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}, { "tin": { "type": "ein", "value": "941700729" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 1330.46, "providers": [{ "billed_charge": 957.00, "npi": [1881646909] } ] } ] } ] }, { "name": "SCR MAMMO BI INCL CAD", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "77067", "description": "SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (", "allowed_amounts": [{ "tin": { "type": "ein", "value": "954651287" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1376.38, "providers": [{ "billed_charge": 2072.00, "npi": [1962457812] } ] } ] }, { "tin": { "type": "ein", "value": "951644042" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 1594.99, "providers": [{ "billed_charge": 1057.20, "npi": [1477502797] } ] } ] }, { "tin": { "type": "ein", "value": "275493321" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 12277.81, "providers": [{ "billed_charge": 8962.03, "npi": [1386313740] } ] } ] }, { "tin": { "type": "ein", "value": "952592769" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 17403.28, "providers": [{ "billed_charge": 24192.00, "npi": [1053355792] } ] } ] }, { "tin": { "type": "ein", "value": "941700729" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 1447.55, "providers": [{ "billed_charge": 1155.00, "npi": [1881646909] } ] } ] } ] }, { "name": "GUIDANCE FOR RADIAJ TX DLVR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "77387", "description": "GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR DELIVERY OF RADIATION TREATMENT DELIVERY, INCLUDES IN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "650825133" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 8583.19, "providers": [{ "billed_charge": 1026.00, "npi": [1760590962] } ] } ] }, { "tin": { "type": "ein", "value": "851303970" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 1457.68, "providers": [{ "billed_charge": 1050.00, "npi": [1649895194] } ] } ] } ] }, { "name": "RADIATION TREATMENT DELIVERY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "77407", "description": "RADIATION TREATMENT DELIVERY, =>1 MEV; INTERMEDIATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "650825133" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 10233.25, "providers": [{ "billed_charge": 16283.00, "npi": [1760590962] } ] } ] } ] }, { "name": "METABOLIC PANEL TOTAL CA", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "80048", "description": "BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS 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["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.10, "providers": [{ "billed_charge": 31.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4529.79, "providers": [{ "billed_charge": 829.08, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 15503.92, "providers": [{ "billed_charge": 1423.26, "npi": [1942257191] } ] } ] } ] }, { "name": "GENERAL HEALTH PANEL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "80050", "description": "GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3180.22, "providers": [{ "billed_charge": 2697.84, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1494.78, "providers": [{ "billed_charge": 597.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 87472.12, "providers": [{ "billed_charge": 71191.64, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 862.54, "providers": [{ "billed_charge": 1330.35, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5979.63, "providers": [{ "billed_charge": 9243.22, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "954524103" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.17, "providers": [{ "billed_charge": 340.00, "npi": [1548225428] } ] } ] }, { "tin": { "type": "ein", "value": "161387862" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1410.48, "providers": [{ "billed_charge": 3156.70, "npi": [1932145778] } ] } ] } ] }, { "name": "COMPREHEN METABOLIC PANEL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "80053", "description": "COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 3025.44, "providers": [{ "billed_charge": 597.95, "npi": [1730119553] } ] }, { "allowed_amount": 1388.06, "providers": [{ "billed_charge": 238.69, "npi": [1730119553] } ] }, { "allowed_amount": 35000.86, "providers": [{ "billed_charge": 2204.57, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.44, "providers": [{ "billed_charge": 60.00, "npi": [1174113534] } ] }, { "allowed_amount": 3557.77, "providers": [{ "billed_charge": 750.00, "npi": [1174113534] } ] }, { "allowed_amount": 11388.90, "providers": [{ "billed_charge": 750.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4006.92, "providers": [{ "billed_charge": 1585.66, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1079.32, "providers": [{ "billed_charge": 468.00, "npi": [1316984388] } ] }, { "allowed_amount": 2524.02, "providers": [{ "billed_charge": 546.00, "npi": [1316984388] } ] }, { "allowed_amount": 6083.80, "providers": [{ "billed_charge": 3393.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 573.17, "providers": [{ "billed_charge": 180.