "providers": [{ "billed_charge": 18056.78, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 125", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86304", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 72.87, "providers": [{ "billed_charge": 291.34, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2680.27, "providers": [{ "billed_charge": 37233.47, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY INFECTIOUS AGENT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86317", "description": "IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4809.98, "providers": [{ "billed_charge": 49475.58, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOFIX E-PHORESIS, SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86334", "description": "IMMUNOFIXATION ELECTROPHORESIS; SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2428.36, "providers": [{ "billed_charge": 37789.57, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNFIX E-PHORSIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86335", "description": "IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION (EG, URINE, CSF)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 347.93, "providers": [{ "billed_charge": 4108.74, "npi": [1234567893] } ] } ] } ] }, { "name": "INSULIN ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86337", "description": "INSULIN ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 172.01, "providers": [{ "billed_charge": 2791.42, "npi": [1234567893] } ] } ] } ] }, { "name": "ISLET CELL ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86341", "description": "ISLET CELL ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1108.01, "providers": [{ "billed_charge": 18388.13, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELLS, TOTAL COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86359", "description": "T CELLS; TOTAL COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 162.04, "providers": [{ "billed_charge": 1389.82, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT/RATIO", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86360", "description": "T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11123.60, "providers": [{ "billed_charge": 122934.34, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86361", "description": "T CELLS; ABSOLUTE CD4 COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3149.45, "providers": [{ "billed_charge": 32157.17, "npi": [1234567893] } ] } ] } ] }, { "name": "TISS TRNSGLTMNASE EA IG CLAS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86364", "description": "TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1474.33, "providers": [{ "billed_charge": 39134.22, "npi": [1234567893] } ] } ] } ] }, { "name": "MICROSOMAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86376", "description": "MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.39, "providers": [{ "billed_charge": 4805.55, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 218.40, "providers": [{ "billed_charge": 873.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 211.12, "providers": [{ "billed_charge": 1768.71, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15761.73, "providers": [{ "billed_charge": 206749.99, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 432.00, "providers": [{ "billed_charge": 1768.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 425.70, "providers": [{ "billed_charge": 1520.69, "npi": [1730617523] } ] }, { "allowed_amount": 9.90, "providers": [{ "billed_charge": 36.38, "npi": [1730617523] } ] } ] } ] }, { "name": "MITOCHONDRIAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86381", "description": "MITOCHONDRIAL ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3045.28, "providers": [{ "billed_charge": 29397.43, "npi": [1234567893] } ] } ] } ] }, { "name": "RHEUMATOID FACTOR, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86431", "description": "RHEUMATOID FACTOR; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.92, "providers": [{ "billed_charge": 959.61, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.30, "providers": [{ "billed_charge": 55.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.36, "providers": [{ "billed_charge": 56.72, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.36, "providers": [{ "billed_charge": 80.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.40, "providers": [{ "billed_charge": 237.90, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6345.45, "providers": [{ "billed_charge": 110024.82, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 206.96, "providers": [{ "billed_charge": 770.00, "npi": [1174172845] } ] } ] } ] }, { "name": "TB TEST CELL IMMUN MEASURE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86480", "description": "TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.98, "providers": [{ "billed_charge": 520.