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"ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 68.64, "providers": [{ "billed_charge": 455.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9910.56, "providers": [{ "billed_charge": 39642.24, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 228347.81, "providers": [{ "billed_charge": 2506239.25, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 345.12, "providers": [{ "billed_charge": 1182.72, "npi": [1730617523] } ] } ] } ] }, { "name": "LIPID PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80061", "description": "LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7998.00, "providers": [{ "billed_charge": 86550.59, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 710.20, "providers": [{ "billed_charge": 1633.58, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.76, "providers": [{ "billed_charge": 60.00, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.70, "providers": [{ "billed_charge": 562.38, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 402.00, "providers": [{ "billed_charge": 1020.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.69, "providers": [{ "billed_charge": 55.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.10, "providers": [{ "billed_charge": 516.76, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 676.70, "providers": [{ "billed_charge": 3030.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 750.40, "providers": [{ "billed_charge": 2240.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 187.60, "providers": [{ "billed_charge": 4200.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 696.80, "providers": [{ "billed_charge": 6760.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 744.10, "providers": [{ "billed_charge": 2835.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.20, "providers": [{ "billed_charge": 360.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 623.10, "providers": [{ "billed_charge": 3113.64, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1149.05, "providers": [{ "billed_charge": 6517.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11711.60, "providers": [{ "billed_charge": 98167.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 251343.20, "providers": [{ "billed_charge": 3667929.51, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1311.84, "providers": [{ "billed_charge": 4285.52, "npi": [1730617523] } ] } ] } ] }, { "name": "RENAL FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80069", "description": "RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1370.18, "providers": [{ "billed_charge": 19261.56, "npi": [1234567893] } ] } ] } ] }, { "name": "ACUTE HEPATITIS PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80074", "description": "ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 318.20, "providers": [{ "billed_charge": 3400.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5835.90, "providers": [{ "billed_charge": 47282.55, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31614.21, "providers": [{ "billed_charge": 465812.68, "npi": [1234567893] } ] } ] } ] }, { "name": "HEPATIC FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80076", "description": "HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 271.32, "providers": [{ "billed_charge": 1463.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2647.34, "providers": [{ "billed_charge": 31606.12, "npi": [1234567893] } ] } ] } ] }, { "name": "OBSTETRIC PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80081", "description": "OBSTETRIC PANEL (INCLUDES HIV TESTING)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18785.59, "providers": [{ "billed_charge": 202915.73, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY, CARBAMAZEPINE, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80156", "description": "CARBAMAZEPINE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.73, "providers": [{ "billed_charge": 249.62, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY DIPROPYLACETIC ACD TOT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80164", "description": "VALPROIC ACID (DIPROPYLACETIC ACID); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 358.22, "providers": [{ "billed_charge": 5400.10, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCRN QUAN LEVETIRACETAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80177", "description": "LEVETIRACETAM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 309.87, "providers": [{ "billed_charge": 5173.39, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LITHIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80178", "description": "LITHIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 86.89, "providers": [{ "billed_charge": 1660.96, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TACROLIMUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80197", "description": "TACROLIMUS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.69, "providers": [{ "billed_charge": 3689.37, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG TEST PRSMV CHEM ANLYZR", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80307", "description": "DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "464163620" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14885.64, "providers": [{ "billed_charge": 67831.60, "npi": [1265854855] } ] } ] }, { "tin": { "type": "ein", "value": "993314772" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 806.33, "providers": [{ "billed_charge": 4474.08, "npi": [1275369233] } ] } ] }, { "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20812.25, "providers": [{ "billed_charge": 346035.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "453717894" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 124.28, "providers": [{ "billed_charge": 297.00, "npi": [1730466590] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2858.44, "providers": [{ "billed_charge": 15348.58, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2330.25, "providers": [{ "billed_charge": 9321.00, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3262.35, "providers": [{ "billed_charge": 15750.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "830973361" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13235.82, "providers": [{ "billed_charge": 105886.56, "npi": [1447814272] } ] } ] }, { "tin": { "type": "ein", "value": "471489220" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 248.56, "providers": [{ "billed_charge": 1242.80, "npi": [1861895500] } ] } ] }, { "tin": { "type": "ein", "value": "461242694" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 367.49, "providers": [{ "billed_charge": 675.00, "npi": [1134559685] } ] } ] }, { "tin": { "type": "ein", "value": "464460776" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.63, "providers": [{ "billed_charge": 5400.00, "npi": [1235665175] } ] } ] }, { "tin": { "type": "ein", "value": "472177895" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 528.19, "providers": [{ "billed_charge": 2237.22, "npi": [1477925188] } ] } ] }, { "tin": { "type": "ein", "value": "800686939" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.98, "providers": [{ "billed_charge": 952.00, "npi": [1699045674] } ] } ] }, { "tin": { "type": "ein", "value": "611803788" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1460.29, "providers": [{ "billed_charge": 5640.00, "npi": [1053841023] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 528.19, "providers": [{ "billed_charge": 2112.76, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 929.70, "providers": [{ "billed_charge": 4200.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 932.10, "providers": [{ "billed_charge": 4755.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 201.36, "providers": [{ "billed_charge": 931.82, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36099.00, "providers": [{ "billed_charge": 207243.02, "npi": [1234567893] } ] } ] } ] }, { "name": "ALCOHOLS BIOMARKERS 1OR 2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80321", "description": "ALCOHOL BIOMARKERS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 352.50, "providers": [{ "billed_charge": 1409.86, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREEN AMPHETAMINES 1/2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80324", "description": "AMPHETAMINES; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 71.99, "providers": [{ "billed_charge": 272.88, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 289.92, "providers": [{ "billed_charge": 795.60, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 452.80, "providers": [{ "billed_charge": 1811.06, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTIDEPRESSANTS CLASS 1 OR 2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80332", "description": "ANTIDEPRESSANTS, SEROTONERGIC CLASS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 287.78, "providers": [{ "billed_charge": 1544.40, "npi": [1164017422] } ] } ] } ] }, { "name": "ANTIDEPRESSANT TRICYCLIC 1/2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80335", "description": "ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 