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "800151023" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 107.91, "providers": [{ "billed_charge": 32.70, "npi": [1316196892] } ] }, { "allowed_amount": 371.46, "providers": [{ "billed_charge": 49.05, "npi": [1316196892] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 27440.88, "providers": [{ "billed_charge": 6177.00, "npi": [1356409379] } ] }, { "allowed_amount": 229.92, "providers": [{ "billed_charge": 329.44, "npi": [1356409379] } ] }, { "allowed_amount": 1025.93, "providers": [{ "billed_charge": 1894.28, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "591173832" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 406.04, "providers": [{ "billed_charge": 111.00, "npi": [1003881210] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 117.12, "providers": [{ "billed_charge": 69.82, "npi": [1942257191] } ] }, { "allowed_amount": 207.87, "providers": [{ "billed_charge": 349.10, "npi": [1942257191] } ] }, { "allowed_amount": 6876.34, "providers": [{ "billed_charge": 3343.42, "npi": [1942257191] } ] } ] }, { "tin": { "type": "ein", "value": "954126874" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1227.30, "providers": [{ "billed_charge": 112.00, "npi": [1053305797] } ] } ] }, { "tin": { "type": "ein", "value": "952645519" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.55, "providers": [{ "billed_charge": 139.94, "npi": [1568431088] } ] }, { "allowed_amount": 285.20, "providers": [{ "billed_charge": 419.82, "npi": [1568431088] } ] }, { "allowed_amount": 29.96, "providers": [{ "billed_charge": 279.88, "npi": [1568431088] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1629.66, "providers": [{ "billed_charge": 1672.48, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1896.24, "providers": [{ "billed_charge": 924.00, "npi": [1861018574] } ] }, { "allowed_amount": 382.26, "providers": [{ "billed_charge": 332.64, "npi": [1578549044] } ] }, { "allowed_amount": 48275.33, "providers": [{ "billed_charge": 14007.84, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "475583986" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1529.98, "providers": [{ "billed_charge": 406.00, "npi": [1699120857] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1262.14, "providers": [{ "billed_charge": 373.10, "npi": [1538144910] } ] }, { "allowed_amount": 1699.85, "providers": [{ "billed_charge": 1192.07, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5356.42, "providers": [{ "billed_charge": 1319.89, "npi": [1043256886] } ] } ] } ] }, { "name": "LIPID PANEL", "billing_code_type": "HCPCS", "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": "455080644" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 601.70, "providers": [{ "billed_charge": 205.00, "npi": [1861413023] } ] } ] }, { "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4793.97, "providers": [{ "billed_charge": 3805.43, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 116535.89, "providers": [{ "billed_charge": 31730.99, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1238.05, "providers": [{ "billed_charge": 2312.70, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2537.02, "providers": [{ "billed_charge": 665.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 628.32, "providers": [{ "billed_charge": 416.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2960.75, "providers": [{ "billed_charge": 2914.70, "npi": [1063497451] } ] }, { "allowed_amount": 1502.07, "providers": [{ "billed_charge": 1105.26, "npi": [1538144910] } ] }, { "allowed_amount": 975.02, "providers": [{ "billed_charge": 514.50, "npi": [1295726032] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11841.01, "providers": [{ "billed_charge": 9851.41, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 238.68, "providers": [{ "billed_charge": 355.80, "npi": [1932166386] } ] } ] }, { "tin": { "type": "ein", "value": "954524103" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 230.56, "providers": [{ "billed_charge": 121.00, "npi": [1548225428] } ] } ] }, { "tin": { "type": "ein", "value": "161387862" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2298.08, "providers": [{ "billed_charge": 4422.09, "npi": [1932145778] } ] } ] }, { "tin": { "type": "ein", "value": "453205266" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 745.07, "providers": [{ "billed_charge": 293.92, "npi": [1174882948] } ] } ] } ] }, { "name": "RENAL FUNCTION PANEL", "billing_code_type": "HCPCS", "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": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11045.62, "providers": [{ "billed_charge": 2897.77, "npi": [1356409379] } ] } ] } ] }, { "name": "HEPATIC FUNCTION PANEL", "billing_code_type": "HCPCS", "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": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1917.94, "providers": [{ "billed_charge": 772.20, "npi": 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"allowed_amount": 27.74, "providers": [{ "billed_charge": 17.49, "npi": [1730119553] } ] } ] } ] }, { "name": "GLUCOSE TEST", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82950", "description": "GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.14, "providers": [{ "billed_charge": 55.02, "npi": [1720279805] } ] } ] } ] }, { "name": "GLUCOSE BLOOD TEST", "billing_code_type": "HCPCS", "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": "911879977" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 8205.34, "providers": [{ "billed_charge": 