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49.50, "providers": [{ "billed_charge": 66.00, "npi": [1700910189] } ] }, { "allowed_amount": 40.50, "providers": [{ "billed_charge": 54.00, "npi": [1700910189] } ] }, { "allowed_amount": 2362.50, "providers": [{ "billed_charge": 509498.00, "npi": [1700910189] } ] } ] }, { "tin": { "type": "ein", "value": "862195601" }, "service_code": ["23"], "billing_class": "institutional", "payments": [{ "allowed_amount": 770.86, "providers": [{ "billed_charge": 3558.43, "npi": [1881352037] } ] } ] }, { "tin": { "type": "ein", "value": "721561134" }, "service_code": ["22", "23", "21"], "billing_class": "institutional", "payments": [{ "allowed_amount": 77.80, "providers": [{ "billed_charge": 1035.00, "npi": [1609408665] } ] }, { "allowed_amount": 3681.00, "providers": [{ "billed_charge": 113230.00, "npi": [1982733655] } ] }, { "allowed_amount": 5805.19, "providers": [{ "billed_charge": 13411.50, "npi": [1982733655] } ] }, { "allowed_amount": 22.68, "providers": [{ "billed_charge": 409.00, "npi": 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["23"], "billing_class": "institutional", "payments": [{ "allowed_amount": 1422.01, "providers": [{ "billed_charge": 24344.00, "npi": [1700910189] } ] } ] }, { "tin": { "type": "ein", "value": "383990879" }, "service_code": ["23"], "billing_class": "institutional", "payments": [{ "allowed_amount": 780.24, "providers": [{ "billed_charge": 15713.00, "npi": [1689121188] } ] } ] }, { "tin": { "type": "ein", "value": "721561134" }, "service_code": ["22", "23", "21"], "billing_class": "institutional", "payments": [{ "allowed_amount": 1728.76, "providers": [{ "billed_charge": 19767.00, "npi": [1982733655] } ] }, { "allowed_amount": 449.25, "providers": [{ "billed_charge": 599.00, "npi": [1982733655] }, { "billed_charge": 14975.00, "npi": [1982733655] } ] } ] }, { "tin": { "type": "ein", "value": "860800150" }, "service_code": ["23"], "billing_class": "institutional", "payments": [{ "allowed_amount": 653.22, "providers": [{ "billed_charge": 3655.00, "npi": [1154392231] } ] } ] } ] }, { "name": 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["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.60, "providers": [{ "billed_charge": 195.48, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2880.36, "providers": [{ "billed_charge": 38081.48, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], 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"billed_charge": 671.85, "npi": [1740262880] } ] } ] } ] }, { "name": "MICROALBUMIN, QUANTITATIVE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82043", "description": "ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1944.72, "providers": [{ "billed_charge": 32565.47, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF BREATH ETHANOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82075", "description": "ALCOHOL (ETHANOL), BREATH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870847992" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.00, "providers": [{ "billed_charge": 270.00, "npi": [1871547380] } ] } ] } ] }, { "name": "ALPHA-FETOPROTEIN, SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82105", "description": "ALPHA-FETOPROTEIN (AFP); SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.24, "providers": [{ "billed_charge": 237.30, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF AMYLASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82150", "description": "AMYLASE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.64, "providers": [{ "billed_charge": 712.82, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF APOLIPOPROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82172", "description": "APOLIPOPROTEIN, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 866.51, "providers": [{ "billed_charge": 2848.38, "npi": [1740262880] } ] } ] } ] }, { "name": "BILIRUBIN, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82247", "description": "BILIRUBIN; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 329.43, "providers": [{ "billed_charge": 428.32, "npi": [1740262880] } ] } ] } ] }, { "name": "BILIRUBIN, DIRECT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82248", "description": "BILIRUBIN; DIRECT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 211.60, "providers": [{ "billed_charge": 402.05, "npi": [1740262880] } ] } ] } ] }, { "name": "VITAMIN D 25 HYDROXY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82306", "description": "VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20861.18, "providers": [{ "billed_charge": 342389.61, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF CALCIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82310", "description": "CALCIUM; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 297.50, "providers": [{ "billed_charge": 356.55, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF CALCIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82330", "description": "CALCIUM; IONIZED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.27, "providers": [{ "billed_charge": 115.50, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY, BLOOD CARBON DIOXIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82374", "description": "CARBON DIOXIDE (BICARBONATE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.57, "providers": [{ "billed_charge": 70.02, "npi": [1740262880] } ] } ] } ] }, { "name": "CARCINOEMBRYONIC ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82378", "description": "CARCINOEMBRYONIC ANTIGEN (CEA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 552.52, "providers": [{ "billed_charge": 5222.59, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF BLOOD CHLORIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82435", "description": "CHLORIDE; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.37, "providers": [{ "billed_charge": 361.11, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF COPPER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82525", "description": "COPPER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.52, "providers": [{ "billed_charge": 189.50, "npi": [1740262880] } ] } ] } ] }, { "name": "TOTAL CORTISOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82533", "description": "CORTISOL; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1823.55, "providers": [{ "billed_charge": 16893.91, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF CK (CPK)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82550", "description": "CREATINE KINASE (CK), (CPK); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 79.84, "providers": [{ "billed_charge": 679.30, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF CREATININE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82565", "description": "CREATININE; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 372.73, "providers": [{ "billed_charge": 852.90, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF URINE CREATININE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82570", "description": "CREATININE; OTHER SOURCE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1738.46, "providers": [{ "billed_charge": 28223.52, "npi": [1740262880] } ] } ] } ] }, { "name": "VITAMIN B-12", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82607", "description": "CYANOCOBALAMIN (VITAMIN B-12);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5867.40, "providers": [{ "billed_charge": 53767.13, "npi": [1740262880] } ] } ] } ] }, { "name": "DEHYDROEPIANDROSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82627", "description": "DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3152.40, "providers": [{ "billed_charge": 33081.44, "npi": [1740262880] } ] } ] } ] }, { "name": "DIHYDROTESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82642", "description": "DIHYDROTESTOSTERONE (DHT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 291.59, "providers": [{ "billed_charge": 2459.20, "npi": [1740262880] } ] } ] } ] }, { "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": 10533.72, "providers": [{ "billed_charge": 88455.98, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 814.38, "providers": [{ "billed_charge": 8805.77, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF ESTRONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82679", "description": "ESTRONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 879.98, "providers": [{ "billed_charge": 9427.58, "npi": [1740262880] } ] } ] } ] }, { "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": 4228.20, "providers": [{ "billed_charge": 35057.98, "npi": [1740262880] } ] } ] } ] }, { "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": 4169.90, "providers": [{ "billed_charge": 38795.03, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 401.65, "providers": [{ "billed_charge": 7745.85, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.68, "providers": [{ "billed_charge": 1677.77, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 196.14, "providers": [{ "billed_charge": 540.49, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 334.88, "providers": [{ "billed_charge": 2702.35, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.90, "providers": [{ "billed_charge": 378.15, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.00, "providers": [{ "billed_charge": 90.92, "npi": [1740262880] } ] } ] } ] }, { "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": 507.84, "providers": [{ "billed_charge": 3656.31, "npi": [1740262880] } ] } ] } ] }, { "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": 4542.56, "providers": [{ "billed_charge": 39110.13, "npi": [1740262880] } ] } ] } ] }, { "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": 3448.17, "providers": [{ "billed_charge": 29721.54, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 516.10, "providers": [{ "billed_charge": 3402.00, "npi": [1740262880] } ] } ] } ] }, { "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": 12261.12, "providers": [{ "billed_charge": 127063.62, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF HOMOCYSTINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83090", "description": "HOMOCYSTEINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 659.43, "providers": [{ "billed_charge": 9687.31, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.36, "providers": [{ "billed_charge": 758.76, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.98, "providers": [{ "billed_charge": 9671.11, "npi": [1740262880] } ] } ] } ] }, { "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": 802.69, "providers": [{ "billed_charge": 11087.74, "npi": [1740262880] } ] } ] } ] }, { "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": 1983.40, "providers": [{ "billed_charge": 14353.01, "npi": [1740262880] } ] } ] } ] }, { "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": 2318.20, "providers": [{ "billed_charge": 16961.70, "npi": [1740262880] } ] } ] } ] }, { "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": 406.07, "providers": [{ "billed_charge": 2128.12, "npi": [1740262880] } ] } ] } ] }, { "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": 121.44, "providers": [{ "billed_charge": 1449.54, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 208.32, "providers": [{ "billed_charge": 3374.49, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF MAGNESIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83735", "description": "MAGNESIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 786.42, "providers": [{ "billed_charge": 7408.39, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PARATHORMONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83970", "description": "PARATHORMONE (PARATHYROID HORMONE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1043.79, "providers": [{ "billed_charge": 6631.14, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY ALKALINE PHOSPHATASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84075", "description": "PHOSPHATASE, ALKALINE;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 329.61, "providers": [{ "billed_charge": 395.23, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PHOSPHORUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84100", "description": "PHOSPHORUS INORGANIC (PHOSPHATE);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 415.76, "providers": [{ "billed_charge": 2664.70, "npi": [1740262880] } ] } ] } ] }, { "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": 149.00, "providers": [{ "billed_charge": 213.05, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PREGNENOLONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84140", "description": "PREGNENOLONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 47.52, "providers": [{ "billed_charge": 352.20, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5052.84, "providers": [{ "billed_charge": 44966.38, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PROLACTIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84146", "description": "PROLACTIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1707.75, "providers": [{ "billed_charge": 16539.26, "npi": [1740262880] } ] } ] } ] }, { "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": 3029.35, "providers": [{ "billed_charge": 25806.20, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 479.06, "providers": [{ "billed_charge": 3544.06, "npi": [1740262880] } ] } ] } ] }, { "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": 249.70, "providers": [{ "billed_charge": 510.97, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF PROTEIN, URINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84156", "description": "PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 98.35, "providers": [{ "billed_charge": 1253.40, "npi": [1740262880] } ] } ] } ] }, { "name": "PROTEIN E-PHORESIS, SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84165", "description": "PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.69, "providers": [{ "billed_charge": 192.64, "npi": [1740262880] } ] } ] } ] }, { "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": 1631.75, "providers": [{ "billed_charge": 15073.72, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF SERUM SODIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84295", "description": "SODIUM; SERUM, PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 275.03, "providers": [{ "billed_charge": 343.69, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF SOMATOMEDIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84305", "description": "SOMATOMEDIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 407.25, "providers": [{ "billed_charge": 7483.06, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF FREE TESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84402", "description": "TESTOSTERONE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8838.03, "providers": [{ "billed_charge": 85480.94, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF TOTAL TESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84403", "description": "TESTOSTERONE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12243.86, "providers": [{ "billed_charge": 115252.15, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF TOTAL THYROXINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84436", "description": "THYROXINE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 441.84, "providers": [{ "billed_charge": 3996.62, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF FREE THYROXINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84439", "description": "THYROXINE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5845.86, "providers": [{ "billed_charge": 89938.73, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY THYROID STIM HORMONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84443", "description": "THYROID STIMULATING HORMONE (TSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21119.67, "providers": [{ "billed_charge": 202039.81, "npi": [1740262880] } ] } ] } ] }, { "name": "TRANSFERASE (AST) (SGOT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84450", "description": "TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 371.67, "providers": [{ "billed_charge": 773.09, "npi": [1740262880] } ] } ] } ] }, { "name": "ALANINE AMINO (ALT) (SGPT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84460", "description": "TRANSFERASE; ALANINE AMINO (ALT) (SGPT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.69, "providers": [{ "billed_charge": 806.22, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF TRANSFERRIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84466", "description": "TRANSFERRIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.22, "providers": [{ "billed_charge": 1713.80, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF THYROID (T3 OR T4)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84479", "description": "THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 138.88, "providers": [{ "billed_charge": 1299.85, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY, TRIIODOTHYRONINE (T3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84480", "description": "TRIIODOTHYRONINE T3; TOTAL (TT-3)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 217.40, "providers": [{ "billed_charge": 2339.77, "npi": [1740262880] } ] } ] } ] }, { "name": "FREE ASSAY (FT-3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84481", "description": "TRIIODOTHYRONINE T3; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6451.60, "providers": [{ "billed_charge": 109069.94, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 652.32, "providers": [{ "billed_charge": 12247.88, "npi": [1740262880] } ] } ] } ] }, { "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": 264.77, "providers": [{ "billed_charge": 471.66, "npi": [1740262880] } ] } ] } ] }, { "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": 468.23, "providers": [{ "billed_charge": 3463.14, "npi": [1740262880] } ] } ] } ] }, { "name": "ASSAY OF ZINC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84630", "description": "ZINC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.84, "providers": [{ "billed_charge": 827.96, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.05, "providers": [{ "billed_charge": 618.43, "npi": [1740262880] } ] } ] } ] }, { "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": 710.16, "providers": [{ "billed_charge": 5189.85, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.10, "providers": [{ "billed_charge": 185.91, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.86, "providers": [{ "billed_charge": 136.59, "npi": [1740262880] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12366.04, "providers": [{ "billed_charge": 97726.31, "npi": [1740262880] } ] } ] } ] }, { "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": 570.72, "providers": [{ "billed_charge": 4368.73, "npi": [1740262880] } ] } ] } ] }, { "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": 12.28, "providers": [{ "billed_charge": 165.83, "npi": [1740262880] } ] } ] } ] }, { "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": 391.29, "providers": [{ "billed_charge": 5323.17, "npi": [1740262880] } ] } ] } ] }, { "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": 331.20, "providers": [{ "billed_charge": 5960.37, "npi": [1740262880] } ] } ] } ] }, { "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": 377.20, "providers": [{ "billed_charge": 5257.21, "npi": [1740262880] } ] } ] } ] }, { "name": "ANTINUCLEAR ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": 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