290.06, "providers": [{ "billed_charge": 1544.40, "npi": [1164017422] } ] } ] } ] }, { "name": "ANTIDEPRESSANT NOT SPECIFIED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80338", "description": "ANTIDEPRESSANTS, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "474579289" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 68.88, "providers": [{ "billed_charge": 229.50, "npi": [1720448061] } ] } ] } ] }, { "name": "ANTIPSYCHOTICS NOS 1-3", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80342", "description": "ANTIPSYCHOTICS, NOT OTHERWISE SPECIFIED; 1-3", "allowed_amounts": [{ "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 287.78, "providers": [{ "billed_charge": 1544.40, "npi": [1164017422] } ] } ] } ] }, { "name": "DRUG SCREENING BARBITURATES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80345", "description": "BARBITURATES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 290.99, "providers": [{ "billed_charge": 1544.40, "npi": [1164017422] } ] } ] } ] }, { "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": 72.06, "providers": [{ "billed_charge": 294.48, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 292.20, "providers": [{ "billed_charge": 807.56, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.89, "providers": [{ "billed_charge": 18.03, "npi": [1609565100] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 420.06, "providers": [{ "billed_charge": 1680.23, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREENING BUPRENORPHINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80348", "description": "BUPRENORPHINE", "allowed_amounts": [{ "tin": 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"billed_charge": 24896.83, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.12, "providers": [{ "billed_charge": 350.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 557.96, "providers": [{ "billed_charge": 1115.92, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 671.06, "providers": [{ "billed_charge": 3355.30, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 384.54, "providers": [{ "billed_charge": 969.00, "npi": [1487429874] } ] } ] }, { "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": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 701.22, "providers": [{ "billed_charge": 2804.88, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.48, "providers": [{ "billed_charge": 504.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2744.56, "providers": [{ "billed_charge": 22997.52, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 60403.67, "providers": [{ "billed_charge": 807513.77, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 874.78, "providers": [{ "billed_charge": 3706.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 420.66, "providers": [{ "billed_charge": 1319.50, "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": 1310.62, "providers": [{ "billed_charge": 23181.21, "npi": [1234567893] } ] } ] } ] }, { "name": "DEHYDROEPIANDROSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", 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"463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 181.56, "providers": [{ "billed_charge": 496.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.24, "providers": [{ "billed_charge": 111.16, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 467.04, "providers": [{ "billed_charge": 1176.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.60, "providers": [{ "billed_charge": 466.05, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7835.96, "providers": [{ "billed_charge": 117721.86, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 181.56, "providers": [{ "billed_charge": 533.58, "npi": [1730617523] } ] } ] } ] }, { "name": "VIT D 1 25-DIHYDROXY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82652", "description": "VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 197.68, "providers": [{ "billed_charge": 2482.10, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ERYTHROPOIETIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82668", "description": "ERYTHROPOIETIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 443.81, "providers": [{ "billed_charge": 7494.49, "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": 970.00, "providers": [{ "billed_charge": 9686.28, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 209.11, "providers": [{ "billed_charge": 593.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.76, "providers": [{ "billed_charge": 558.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.99, "providers": [{ "billed_charge": 39.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 405.13, "providers": [{ "billed_charge": 1620.52, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 586.74, "providers": [{ "billed_charge": 1470.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1564.64, "providers": [{ "billed_charge": 13117.44, "npi": [1235186800] } ] } ] }, { "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25272.36, "providers": [{ "billed_charge": 304937.04, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1425.18, "providers": [{ "billed_charge": 5376.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 228.12, "providers": [{ "billed_charge": 698.50, "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": 2484.29, "providers": [{ "billed_charge": 29587.71, "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": 1117.46, "providers": [{ "billed_charge": 9493.44, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 347.82, "providers": [{ "billed_charge": 695.13, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 204.60, "providers": [{ "billed_charge": 1022.40, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 272.80, "providers": [{ "billed_charge": 720.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.46, "providers": [{ "billed_charge": 81.78, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 47.74, "providers": [{ "billed_charge": 190.82, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 757.02, "providers": [{ "billed_charge": 6336.99, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 259.16, "providers": [{ "billed_charge": 1330.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43860.90, "providers": [{ "billed_charge": 494405.38, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 654.16, "providers": [{ "billed_charge": 2430.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.70, "providers": [{ "billed_charge": 327.17, "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": 929.11, "providers": [{ "billed_charge": 10314.71, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 102.12, "providers": [{ "billed_charge": 348.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 374.85, "providers": [{ "billed_charge": 749.70, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 286.65, "providers": [{ "billed_charge": 1433.25, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.88, "providers": [{ "billed_charge": 320.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 521.85, "providers": [{ "billed_charge": 2087.40, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 316.05, "providers": [{ "billed_charge": 817.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.70, "providers": [{ "billed_charge": 58.80, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2263.80, "providers": [{ "billed_charge": 18978.96, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38465.62, "providers": [{ "billed_charge": 488684.51, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 820.45, "providers": [{ "billed_charge": 3672.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 110.11, "providers": [{ "billed_charge": 345.45, "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": 878.99, "providers": [{ "billed_charge": 11938.24, "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": 3043.00, "providers": [{ "billed_charge": 38482.69, "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": 1950.74, "providers": [{ "billed_charge": 21953.62, "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": 15.40, "providers": [{ "billed_charge": 229.67, "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": 25.61, "providers": [{ "billed_charge": 130.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.61, "providers": [{ "billed_charge": 128.21, "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": 3527.61, "providers": [{ "billed_charge": 8150.07, "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": 158.76, "providers": [{ "billed_charge": 1260.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.68, "providers": [{ "billed_charge": 310.00, "npi": [1538526702] } ] }, { "allowed_amount": 166.92, "providers": [{ "billed_charge": 390.00, "npi": [1003273731] } ] }, { "allowed_amount": 119.84, "providers": [{ "billed_charge": 280.00, "npi": [1669082723] } ] } ] } ] }, { "name": "GLUCOSE TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82950", "description": "GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.38, "providers": [{ "billed_charge": 16.