3408.64, "npi": [1730119553] } ] }, { "allowed_amount": 5.42, "providers": [{ "billed_charge": 64.28, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "880107050" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 706.29, "providers": [{ "billed_charge": 133.00, "npi": [1083675169] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (FSH)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83001", "description": "GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5897.09, "providers": [{ "billed_charge": 1560.72, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (LH)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83002", "description": "GONADOTROPIN; LUTEINIZING HORMONE (LH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1625.21, "providers": [{ "billed_charge": 518.56, "npi": [1720279805] } ] } ] } ] }, { "name": "GLYCOSYLATED HEMOGLOBIN TEST", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83036", "description": "HEMOGLOBIN; GLYCOSYLATED (A1C)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4299.65, "providers": [{ "billed_charge": 2478.85, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 536.78, "providers": [{ "billed_charge": 802.80, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 107454.87, "providers": [{ "billed_charge": 19680.21, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 261.44, "providers": [{ "billed_charge": 70.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 757.20, "providers": [{ "billed_charge": 312.70, "npi": [1538144910] } ] }, { "allowed_amount": 2259.88, "providers": [{ "billed_charge": 1200.05, "npi": [1063497451] } ] }, { "allowed_amount": 251.95, "providers": [{ "billed_charge": 138.60, "npi": [1295726032] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11065.27, "providers": [{ "billed_charge": 3971.50, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "161387862" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1786.02, "providers": [{ "billed_charge": 1414.45, "npi": [1932145778] } ] } ] }, { "tin": { "type": "ein", "value": "453205266" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1380.20, "providers": [{ "billed_charge": 319.68, "npi": [1174882948] } ] } ] } ] }, { "name": "ASSAY OF IRON", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83540", "description": "IRON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 35096.41, "providers": [{ "billed_charge": 3737.25, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF LACTIC ACID", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83605", "description": "LACTATE (LACTIC ACID)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1106.19, "providers": [{ "billed_charge": 28.40, "npi": [1730119553] } ] } ] } ] }, { "name": "LACTATE (LD) (LDH) ENZYME", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83615", "description": "LACTATE DEHYDROGENASE (LD), (LDH);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "952697418" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 210.12, "providers": [{ "billed_charge": 93.60, "npi": [1356409379] } ] }, { "allowed_amount": 15732.80, "providers": [{ "billed_charge": 1918.80, "npi": [1356409379] } ] } ] } ] }, { "name": "ASSAY OF LIPASE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83690", "description": "LIPASE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 299.60, "providers": [{ "billed_charge": 30.00, "npi": [1174113534] } ] }, { "allowed_amount": 783.18, "providers": [{ "billed_charge": 60.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 842.60, "providers": [{ "billed_charge": 120.60, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN(A)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83695", "description": "LIPOPROTEIN (A)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11643.38, "providers": [{ "billed_charge": 2606.24, "npi": [1720279805] } ] } ] } ] }, { "name": "LIPOPROTEIN BLD QUAN PART", "billing_code_type": "HCPCS", "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": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1028.80, "providers": [{ "billed_charge": 980.00, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF MAGNESIUM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83735", "description": "MAGNESIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1339.85, "providers": [{ "billed_charge": 659.25, "npi": [1730119553] } ] }, { "allowed_amount": 545.52, "providers": [{ "billed_charge": 146.50, "npi": [1730119553] } ] }, { "allowed_amount": 37390.03, "providers": [{ "billed_charge": 3842.88, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 5571.32, "providers": [{ "billed_charge": 485.00, "npi": [1174113534] } ] }, { "allowed_amount": 649.20, "providers": [{ "billed_charge": 84.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1530.31, "providers": [{ "billed_charge": 142.00, "npi": [1316984388] } ] }, { "allowed_amount": 59.54, "providers": [{ "billed_charge": 25.