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39502.23, "providers": [{ "billed_charge": 306509.98, "npi": [1234567893] } ] } ] } ] }, { "name": "TB AG RESPONSE T-CELL SUSP", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86481", "description": "TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3180.00, "providers": [{ "billed_charge": 17886.44, "npi": [1234567893] } ] } ] } ] }, { "name": "SYPHILIS TEST NON-TREP QUAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86592", "description": "SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 302.94, "providers": [{ "billed_charge": 4500.33, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44.94, "providers": [{ "billed_charge": 360.99, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18554.74, "providers": [{ "billed_charge": 293620.40, "npi": [1234567893] } ] } ] } ] }, { "name": "SYPHILIS TEST NON-TREP QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86593", "description": "SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1335.64, "providers": [{ "billed_charge": 19339.97, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86631", "description": "ANTIBODY; CHLAMYDIA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1143.24, "providers": [{ "billed_charge": 13138.89, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA IGM ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86632", "description": "ANTIBODY; CHLAMYDIA, IGM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 623.25, "providers": [{ "billed_charge": 7061.62, "npi": [1234567893] } ] } ] } ] }, { "name": "EPSTEIN-BARR NUCLEAR ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86664", "description": "ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 331.25, "providers": [{ "billed_charge": 3886.71, "npi": [1234567893] } ] } ] } ] }, { "name": "EPSTEIN-BARR CAPSID VCA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86665", "description": "ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1133.10, "providers": [{ "billed_charge": 12906.40, "npi": [1234567893] } ] } ] } ] }, { "name": "FUNGUS NES ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86671", "description": "ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 178.56, "providers": [{ "billed_charge": 2751.82, "npi": [1234567893] } ] } ] } ] }, { "name": "HELMINTH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86682", "description": "ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.81, "providers": [{ "billed_charge": 247.08, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX TYPE 1 TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86695", "description": "ANTIBODY; HERPES SIMPLEX, TYPE 1", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.40, "providers": [{ "billed_charge": 497.61, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13123.78, "providers": [{ "billed_charge": 157312.19, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX TYPE 2 TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86696", "description": "ANTIBODY; HERPES SIMPLEX, TYPE 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 145.20, "providers": [{ "billed_charge": 1217.25, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23309.14, "providers": [{ "billed_charge": 302954.02, "npi": [1234567893] } ] } ] } ] }, { "name": "HIV-1ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86701", "description": "ANTIBODY; HIV-1", "allowed_amounts": [{ "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.80, "providers": [{ "billed_charge": 71.12, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.74, "providers": [{ "billed_charge": 3014.82, "npi": [1234567893] } ] } ] } ] }, { "name": "HIV-2 ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86702", "description": "ANTIBODY; HIV-2", 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"payments": [{ "allowed_amount": 76.25, "providers": [{ "billed_charge": 125.00, "npi": [1932785854] } ] }, { "allowed_amount": 5326.16, "providers": [{ "billed_charge": 8500.00, "npi": [1932785854] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11", "10"], "billing_class": "professional", "payments": [{ "allowed_amount": 157.78, "providers": [{ "billed_charge": 490.00, "npi": [1821671504] } ] }, { "allowed_amount": 45.75, "providers": [{ "billed_charge": 147.00, "npi": [1821671504] } ] } ] }, { "tin": { "type": "ein", "value": "760568042" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 214.23, "providers": [{ "billed_charge": 390.00, "npi": [1154778611] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11", "10"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.25, "providers": [{ "billed_charge": 375.00, "npi": [1144275355] } ] }, { "allowed_amount": 45035.97, "providers": [{ "billed_charge": 214425.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "208439006" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1594.08, "providers": [{ "billed_charge": 2460.00, "npi": [1649648759] } ] } ] }, { "tin": { "type": "ein", "value": "760151142" }, "service_code": ["11", "02"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.68, "providers": [{ "billed_charge": 20.00, "npi": [1326676362] } ] }, { "allowed_amount": 373.73, "providers": [{ "billed_charge": 461.00, "npi": [1326676362] } ] } ] }, { "tin": { "type": "ein", "value": "824771503" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1164.35, "providers": [{ "billed_charge": 1460.00, "npi": [1598990772] } ] } ] }, { "tin": { "type": "ein", "value": "760540476" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.00, "providers": [{ "billed_charge": 152.00, "npi": [1609288208] } ] } ] }, { "tin": { "type": "ein", "value": "742515841" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 230.73, "providers": [{ "billed_charge": 3360.00, "npi": [1932205838] } ] } ] }, { "tin": { "type": "ein", "value": "202798379" }, "service_code": ["11", "10"], "billing_class": "professional", "payments": [{ "allowed_amount": 223.30, "providers": [{ "billed_charge": 669.90, "npi": [1093212821] } ] }, { "allowed_amount": 15.95, "providers": [{ "billed_charge": 47.85, "npi": [1093212821] } ] }, { "allowed_amount": 47.85, "providers": [{ "billed_charge": 143.55, "npi": [1598129702] } ] } ] }, { "tin": { "type": "ein", "value": "834419988" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.01, "providers": [{ "billed_charge": 25.00, "npi": [1598786691] } ] } ] }, { "tin": { "type": "ein", "value": "752600873" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 513.92, "providers": [{ "billed_charge": 704.00, "npi": [1295350999] } ] } ] }, { "tin": { "type": "ein", "value": "741282696" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.68, "providers": [{ "billed_charge": 240.00, "npi": [1679953749] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11", "02"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.00, "providers": [{ "billed_charge": 200.00, "npi": [1316188725] } ] }, { "allowed_amount": 686.25, "providers": [{ "billed_charge": 2214.00, "npi": [1316188725] } ] }, { "allowed_amount": 25.92, "providers": [{ "billed_charge": 82.00, "npi": [1033954771] } ] } ] }, { "tin": { "type": "ein", "value": "263275773" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 47.51, "providers": [{ "billed_charge": 300.00, "npi": [1629224118] } ] }, { "allowed_amount": 1313.46, "providers": [{ "billed_charge": 10100.00, "npi": [1467182865] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC;METHDONE ADM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG BY A LI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274250532" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1020.60, "providers": [{ "billed_charge": 2262.96, "npi": [1770781106] } ] } ] } ] }, { "name": "BHVAL HEALTH PREV EDUCATION", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0025", "description": "BEHAVIORAL HEALTH PREVENTION EDUCATION SERVICE (DELIVERY OF SERVICES WITH TARGET POPULATION TO AFFEC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810965592" }, "service_code": ["10"], "billing_class": "professional", "payments": [{ "allowed_amount": 4650.00, "providers": [{ "billed_charge": 4650.00, "npi": [1538480686] } ] } ] } ] }, { "name": "ORAL MEDADMIN DIR OBSERV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0033", "description": "ORAL MEDICATION ADMINISTRATION, DIRECT OBSERVATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741547909" }, "service_code": ["57", "58"], "billing_class": "professional", "payments": [{ "allowed_amount": 3202.78, "providers": [{ "billed_charge": 13426.00, "npi": [1245769223] } ] }, { "allowed_amount": 1169.00, "providers": [{ "billed_charge": 4676.00, "npi": [1245769223] } ] } ] } ] }, { "name": "ALCOHOL &OR OTH DRUG ABS SRV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0047", "description": "ALCOHOL AND/OR OTHER DRUG ABUSE SERVICES, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751249456" }, "service_code": ["55"], "billing_class": "professional", "payments": [{ "allowed_amount": 588.60, "providers": [{ "billed_charge": 1962.00, "npi": [1376590422] } ] } ] } ] }, { "name": "ALCOHOL &/OR DRUG SCREENING", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0049", "description": "ALCOHOL AND/OR DRUG SCREENING", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760537608" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 280.00, "providers": [{ "billed_charge": 700.00, "npi": [1770583411] } ] } ] } ] }, { "name": "ALCOHOL &OR OTH DRUG TX PROG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H2035", "description": "ALCOHOL AND/OR OTHER DRUG TREATMENT PROGRAM, PER HOUR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751249456" }, "service_code": ["55"], "billing_class": "professional", "payments": [{ "allowed_amount": 1017.90, "providers": [{ "billed_charge": 3393.00, "npi": [1376590422] } ] } ] } ] }, { "name": "INJ CEFAZOLIN SODIUM 500MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0690", "description": "INJECTION, CEFAZOLIN SODIUM, 500 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.00, "providers": [{ "billed_charge": 366.80, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ CEFTRIAXONE SODM PER 250", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0696", "description": "INJECTION, CEFTRIAXONE SODIUM, PER 250 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.82, "providers": [{ "billed_charge": 1210.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.40, "providers": [{ "billed_charge": 1025.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.93, "providers": [{ "billed_charge": 180.