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1182.04, "providers": [{ "billed_charge": 14808.72, "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": 650.56, "providers": [{ "billed_charge": 7104.75, "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": 164.86, "providers": [{ "billed_charge": 1707.56, "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": 221.95, "providers": [{ "billed_charge": 2892.90, "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": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.30, "providers": [{ "billed_charge": 211.00, "npi": [1144282989] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.28, "providers": [{ "billed_charge": 30.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.60, "providers": [{ "billed_charge": 232.00, "npi": [1265493688] } ] }, { "allowed_amount": 20.16, "providers": [{ "billed_charge": 48.00, "npi": [1326017872] } ] }, { "allowed_amount": 6.72, "providers": [{ "billed_charge": 16.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.12, "providers": [{ "billed_charge": 120.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.48, "providers": [{ "billed_charge": 42.00, "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": 170.00, "providers": [{ "billed_charge": 1156.02, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.40, "providers": [{ "billed_charge": 351.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 115.20, "providers": [{ "billed_charge": 965.76, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6723.78, "providers": [{ "billed_charge": 52011.91, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 492.80, "providers": [{ "billed_charge": 2080.00, "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": 864.97, "providers": [{ "billed_charge": 9121.95, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.95, "providers": [{ "billed_charge": 111.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65.03, "providers": [{ "billed_charge": 325.15, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 167.22, "providers": [{ "billed_charge": 668.88, "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": 1504.98, "providers": [{ "billed_charge": 12621.42, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19943.00, "providers": [{ "billed_charge": 231294.40, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1210.09, "providers": [{ "billed_charge": 5289.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 88.55, "providers": [{ "billed_charge": 232.25, "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": 501.54, "providers": [{ "billed_charge": 5219.52, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 138.60, "providers": [{ "billed_charge": 381.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.04, "providers": [{ "billed_charge": 185.20, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.04, "providers": [{ "billed_charge": 248.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1444.56, "providers": [{ "billed_charge": 12111.84, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15880.67, "providers": [{ "billed_charge": 179486.23, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1204.46, "providers": [{ "billed_charge": 5166.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 151.20, "providers": [{ "billed_charge": 481.52, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY, GROWTH HORMONE (HGH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83003", "description": "GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.20, "providers": [{ "billed_charge": 385.00, "npi": [1760897755] } ] } ] } ] }, { "name": "ASSAY OF HAPTOGLOBIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83010", "description": "HAPTOGLOBIN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 651.34, "providers": [{ "billed_charge": 9867.41, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI (C-13), BREATH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83013", "description": "HELICOBACTER PYLORI; BREATH TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (EG, C-13)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3502.72, "providers": [{ "billed_charge": 29362.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38581.80, "providers": [{ "billed_charge": 305011.46, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI DRUG ADMIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83014", "description": "HELICOBACTER PYLORI; DRUG ADMINISTRATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 318.33, "providers": [{ "billed_charge": 2668.14, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1215.36, "providers": [{ "billed_charge": 17446.54, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMOGLOBIN ELECTROPHORESIS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83020", "description": "HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (EG, A2, S, C, AND/OR F)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2030.28, "providers": [{ "billed_charge": 38171.82, "npi": [1234567893] } ] } ] } ] }, { "name": "GLYCOSYLATED HEMOGLOBIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83036", "description": "HEMOGLOBIN; GLYCOSYLATED (A1C)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5311.12, "providers": [{ "billed_charge": 60833.01, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 563.76, "providers": [{ "billed_charge": 1126.36, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.25, "providers": [{ "billed_charge": 26.64, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 170.10, "providers": [{ "billed_charge": 679.70, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.38, "providers": [{ "billed_charge": 2075.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 291.60, "providers": [{ "billed_charge": 780.00, "npi": [1487429874] } ] } ] }, { "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": 486.00, "providers": [{ "billed_charge": 1500.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 976.86, "providers": [{ "billed_charge": 9045.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 608.06, "providers": [{ "billed_charge": 2440.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.72, "providers": [{ "billed_charge": 58.26, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.30, "providers": [{ "billed_charge": 220.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 518.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 442.26, "providers": [{ "billed_charge": 2209.48, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 818.91, "providers": [{ "billed_charge": 4044.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.62, "providers": [{ "billed_charge": 544.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8014.14, "providers": [{ "billed_charge": 67081.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "751414940" }, "service_code": ["11", "50"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.86, "providers": [{ "billed_charge": 19.00, "npi": [1578897765] } ] }, { "allowed_amount": 68.04, "providers": [{ "billed_charge": 266.00, "npi": [1578897765] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 168082.69, "providers": [{ "billed_charge": 2315833.81, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.16, "providers": [{ "billed_charge": 800.00, "npi": [1669082723] } ] }, { "allowed_amount": 140.42, "providers": [{ "billed_charge": 850.00, "npi": [1538526702] } ] }, { "allowed_amount": 119.77, "providers": [{ "billed_charge": 725.00, "npi": [1003273731] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 832.86, "providers": [{ "billed_charge": 2729.14, "npi": [1730617523] } ] } ] } ] }, { "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": 119.21, "providers": [{ "billed_charge": 2794.70, "npi": [1234567893] } ] } ] } ] }, { "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": 3492.26, "providers": [{ "billed_charge": 32311.07, "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": 132.66, "providers": [{ "billed_charge": 4508.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3797.66, "providers": [{ "billed_charge": 93740.08, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4188.41, "providers": [{ "billed_charge": 51409.39, "npi": [1234567893] } ] } ] } ] }, { "name": "IG LIGHT CHAINS FREE EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83521", "description": "IMMUNOGLOBULIN LIGHT CHAINS FREE EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1954.82, "providers": [{ "billed_charge": 31639.21, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF INSULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83525", "description": "INSULIN; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 142.92, "providers": [{ "billed_charge": 1899.56, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 91.30, "providers": [{ "billed_charge": 270.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 228.80, "providers": [{ "billed_charge": 600.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 663.52, "providers": [{ "billed_charge": 5561.04, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5206.77, "providers": [{ "billed_charge": 73244.85, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1246.43, "providers": [{ "billed_charge": 4738.