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1091.12, "providers": [{ "billed_charge": 184.15, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 119.20, "providers": [{ "billed_charge": 52.41, "npi": [1356409379] } ] }, { "allowed_amount": 35872.86, "providers": [{ "billed_charge": 4769.31, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 14496.75, "providers": [{ "billed_charge": 863.27, "npi": [1942257191] } ] } ] } ] }, { "name": "ASSAY OF PARATHORMONE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83970", "description": "PARATHORMONE (PARATHYROID HORMONE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3266.35, "providers": [{ "billed_charge": 2167.20, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF PHOSPHORUS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84100", "description": "PHOSPHORUS INORGANIC (PHOSPHATE);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 21551.93, "providers": [{ "billed_charge": 596.01, "npi": [1730119553] } ] }, { "allowed_amount": 226.43, "providers": [{ "billed_charge": 16.44, "npi": [1730119553] } ] }, { "allowed_amount": 1267.32, "providers": [{ "billed_charge": 164.40, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 16792.09, "providers": [{ "billed_charge": 1647.36, "npi": [1356409379] } ] }, { "allowed_amount": 25.35, "providers": [{ "billed_charge": 37.44, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 17464.38, "providers": [{ "billed_charge": 529.52, "npi": [1942257191] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 895.86, "providers": [{ "billed_charge": 365.05, "npi": [1720279805] } ] } ] } ] }, { "name": "PROCALCITONIN (PCT)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84145", "description": "PROCALCITONIN (PCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 3378.17, "providers": [{ "billed_charge": 1411.28, "npi": [1356409379] } ] } ] } ] }, { "name": "ASSAY OF PSA, TOTAL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84153", "description": "PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 145.54, "providers": [{ "billed_charge": 225.84, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21219.64, "providers": [{ "billed_charge": 7587.57, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 837.15, "providers": [{ "billed_charge": 535.05, "npi": [1043256886] } ] } ] } ] }, { "name": "ASSAY OF PROTEIN, URINE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84156", "description": "PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 171.50, "providers": [{ "billed_charge": 43.26, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF SEX HORMONE GLOBUL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84270", "description": "SEX HORMONE BINDING GLOBULIN (SHBG)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 298.00, "providers": [{ "billed_charge": 49.00, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF FREE TESTOSTERONE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84402", "description": "TESTOSTERONE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 781.57, "providers": [{ "billed_charge": 206.00, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF TOTAL TESTOSTERONE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84403", "description": "TESTOSTERONE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1129.28, "providers": [{ "billed_charge": 1055.29, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8814.17, "providers": [{ "billed_charge": 2826.20, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1021.28, "providers": [{ "billed_charge": 767.46, "npi": [1043256886] } ] } ] } ] }, { "name": "ASSAY OF FREE THYROXINE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84439", "description": "THYROXINE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 462.93, "providers": [{ "billed_charge": 170.40, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31938.89, "providers": [{ "billed_charge": 5335.33, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 972.47, "providers": [{ "billed_charge": 192.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3031.75, "providers": [{ "billed_charge": 2266.60, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "453205266" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.58, "providers": [{ "billed_charge": 49.48, "npi": [1174882948] } ] } ] } ] }, { "name": "ASSAY THYROID STIM HORMONE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84443", "description": "THYROID STIMULATING HORMONE (TSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 84.14, "providers": [{ "billed_charge": 62.37, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21516.84, "providers": [{ "billed_charge": 7820.40, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.64, "providers": [{ "billed_charge": 43.00, "npi": [1063497451] } ] } ] } ] }, { "name": "ASSAY OF TRANSFERRIN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84466", "description": "TRANSFERRIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33914.14, "providers": [{ "billed_charge": 7368.90, "npi": [1720279805] } ] } ] } ] }, { "name": "FREE ASSAY (FT-3)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84481", "description": "TRIIODOTHYRONINE T3; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1127.37, "providers": [{ "billed_charge": 296.45, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 196.02, "providers": [{ "billed_charge": 122.00, "npi": [1750348033] } ] } ] } ] }, { "name": "ASSAY OF TROPONIN, QUANT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84484", "description": "TROPONIN, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 905.66, "providers": [{ "billed_charge": 199.39, "npi": [1730119553] } ] }, { "allowed_amount": 521.54, "providers": [{ "billed_charge": 115.33, "npi": [1730119553] } ] }, { "allowed_amount": 939.00, "providers": [{ "billed_charge": 76.23, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 551.80, "providers": [{ "billed_charge": 130.00, "npi": [1174113534] } ] }, { "allowed_amount": 563.40, "providers": [{ "billed_charge": 245.00, "npi": [1174113534] } ] } ] } ] }, { "name": "ASSAY OF 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[1730119553] } ] }, { "allowed_amount": 53777.40, "providers": [{ "billed_charge": 2706.03, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.44, "providers": [{ "billed_charge": 60.00, "npi": [1174113534] } ] }, { "allowed_amount": 10230.77, "providers": [{ "billed_charge": 1260.00, "npi": [1174113534] } ] }, { "allowed_amount": 4156.31, "providers": [{ "billed_charge": 924.