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.64, "providers": [{ "billed_charge": 51.84, "npi": [1447747860] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 587.12, "providers": [{ "billed_charge": 53575.46, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.38, "providers": [{ "billed_charge": 434.88, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.83, "providers": [{ "billed_charge": 7675.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "461513436" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.28, "providers": [{ "billed_charge": 300.00, "npi": [1629099221] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 148.67, "providers": [{ "billed_charge": 27120.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.40, "providers": [{ "billed_charge": 600.00, "npi": [1316188725] } ] } ] } ] }, { "name": "Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0872", "description": "njection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1315.00, "providers": [{ "billed_charge": 112140.00, "npi": [1234567893] } ] } ] } ] }, { "name": "INJECTION DAPTOMYCIN 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0878", "description": "INJECTION, DAPTOMYCIN, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 453.00, "providers": [{ "billed_charge": 1057.00, "npi": [1447747860] } ] } ] } ] }, { "name": "Injection, methylprednisolone acetate, 1 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1010", "description": "Injection, methylprednisolone acetate, 1 mg ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 451.80, "providers": [{ "billed_charge": 1355.40, "npi": [1972519544] } ] } ] } ] }, { "name": "INJ DEXMETH SODM PHOSHA 1MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1100", "description": "INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.62, "providers": [{ "billed_charge": 1700.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.61, "providers": [{ "billed_charge": 3390.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.92, "providers": [{ "billed_charge": 1272.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.99, "providers": [{ "billed_charge": 610.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.09, "providers": [{ "billed_charge": 138.37, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 0.45, "providers": [{ "billed_charge": 1.80, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.06, "providers": [{ "billed_charge": 6825.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.52, "providers": [{ "billed_charge": 6180.00, "npi": [1316188725] } ] } ] } ] }, { "name": "INJ ERTAPENEM SODIUM 500MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1335", "description": "INJECTION, ERTAPENEM SODIUM, 500 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1639.68, "providers": [{ "billed_charge": 45391.08, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ KETOROLAC TROMETHAMINE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1885", "description": "INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.85, "providers": [{ "billed_charge": 510.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.12, "providers": [{ "billed_charge": 905.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.44, "providers": [{ "billed_charge": 360.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.44, "providers": [{ "billed_charge": 321.36, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.58, "providers": [{ "billed_charge": 5720.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.67, "providers": [{ "billed_charge": 1710.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.40, "providers": [{ "billed_charge": 510.00, "npi": [1316188725] } ] } ] } ] }, { "name": "INJECTION MEROPENEM 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2185", "description": "INJECTION, MEROPENEM, 100 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1045.92, "providers": [{ "billed_charge": 32042.21, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ ONDANSETRON HCL PER 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2405", "description": "INJECTION, ONDANSETRON HCL, PER 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.20, "providers": [{ "billed_charge": 50.40, "npi": [1972519544] } ] } ] } ] }, { "name": "Injection, methylprednisolone sodium succinate, 5 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2919", "description": "Injection, methylprednisolone sodium succinate, 5 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.50, "providers": [{ "billed_charge": 1020.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.80, "providers": [{ "billed_charge": 417.30, "npi": [1972519544] } ] } ] } ] }, { "name": "Vancomycin Hydrochloride, 10 mg,", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3373", "description": "Vancomycin Hydrochloride, 10 mg,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 135.00, "providers": [{ "billed_charge": 3720.21, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ PYRIDOXINE HCL 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3415", "description": "INJECTION, PYRIDOXINE HCL, 100 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "815097602" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 194.32, "providers": [{ "billed_charge": 1700.00, "npi": [1649235490] } ] } ] } ] }, { "name": "INJ VIT B-12 CYNOCOBLMN TO", "billing_code_type": "HCPCS", 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