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.36, "providers": [{ "billed_charge": 285.81, "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": 147.92, "providers": [{ "billed_charge": 2425.13, "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": 502.01, "providers": [{ "billed_charge": 2984.08, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 200.88, "providers": [{ "billed_charge": 401.14, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 243.00, "providers": [{ "billed_charge": 1213.50, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.30, "providers": [{ "billed_charge": 150.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.08, "providers": [{ "billed_charge": 378.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.88, "providers": [{ "billed_charge": 155.28, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 417.96, "providers": [{ "billed_charge": 3502.35, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 103.68, "providers": [{ "billed_charge": 640.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19077.67, "providers": [{ "billed_charge": 182970.18, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 303.36, "providers": [{ "billed_charge": 1350.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.23, "providers": [{ "billed_charge": 48.54, "npi": [1730617523] } ] }, { "allowed_amount": 4.41, "providers": [{ "billed_charge": 16.18, "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": 503.81, "providers": [{ "billed_charge": 3930.13, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 183.54, "providers": [{ "billed_charge": 462.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.92, "providers": [{ "billed_charge": 586.08, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20641.58, "providers": [{ "billed_charge": 221624.05, "npi": [1234567893] } ] } ] } ] }, { "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": 38.88, "providers": [{ "billed_charge": 109.41, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.32, "providers": [{ "billed_charge": 144.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.80, "providers": [{ "billed_charge": 320.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.55, "providers": [{ "billed_charge": 50.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3616.66, "providers": [{ "billed_charge": 18996.02, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 402.58, "providers": [{ "billed_charge": 1690.00, "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": 17.78, "providers": [{ "billed_charge": 132.71, "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": 1154.57, "providers": [{ "billed_charge": 15116.95, "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": 9.56, "providers": [{ "billed_charge": 124.69, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3864.36, "providers": [{ "billed_charge": 71110.62, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 412.95, "providers": [{ "billed_charge": 1695.00, "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": 415.28, "providers": [{ "billed_charge": 3480.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4344.50, "providers": [{ "billed_charge": 70477.34, "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": 305.69, "providers": [{ "billed_charge": 629.20, "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": 1470.01, "providers": [{ "billed_charge": 10868.88, "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": 60.00, "providers": [{ "billed_charge": 209.00, "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": 165.63, "providers": [{ "billed_charge": 2063.49, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 78.75, "providers": [{ "billed_charge": 252.00, "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": 44.80, "providers": [{ "billed_charge": 520.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.90, "providers": [{ "billed_charge": 1024.16, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.28, "providers": [{ "billed_charge": 169.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.95, "providers": [{ "billed_charge": 381.90, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 174.20, "providers": [{ "billed_charge": 871.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.80, "providers": [{ "billed_charge": 26.00, "npi": [1265493688] } ] }, { "allowed_amount": 3.35, "providers": [{ "billed_charge": 39.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.95, "providers": [{ "billed_charge": 740.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.70, "providers": [{ "billed_charge": 378.00, "npi": [1487429874] } ] } ] }, { "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": 8723.29, "providers": [{ "billed_charge": 118181.41, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.45, "providers": [{ "billed_charge": 63.00, "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": 46.74, "providers": [{ "billed_charge": 1042.77, "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": 14555.24, "providers": [{ "billed_charge": 136475.38, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1769.44, "providers": [{ "billed_charge": 3738.00, "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": 108.64, "providers": [{ "billed_charge": 879.31, "npi": [1234567893] } ] } ] } ] }, { "name": "ORGANIC ACID SINGLE QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83921", "description": "ORGANIC ACID, SINGLE, 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"professional", "payments": [{ "allowed_amount": 2235.92, "providers": [{ "billed_charge": 5775.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 280.90, "providers": [{ "billed_charge": 784.32, "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": 107.10, "providers": [{ "billed_charge": 302.40, "npi": [1720448061] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.25, "providers": [{ "billed_charge": 51.19, "npi": [1609565100] } ] } ] } ] }, { "name": "ASSAY 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"billing_class": "professional", "payments": [{ "allowed_amount": 16.59, "providers": [{ "billed_charge": 77.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.30, "providers": [{ "billed_charge": 85.32, "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": 36.53, "providers": [{ "billed_charge": 73.57, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3735.11, "providers": [{ "billed_charge": 7462.40, "npi": [1234567893] 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"npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 83.44, "providers": [{ "billed_charge": 417.20, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.58, "providers": [{ "billed_charge": 250.32, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.31, "providers": [{ "billed_charge": 459.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 542.36, "providers": [{ "billed_charge": 4547.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": 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"value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 498.02, "providers": [{ "billed_charge": 5674.30, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 145.09, "providers": [{ "billed_charge": 401.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.45, "providers": [{ "billed_charge": 242.25, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 813.96, "providers": [{ "billed_charge": 6824.16, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13243.83, "providers": [{ "billed_charge": 173237.73, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 998.86, "providers": [{ "billed_charge": 4224.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.76, "providers": [{ "billed_charge": 174.42, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF PSA, COMPLEXED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84152", "description": "PROSTATE SPECIFIC ANTIGEN (PSA); COMPLEXED (DIRECT MEASUREMENT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36.80, "providers": [{ "billed_charge": 168.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF PSA, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84153", "description": "PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 447.30, "providers": [{ "billed_charge": 4574.11, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.60, "providers": [{ "billed_charge": 73.56, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 124.20, "providers": [{ "billed_charge": 702.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.60, "providers": [{ "billed_charge": 140.34, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2355.20, "providers": [{ "billed_charge": 19737.60, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40000.71, "providers": [{ "billed_charge": 517362.72, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PSA, FREE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84154", "description": "PROSTATE SPECIFIC ANTIGEN (PSA); FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 110.40, "providers": [{ "billed_charge": 624.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.00, "providers": [{ "billed_charge": 385.