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3967.97, "providers": [{ "billed_charge": 1012.68, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 4164.87, "providers": [{ "billed_charge": 2130.00, "npi": [1316984388] } ] }, { "allowed_amount": 1468.65, "providers": [{ "billed_charge": 366.00, "npi": [1316984388] } ] }, { "allowed_amount": 727.62, "providers": [{ "billed_charge": 280.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 513.02, "providers": [{ "billed_charge": 252.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "800151023" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.39, "providers": [{ "billed_charge": 12.25, "npi": [1316196892] } ] }, { "allowed_amount": 4175.56, "providers": [{ "billed_charge": 85.75, "npi": [1316196892] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 390.62, "providers": [{ "billed_charge": 359.40, "npi": [1356409379] } ] }, { "allowed_amount": 33992.44, "providers": [{ "billed_charge": 7188.00, "npi": [1356409379] } ] }, { "allowed_amount": 1174.34, "providers": [{ "billed_charge": 1797.00, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.66, "providers": [{ "billed_charge": 72.00, "npi": [1811944101] } ] } ] }, { "tin": { "type": "ein", "value": "591173832" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 139.00, "providers": [{ "billed_charge": 32.00, "npi": [1003881210] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 331.98, "providers": [{ "billed_charge": 193.24, "npi": [1942257191] } ] }, { "allowed_amount": 21855.48, "providers": [{ "billed_charge": 1978.17, "npi": [1942257191] } ] } ] }, { "tin": { "type": "ein", "value": "954126874" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.70, "providers": [{ "billed_charge": 36.00, "npi": [1053305797] } ] } ] }, { "tin": { "type": "ein", "value": "952645519" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 142.27, "providers": [{ "billed_charge": 181.52, "npi": [1568431088] } ] }, { "allowed_amount": 204.80, "providers": [{ "billed_charge": 45.38, "npi": [1568431088] } ] }, { "allowed_amount": 121.63, "providers": [{ "billed_charge": 136.14, "npi": [1568431088] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2143.31, "providers": [{ "billed_charge": 734.40, "npi": [1861018574] } ] }, { "allowed_amount": 41522.91, "providers": [{ "billed_charge": 9112.00, "npi": [1720279805] } ] }, { "allowed_amount": 1325.76, "providers": [{ "billed_charge": 680.00, "npi": [1578549044] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 407.97, "providers": [{ "billed_charge": 273.25, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1238.80, "providers": [{ "billed_charge": 162.75, "npi": [1538144910] } ] }, { "allowed_amount": 784.84, "providers": [{ "billed_charge": 227.85, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "475583986" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 859.37, "providers": [{ "billed_charge": 258.00, "npi": [1699120857] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 570.65, "providers": [{ "billed_charge": 109.30, "npi": [1043256886] } ] } ] } ] }, { "name": "COMPLETE CBC, AUTOMATED", "billing_code_type": "HCPCS", "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": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 10813.61, "providers": [{ "billed_charge": 463.68, "npi": [1730119553] } ] }, { "allowed_amount": 114.35, "providers": [{ "billed_charge": 17.94, "npi": [1730119553] } ] }, { "allowed_amount": 89.17, "providers": [{ "billed_charge": 53.82, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 246.89, "providers": [{ "billed_charge": 22.65, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1033.56, "providers": [{ "billed_charge": 188.00, "npi": [1316984388] } ] }, { "allowed_amount": 4526.99, "providers": [{ "billed_charge": 520.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.12, "providers": [{ "billed_charge": 50.54, "npi": [1356409379] } ] }, { "allowed_amount": 13722.17, "providers": [{ "billed_charge": 2425.92, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 602.65, "providers": [{ "billed_charge": 219.01, "npi": [1942257191] } ] }, { "allowed_amount": 146.80, "providers": [{ "billed_charge": 39.46, "npi": [1942257191] } ] } ] } ] }, { "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": "921385442" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 1165063.44, "providers": [{ "billed_charge": 44052.00, "npi": [1649051475] } ] } ] } ] }, { "name": "PROTHROMBIN TIME", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "85610", "description": "PROTHROMBIN TIME;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 9560.60, "providers": [{ "billed_charge": 210.36, "npi": [1730119553] } ] }, { "allowed_amount": 1260.09, "providers": [{ "billed_charge": 95.92, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23"], "billing_class": "professional", "payments": [{ "allowed_amount": 287.80, "providers": [{ "billed_charge": 30.