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"providers": [{ "billed_charge": 17642.50, "npi": [1770059800] } ] } ] }, { "tin": { "type": "ein", "value": "630957564" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 3024.90, "providers": [{ "billed_charge": 8551.85, "npi": [1467546242] } ] } ] }, { "tin": { "type": "ein", "value": "850580697" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 37943.76, "providers": [{ "billed_charge": 114570.00, "npi": [1851917504] } ] } ] }, { "tin": { "type": "ein", "value": "636001201" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 30954.12, "providers": [{ "billed_charge": 55291.29, "npi": [1962487355] } ] } ] }, { "tin": { "type": "ein", "value": "465007345" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 672.20, "providers": [{ "billed_charge": 2098.04, "npi": [1891240859] } ] } ] }, { "tin": { "type": "ein", "value": 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{ "name": "FLTR DISPBL W/POS ARWAY PRSS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7038", "description": "FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1000.97, "providers": [{ "billed_charge": 5201.44, "npi": [1234567893] } ] } ] } ] }, { "name": "WATR CHAMB HUMDIFIR USED W/P", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7046", "description": "WATER CHAMBER FOR HUMIDIFIER, USED WITH POSITIVE AIRWAY PRESSURE DEVICE, REPLACEMENT, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.57, "providers": [{ "billed_charge": 675.92, "npi": [1234567893] } ] } ] } ] }, { "name": "WALKER FOLD WHEELED ADJUSTBL", 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"allowed_amount": 2288.88, "providers": [{ "billed_charge": 2288.88, "npi": [1114398799] } ] } ] } ] }, { "name": "MENTAL HLTH PART HOSP TX <24", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0035", "description": "MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "992174368" }, "service_code": ["57"], "billing_class": "professional", "payments": [{ "allowed_amount": 2700.00, "providers": [{ "billed_charge": 33750.00, "npi": [1083976971] } ] } ] } ] }, { "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": "465658180" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.60, "providers": [{ "billed_charge": 11.00, "npi": [1700615846] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.62, "providers": [{ "billed_charge": 67.40, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "823581568" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.16, "providers": [{ "billed_charge": 378.00, "npi": [1124591177] } ] } ] } ] }, { "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": "823581568" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 71.60, "providers": [{ "billed_charge": 301.00, "npi": [1124591177] } ] } ] } ] }, { "name": "INJ DEXMETH SODM PHOSHA 1MG", "billing_code_type": "HCPCS", "billing_code_type_version": 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"name": "INJ TRIAMCINOLON ACETONID NO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3301", "description": "INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "461644524" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.74, "providers": [{ "billed_charge": 85.00, "npi": [1083604961] } ] } ] } ] }, { "name": "STANDARD WHEELCHAIR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0001", "description": "STANDARD WHEELCHAIR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 3821.57, "providers": [{ "billed_charge": 16163.94, "npi": [1234567893] } ] } ] } ] }, { "name": "HEAVY-DUTY WHEELCHAIR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0006", "description": "HEAVY-DUTY WHEELCHAIR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 302.84, "providers": [{ "billed_charge": 1678.95, "npi": [1234567893] } ] } ] } ] }, { "name": "ELEVATING LEGREST PAIR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "K0195", "description": "ELEVATING LEGRESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 240.86, "providers": [{ "billed_charge": 1053.08, "npi": [1234567893] } ] } ] } ] }, { "name": "HOME INFUS TX CATH CARE COMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S5501", "description": "HOME INFUSION THERAPY, CATHETER CARE/MAINTENANCE, COMPLEX (MORE THAN ONE LUMEN), INCLUDES ADMINISTRA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1920.00, "providers": [{ "billed_charge": 6400.00, "npi": [1234567893] } ] } ] } ] }, { "name": "HIT ANTIBIOTIC/ANTIFUNGAL; Q", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "S9500", "description": "HOME INFUSION THERAPY, ANTIBIOTIC, ANTIVIRAL, OR ANTIFUNGAL THERAPY; ONCE EVERY 24 HOURS; ADMINISTRA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11", "12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2610.00, "providers": [{ "billed_charge": 8700.00, "npi": [1234567893] } ] }, { "allowed_amount": 90.00, "providers": [{ "billed_charge": 300.00, "npi": [1234567893] } ] } ] } ] } ] }