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7102.73, "providers": [{ "billed_charge": 78896.87, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PROTEIN SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84155", "description": "PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.31, "providers": [{ "billed_charge": 45.91, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3968.23, "providers": [{ 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"service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.95, "providers": [{ "billed_charge": 600.00, "npi": [1003132663] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1520.60, "providers": [{ "billed_charge": 20857.88, "npi": [1234567893] } ] } ] } ] }, { "name": "PROTEIN E-PHORESIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84166", "description": "PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, OTHER FLUIDS WITH CONCENTRATION (EG, URINE,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 236.00, "providers": [{ "billed_charge": 2594.49, "npi": [1234567893] } ] } ] } ] }, { "name": "PROTEIN WESTERN BLOT TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", 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"value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 533.66, "providers": [{ "billed_charge": 4086.11, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF SEX HORMONE GLOBUL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84270", "description": "SEX HORMONE BINDING GLOBULIN (SHBG)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 165.99, "providers": [{ "billed_charge": 1414.00, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 188.35, "providers": [{ "billed_charge": 559.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.83, "providers": [{ "billed_charge": 488.97, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.80, "providers": [{ "billed_charge": 1120.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 532.63, "providers": [{ "billed_charge": 2129.54, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 467.41, "providers": [{ "billed_charge": 3916.44, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 195.66, "providers": [{ "billed_charge": 1296.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": 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}, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 745.36, "providers": [{ "billed_charge": 3726.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 364.21, "providers": [{ "billed_charge": 946.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.94, "providers": [{ "billed_charge": 67.76, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 304.92, "providers": [{ "billed_charge": 1219.68, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 406.56, "providers": [{ "billed_charge": 3408.48, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31460.76, "providers": [{ "billed_charge": 707067.53, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1025.11, "providers": [{ "billed_charge": 3910.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 541.91, "providers": [{ "billed_charge": 1651.65, "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": 272.46, "providers": [{ "billed_charge": 7874.12, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TROPONIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84484", "description": "TROPONIN, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 681.90, "providers": [{ "billed_charge": 12302.83, "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": 49.11, "providers": [{ "billed_charge": 63.31, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3945.41, "providers": [{ "billed_charge": 5373.24, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF BLOOD/URIC ACID", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84550", "description": "URIC ACID; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 224.44, "providers": [{ "billed_charge": 2106.11, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.04, "providers": [{ "billed_charge": 117.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.34, "providers": [{ "billed_charge": 101.70, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.92, "providers": [{ "billed_charge": 252.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.91, "providers": [{ "billed_charge": 56.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 598.90, "providers": [{ "billed_charge": 5016.45, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10029.07, "providers": [{ "billed_charge": 123816.88, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.36, "providers": [{ "billed_charge": 968.00, "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": 31.15, "providers": [{ "billed_charge": 430.54, "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": 981.34, "providers": [{ "billed_charge": 24733.93, "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": 479.92, "providers": [{ "billed_charge": 6470.11, "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": 1145.10, "providers": [{ "billed_charge": 9593.10, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2230.69, "providers": [{ "billed_charge": 21012.64, "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": 125.52, "providers": [{ "billed_charge": 1512.00, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.06, "providers": [{ "billed_charge": 100.38, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.53, "providers": [{ "billed_charge": 50.19, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8291.41, "providers": [{ "billed_charge": 129197.35, "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": 840.97, "providers": [{ "billed_charge": 16501.12, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 228.86, "providers": [{ "billed_charge": 2390.81, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMOGLOBIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85018", "description": "BLOOD COUNT; HEMOGLOBIN (HGB)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.36, "providers": [{ "billed_charge": 3014.99, "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": 39.00, "providers": [{ "billed_charge": 450.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4123.35, "providers": [{ "billed_charge": 25795.36, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 400.67, "providers": [{ "billed_charge": 979.02, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 221.73, "providers": [{ "billed_charge": 570.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 194.50, "providers": [{ "billed_charge": 1750.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.52, "providers": [{ "billed_charge": 1056.72, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 509.59, "providers": [{ "billed_charge": 1572.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "814211994" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.67, "providers": [{ "billed_charge": 207.12, "npi": [1225567233] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 508.47, "providers": [{ "billed_charge": 1875.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 163.38, "providers": [{ "billed_charge": 979.02, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "751369692" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.50, "providers": [{ "billed_charge": 37.50, "npi": [1700960655] } ] }, { "allowed_amount": 23.34, "providers": [{ "billed_charge": 37.50, "npi": [1700960655] } ] } ] }, { "tin": { "type": "ein", "value": "842477526" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.52, "providers": [{ "billed_charge": 5100.00, "npi": [1134828494] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 182.83, "providers": [{ "billed_charge": 1619.32, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "710892430" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 54.00, "npi": [1154379907] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 671.25, "providers": [{ "billed_charge": 3430.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5449.89, "providers": [{ "billed_charge": 21753.74, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 159.49, "providers": [{ "billed_charge": 1271.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 114849.97, "providers": [{ "billed_charge": 983149.48, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.56, "providers": [{ "billed_charge": 144.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "274967011" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1344.21, "providers": [{ "billed_charge": 2076.00, "npi": [1972519544] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.09, "providers": [{ "billed_charge": 392.49, "npi": [1730617523] } ] } ] } ] }, { "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": 206.54, "providers": [{ "billed_charge": 1502.72, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.34, "providers": [{ "billed_charge": 70.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.96, "providers": [{ "billed_charge": 786.48, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8429.00, "providers": [{ "billed_charge": 74360.14, "npi": [1234567893] } ] } ] } ] }, { "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": 52.41, "providers": [{ "billed_charge": 316.11, "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": 30.58, "providers": [{ "billed_charge": 315.54, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1344.17, "providers": [{ "billed_charge": 21327.94, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.00, "providers": [{ "billed_charge": 96.