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.50, "providers": [{ "billed_charge": 15.00, "npi": [1316984388] } ] }, { "allowed_amount": 2704.58, "providers": [{ "billed_charge": 66.00, "npi": [1316984388] } ] }, { "allowed_amount": 305.81, "providers": [{ "billed_charge": 15.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1832.93, "providers": [{ "billed_charge": 359.46, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 690.62, "providers": [{ "billed_charge": 59.90, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 103.20, "providers": [{ "billed_charge": 28.24, "npi": [1942257191] } ] }, { "allowed_amount": 9150.85, "providers": [{ "billed_charge": 310.64, "npi": [1942257191] } ] } ] } ] }, { "name": "RBC SED RATE, AUTOMATED", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "85652", "description": "SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6271.34, "providers": [{ "billed_charge": 556.20, "npi": [1720279805] } ] } ] } ] }, { "name": "THROMBOPLASTIN TIME, PARTIAL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "85730", "description": "THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 5407.17, "providers": [{ "billed_charge": 206.95, "npi": [1730119553] } ] }, { "allowed_amount": 226.43, "providers": [{ "billed_charge": 19.43, "npi": [1730119553] } ] }, { "allowed_amount": 710.80, "providers": [{ "billed_charge": 77.72, "npi": [1730119553] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86140", "description": "C-REACTIVE PROTEIN;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6421.67, "providers": [{ "billed_charge": 865.20, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 15632.88, "providers": [{ "billed_charge": 1611.71, "npi": [1356409379] } ] }, { "allowed_amount": 192.82, "providers": [{ "billed_charge": 235.86, "npi": [1356409379] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN, HS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86141", "description": "C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2958.33, "providers": [{ "billed_charge": 407.97, "npi": [1720279805] } ] } ] } ] }, { "name": "TISS TRNSGLTMNASE EA IG CLAS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86364", "description": "TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 545.72, "providers": [{ "billed_charge": 186.20, "npi": [1720279805] } ] } ] } ] }, { "name": "MICROSOMAL ANTIBODY EACH", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86376", "description": "MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 79.10, "providers": [{ "billed_charge": 50.93, "npi": [1720279805] } ] } ] } ] }, { "name": "TB TEST CELL IMMUN MEASURE", "billing_code_type": "HCPCS", "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": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16260.03, "providers": [{ "billed_charge": 15618.96, "npi": [1720279805] } ] } ] } ] }, { "name": "SYPHILIS TEST NON-TREP QUAL", "billing_code_type": "HCPCS", "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": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6053.14, "providers": [{ "billed_charge": 373.75, "npi": [1720279805] } ] } ] } ] }, { "name": "HEP B SURFACE ANTIBODY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86706", "description": "HEPATITIS B SURFACE ANTIBODY (HBSAB)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1765.76, "providers": [{ "billed_charge": 413.49, "npi": [1720279805] } ] } ] } ] }, { "name": "RUBELLA ANTIBODY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86762", "description": "ANTIBODY; RUBELLA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4164.40, "providers": [{ "billed_charge": 906.66, "npi": [1720279805] } ] } ] } ] }, { "name": "TREPONEMA PALLIDUM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86780", "description": "ANTIBODY; TREPONEMA PALLIDUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28530.67, "providers": [{ "billed_charge": 5282.76, "npi": [1720279805] } ] } ] } ] }, { "name": "VARICELLA-ZOSTER ANTIBODY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86787", "description": "ANTIBODY; VARICELLA-ZOSTER", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2933.06, "providers": [{ "billed_charge": 631.12, "npi": [1720279805] } ] } ] } ] }, { "name": 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"tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 4167.78, "providers": [{ "billed_charge": 1292.39, "npi": [1477222834] } ] } ] }, { "tin": { "type": "ein", "value": "452683127" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2405.85, "providers": [{ "billed_charge": 1745.00, "npi": [1144767542] } ] } ] } ] }, { "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": "770573175" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 6661.97, "providers": [{ "billed_charge": 1401.95, "npi": [1174749972] } ] } ] }, { "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", 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