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 256.00, "providers": [{ "billed_charge": 1000.00, "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": 6.95, "providers": [{ "billed_charge": 100.00, "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": 201.51, "providers": [{ "billed_charge": 1601.02, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 78.68, "providers": [{ "billed_charge": 642.65, "npi": [1234567893] } ] } ] } ] }, { "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": 40850.56, "providers": [{ "billed_charge": 70432.00, "npi": [1194743013] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 836136.58, "providers": [{ "billed_charge": 7032383.00, "npi": [1234567893] } ] }, { "allowed_amount": 18183.40, "providers": [{ "billed_charge": 177003.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "853224374" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 5312.10, "providers": [{ "billed_charge": 251509.50, "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": 42.04, "providers": [{ "billed_charge": 703.51, "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": 43.45, "providers": [{ "billed_charge": 823.91, "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": 40.64, "providers": [{ "billed_charge": 1043.51, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT C ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85303", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.30, "providers": [{ "billed_charge": 250.94, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT S FREE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85306", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.57, "providers": [{ "billed_charge": 835.13, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRIN DEGRADATION, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85379", "description": "FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 722.75, "providers": [{ "billed_charge": 21479.13, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRINOLYSINS SCREEN I&R", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85390", "description": "FIBRINOLYSINS OR COAGULOPATHY SCREEN, INTERPRETATION AND REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 703.80, "providers": [{ "billed_charge": 4450.00, "npi": [1518254309] } ] }, { "allowed_amount": 1951.14, "providers": [{ "billed_charge": 12150.00, "npi": [1518254309] } ] } ] } ] }, { "name": "CLOTTING ASSAY WHOLE BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85396", "description": "COAGULATION/FIBRINOLYSIS ASSAY, WHOLE BLOOD (EG, VISCOELASTIC CLOT ASSESSMENT), INCLUDING USE OF ANY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.68, "providers": [{ "billed_charge": 272.00, "npi": [1821077728] } ] }, { "allowed_amount": 242.04, "providers": [{ "billed_charge": 816.00, "npi": [1821077728] } ] } ] } ] }, { "name": "BLOOD PLATELET AGGREGATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85576", "description": "PLATELET, AGGREGATION (IN VITRO), EACH AGENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.46, "providers": [{ "billed_charge": 168.00, "npi": [1699734053] } ] }, { "allowed_amount": 8.73, "providers": [{ "billed_charge": 84.00, "npi": [1003132663] } ] }, { "allowed_amount": 43.53, "providers": [{ "billed_charge": 420.00, "npi": [1699734053] } ] }, { "allowed_amount": 1286.84, "providers": [{ "billed_charge": 12264.00, "npi": [1518254309] } ] }, { "allowed_amount": 412.20, "providers": [{ "billed_charge": 3948.00, "npi": [1518254309] } ] }, { "allowed_amount": 124.33, "providers": [{ "billed_charge": 1176.00, "npi": [1003132663] } ] } ] }, { "tin": { "type": "ein", "value": "760421006" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 263.48, "providers": [{ "billed_charge": 263.48, "npi": [1194929778] } ] } ] } ] }, { "name": "HEXAGNAL PHOSPH PLTLT NEUTRL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85598", "description": "PHOSPHOLIPID NEUTRALIZATION; HEXAGONAL PHOSPHOLIPID", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 118.04, "providers": [{ "billed_charge": 1514.51, "npi": [1234567893] } ] } ] } ] }, { "name": "PROTHROMBIN TIME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85610", "description": "PROTHROMBIN TIME;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.60, "providers": [{ "billed_charge": 834.96, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2243.82, "providers": [{ "billed_charge": 36789.47, "npi": [1234567893] } ] } ] } ] }, { "name": "RUSSELL VIPER VENOM, DILUTED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85613", "description": "RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 327.55, "providers": [{ "billed_charge": 5813.24, "npi": [1234567893] } ] } ] } ] }, { "name": "RBC SED RATE, AUTOMATED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85652", "description": "SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65.80, "providers": [{ "billed_charge": 1425.19, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.14, "providers": [{ "billed_charge": 45.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.35, "providers": [{ "billed_charge": 11.31, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3967.58, "providers": [{ "billed_charge": 92103.84, "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": 375.22, "providers": [{ "billed_charge": 6789.31, "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": 37.53, "providers": [{ "billed_charge": 556.42, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2312.85, "providers": [{ "billed_charge": 37527.23, "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": 12628.22, "providers": [{ "billed_charge": 131054.61, "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": 1300.77, "providers": [{ "billed_charge": 20367.20, "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": 162.54, "providers": [{ "billed_charge": 5285.35, "npi": [1234567893] } ] } ] } ] }, { "name": "ANCA SCREEN EACH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86036", "description": "ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 449.48, "providers": [{ "billed_charge": 9335.79, "npi": [1234567893] } ] } ] } ] }, { "name": "ANCA TITER EACH ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86037", "description": "ANTINEUTROPHIL CYTOPLASMIC ANTB TITER EA ANTB", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.71, "providers": [{ "billed_charge": 815.38, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTINUCLEAR ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86038", "description": "ANTINUCLEAR ANTIBODIES (ANA);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.19, "providers": [{ "billed_charge": 2093.91, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 121.00, "providers": [{ "billed_charge": 1013.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15001.87, "providers": [{ "billed_charge": 217820.03, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTINUCLEAR ANTIBODIES (ANA)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86039", "description": "ANTINUCLEAR ANTIBODIES (ANA); TITER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2559.40, "providers": [{ "billed_charge": 33706.43, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTISTREPTOLYSIN O, TITER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86060", "description": "ANTISTREPTOLYSIN 0; TITER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 381.64, "providers": [{ "billed_charge": 5228.54, "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": 273.85, "providers": [{ "billed_charge": 543.75, "npi": [1487652293] } ] }, { "allowed_amount": 118.56, "providers": [{ "billed_charge": 217.50, "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": 107.70, "providers": [{ "billed_charge": 2079.22, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.92, "providers": [{ "billed_charge": 122.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.18, "providers": [{ "billed_charge": 25.90, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.88, "providers": [{ "billed_charge": 694.08, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6228.51, "providers": [{ "billed_charge": 144171.27, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.72, "providers": [{ "billed_charge": 116.55, "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": 90.72, "providers": [{ "billed_charge": 181.30, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 252.72, "providers": [{ "billed_charge": 663.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1192.32, "providers": [{ "billed_charge": 9985.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2914.55, "providers": [{ "billed_charge": 34103.41, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 733.92, "providers": [{ "billed_charge": 3180.00, "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": 4496.30, "providers": [{ "billed_charge": 42412.50, "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": 6074.57, "providers": [{ "billed_charge": 50396.88, "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": 6399.00, "providers": [{ "billed_charge": 104596.87, "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": 5401.17, "providers": [{ "billed_charge": 91245.21, "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": 3527.00, "providers": [{ "billed_charge": 72942.83, "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": 170.35, "providers": [{ "billed_charge": 1428.42, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36228.79, "providers": [{ "billed_charge": 317626.90, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 991.24, "providers": [{ "billed_charge": 24763.49, "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": 73.71, "providers": [{ "billed_charge": 1174.88, "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": 460.90, "providers": [{ "billed_charge": 9835.55, "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": 3989.27, "providers": [{ "billed_charge": 46125.89, "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": 1101.36, "providers": [{ "billed_charge": 17837.87, "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": 41.64, "providers": [{ "billed_charge": 166.48, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1881.31, "providers": [{ "billed_charge": 25737.27, "npi": [1234567893] } ] } ] } ] }, { "name": "HETEROPHILE ANTIBODY SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86308", "description": "HETEROPHILE ANTIBODIES; SCREENING", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.49, "providers": [{ "billed_charge": 57.25, "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": 3598.40, "providers": [{ "billed_charge": 35751.58, "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": 1727.88, "providers": [{ "billed_charge": 26163.58, "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": 191.46, "providers": [{ "billed_charge": 2321.36, "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": 27.72, "providers": [{ "billed_charge": 452.49, "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": 867.84, "providers": [{ "billed_charge": 14409.90, "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": 9136.48, "providers": [{ "billed_charge": 95370.44, "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": 2728.46, "providers": [{ "billed_charge": 27707.64, "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": 1152.46, "providers": [{ "billed_charge": 30512.93, "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": 394.29, "providers": [{ "billed_charge": 3846.51, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.04, "providers": [{ "billed_charge": 523.80, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 182.00, "providers": [{ "billed_charge": 1524.75, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13318.72, "providers": [{ "billed_charge": 171138.71, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 686.80, "providers": [{ "billed_charge": 2958.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 415.80, "providers": [{ "billed_charge": 1236.96, "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": 2266.88, "providers": [{ "billed_charge": 21475.64, "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": 43.34, "providers": [{ "billed_charge": 593.85, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "463663879" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.18, "providers": [{ "billed_charge": 143.00, "npi": [1760897755] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.68, "providers": [{ "billed_charge": 28.36, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.10, "providers": [{ "billed_charge": 50.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 42.60, "providers": [{ "billed_charge": 356.85, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5321.18, "providers": [{ "billed_charge": 92891.23, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 306.36, "providers": [{ "billed_charge": 1155.00, "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": 30.99, "providers": [{ "billed_charge": 260.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31075.20, "providers": [{ "billed_charge": 218293.56, "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": 1020.00, "providers": [{ "billed_charge": 5737.16, "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": 252.45, "providers": [{ "billed_charge": 3787.21, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.22, "providers": [{ "billed_charge": 395.37, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15355.80, "providers": [{ "billed_charge": 241468.87, "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": 1024.49, "providers": [{ "billed_charge": 14500.88, "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": 1420.96, "providers": [{ "billed_charge": 17949.02, "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": 810.26, "providers": [{ "billed_charge": 9657.67, "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": 197.63, "providers": [{ "billed_charge": 2300.25, "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": 786.78, "providers": [{ "billed_charge": 8483.93, "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": 91.33, "providers": [{ "billed_charge": 1388.04, "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": 125.40, "providers": [{ "billed_charge": 1050.51, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11618.28, "providers": [{ "billed_charge": 139087.15, "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": 242.00, "providers": [{ "billed_charge": 2028.75, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19936.56, "providers": [{ "billed_charge": 251024.87, "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": 4.45, "providers": [{ "billed_charge": 17.78, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 109.45, "providers": [{ "billed_charge": 2090.39, "npi": [1234567893] } ] } ] } ] }, { "name": "HIV-2 ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86702", "description": "ANTIBODY; HIV-2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.76, "providers": [{ "billed_charge": 27.04, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 159.38, "providers": [{ "billed_charge": 2975.12, "npi": [1234567893] } ] } ] } ] }, { "name": "HEP B CORE ANTIBODY, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86704", "description": "HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], 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"value": "741772120" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 100716.06, "providers": [{ "billed_charge": 100716.06, "npi": [1437218062] } ] } ] }, { "tin": { "type": "ein", "value": "760133493" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 12813.26, "providers": [{ "billed_charge": 12813.26, "npi": [1760033526] } ] } ] }, { "tin": { "type": "ein", "value": "455508689" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 11589.93, "providers": [{ "billed_charge": 12000.00, "npi": [1992144885] } ] } ] }, { "tin": { "type": "ein", "value": "742777597" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 101150.00, "providers": [{ "billed_charge": 101150.00, "npi": [1063588143] } ] } ] }, { "tin": { "type": "ein", "value": "746001164" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 4276630.49, "providers": [{ "billed_charge": 4453975.19, "npi": [1447375282] } ] } ] }, { "tin": { "type": "ein", "value": "743253181" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 8630.36, "providers": [{ "billed_charge": 11220.00, "npi": [1588809255] } ] } ] }, { "tin": { "type": "ein", "value": "208424689" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 655308.07, "providers": [{ "billed_charge": 1215000.00, "npi": [1952588329] } ] } ] }, { "tin": { "type": "ein", "value": "933583304" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 28879.71, "providers": [{ "billed_charge": 37000.00, "npi": [1386416212] } ] } ] }, { "tin": { "type": "ein", "value": "746002070" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 4268.25, "providers": [{ "billed_charge": 4500.00, "npi": [1053377713] } ] } ] }, { "tin": { "type": "ein", "value": "300688582" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 193468.32, "providers": [{ "billed_charge": 282498.00, "npi": [1750676870] } ] } ] }, { "tin": { "type": "ein", "value": "746000278" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 212354.00, "providers": [{ "billed_charge": 212354.00, "npi": [1982695268] } ] } ] }, { "tin": { "type": "ein", "value": "742028156" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 868.00, "providers": [{ "billed_charge": 868.00, "npi": [1588734594] } ] } ] }, { "tin": { "type": "ein", "value": "746000574" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 121913.85, "providers": [{ "billed_charge": 125796.69, "npi": [1972609337] } ] } ] } ] }, { "name": "ADVNCED LIFE SUPPORT LEVEL 2", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0433", "description": "ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752234266" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 35700.00, "providers": [{ "billed_charge": 35700.00, "npi": [1710981774] } ] } ] }, { "tin": { "type": "ein", "value": "811424190" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 58452.98, "providers": [{ "billed_charge": 58500.00, "npi": [1104286087] } ] } ] }, { "tin": { "type": "ein", "value": "752474011" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 21044.54, "providers": [{ "billed_charge": 21309.14, "npi": [1639103864] } ] } ] }, { "tin": { "type": "ein", "value": "741772120" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 6053.84, "providers": [{ "billed_charge": 6053.84, "npi": [1437218062] } ] } ] } ] }, { "name": "SPECIALTY CARE TRANSPORT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0434", "description": "SPECIALTY CARE TRANSPORT (SCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "300688582" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 42567.23, "providers": [{ "billed_charge": 66252.00, "npi": [1750676870] } ] } ] } ] }, { "name": "AMB RSPN&TREATMENT NO TRNSPT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0998", "description": "AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752234266" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 21600.00, "providers": [{ "billed_charge": 24000.00, "npi": [1710981774] } ] } ] }, { "tin": { "type": "ein", "value": "746001164" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1151.42, "providers": [{ "billed_charge": 1389.64, "npi": [1447375282] } ] } ] }, { "tin": { "type": "ein", "value": "746000085" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 8723.00, "providers": [{ "billed_charge": 11025.00, "npi": [1295704732] } ] } ] }, { "tin": { "type": "ein", "value": "264304912" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 160.00, "providers": [{ "billed_charge": 400.00, "npi": [1871724864] } ] } ] }, { "tin": { "type": "ein", "value": "746000278" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 96.00, "providers": [{ "billed_charge": 240.00, "npi": [1982695268] } ] } ] }, { "tin": { "type": "ein", "value": "746000574" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 685.54, "providers": [{ "billed_charge": 1713.94, "npi": [1972609337] } ] } ] } ] }, { "name": "INFUS SET EXT INSULIN PUMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4230", "description": "INFUSION SET FOR EXTERNAL INSULIN PUMP, NONNEEDLE CANNULA TYPE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 660.50, "providers": [{ "billed_charge": 4776.00, "npi": [1234567893] } ] } ] } ] }, { "name": "SYRINGE NDLE EXT INSULIN PUM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4232", "description": "SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3 CC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 664.80, "providers": [{ "billed_charge": 3147.36, "npi": [1234567893] } ] } ] } ] }, { "name": "SPLY ALW NONIMPL CGM 1 MO SP=1 UOS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4239", "description": "SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "223865781" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 56327.76, "providers": [{ "billed_charge": 224700.00, "npi": [1245259282] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 17547.17, "providers": [{ "billed_charge": 59278.00, "npi": [1234567893] } ] } ] } ] }, { "name": "Disposable collection and storage bag for breast milk, any size, any type, each", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4287", "description": "Disposable collection and storage bag for breast milk, any size, any type, each", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 24000.00, "providers": [{ "billed_charge": 57600.00, "npi": [1234567893] } ] } ] } ] }, { "name": "SKN BARRIER; SOLID 4X4/EQUVA", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4362", "description": "SKIN BARRIER; SOLID, 4 X 4 OR EQUIVALENT; EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 304.20, "providers": [{ "billed_charge": 1170.00, "npi": [1234567893] } ] } ] } ] }, { "name": "OST SKN BARRIER 4X4 EXT W/O", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4385", "description": "OSTOMY SKIN BARRIER, SOLID 4 X 4 OR EQUIVALENT, EXTENDED WEAR, WITHOUT BUILT-IN CONVEXITY, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 144.00, "providers": [{ "billed_charge": 520.00, "npi": [1234567893] } ] } ] } ] }, { "name": "OSTOMY DEODORANT W/WO LUB PE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4394", "description": "OSTOMY DEODORANT, WITH OR WITHOUT LUBRICANT, FOR USE IN OSTOMY POUCH, PER FL OZ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.40, "providers": [{ "billed_charge": 560.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ADHESIVE REMOVER, WIPES, ANY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4456", "description": "ADHESIVE REMOVER, WIPES, ANY TYPE, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.10, "providers": [{ "billed_charge": 365.00, "npi": [1234567893] } ] } ] } ] }, { "name": "INCONTNCE GARMENT ANY TYPE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4520", "description": "INCONTINENCE GARMENT, ANY TYPE, (E.G., BRIEF, DIAPER), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202087851" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1415.65, "providers": [{ "billed_charge": 3539.18, "npi": [1972583078] } ] } ] } ] }, { "name": "DISPOSABLE UNDERPADS ALL SIZ", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4554", "description": "DISPOSABLE UNDERPADS, ALL SIZES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202087851" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 558.00, "providers": [{ "billed_charge": 558.00, "npi": [1972583078] } ] } ] } ] }, { "name": "TUBING W/INTGR HEAT ELEM W/P", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4604", "description": "TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 708.36, "providers": [{ "billed_charge": 2491.22, "npi": [1234567893] } ] } ] } ] }, { "name": "SKIN BARRIER WIPES OR SWABS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A5120", "description": "SKIN BARRIER, WIPES OR SWABS, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.80, "providers": [{ "billed_charge": 360.00, "npi": [1234567893] } ] } ] } ] }, { "name": "SKN SEALNT PROTCT MOISTURZR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6250", "description": "SKIN SEALANTS, PROTECTANTS, MOISTURIZERS, OINTMENTS, ANY TYPE, ANY SIZE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202087851" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.06, "providers": [{ "billed_charge": 5.16, "npi": [1972583078] } ] } ] } ] }, { "name": "SELF-ADHERENT BANDGE WDTH", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6453", "description": "SELF-ADHERENT BANDAGE, ELASTIC, NONKNITTED/NONWOVEN, WIDTH LESS THAN 3 IN, PER YD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "463847386" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.50, "providers": [{ "billed_charge": 40.00, "npi": [1164442778] } ] } ] } ] }, { "name": "GRADIENT COMPRS STK BK 18-30", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A6530", "description": "GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MM HG, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 821.70, "providers": [{ "billed_charge": 1080.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ADMN SET SM VOL NONFILTR NEB", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7003", "description": "ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.84, "providers": [{ "billed_charge": 15.03, "npi": [1942535828] } ] } ] } ] }, { "name": "FULL FCE MASK POS ARWAY PRSS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7030", "description": "FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 161.50, "providers": [{ "billed_charge": 398.00, "npi": [1234567893] } ] } ] } ] }, { "name": "FCE MASK INTERFCE REPL FULL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7031", "description": "FACE MASK INTERFACE, REPLACEMENT FOR FULL FACE MASK, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.24, "providers": [{ "billed_charge": 240.00, "npi": [1234567893] } ] } ] } ] }, { "name": "NASL INTERFCE POS ARWAY PRSS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7034", "description": "NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.62, "providers": [{ "billed_charge": 110.00, "npi": [1234567893] } ] } ] } ] }, { "name": "HEADGEAR USED W/POS ARWAY PR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7035", "description": "HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 193.93, "providers": [{ "billed_charge": 747.37, "npi": [1234567893] } ] } ] } ] }, { "name": "FLTR DISPBL W/POS ARWAY PRSS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7038", "description": "FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 358.28, "providers": [{ "billed_charge": 1456.00, "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": 51.85, "providers": [{ "billed_charge": 383.12, "npi": [1234567893] } ] } ] } ] }, { "name": "SENSOR; INVSV INTRSTL GLU MO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A9276", "description": "SENSOR; INVASIVE (E.G., SUBCUTANEOUS), DISPOSABLE, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 21572.90, "providers": [{ "billed_charge": 37472.58, "npi": [1234567893] } ] } ] } ] }, { 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