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"allowed_amount": 18657.77, "providers": [{ "billed_charge": 50380.80, "npi": [1003437500] } ] } ] }, { "tin": { "type": "ein", "value": "452215107" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6716.41, "providers": [{ "billed_charge": 7829.64, "npi": [1801226543] } ] } ] }, { "tin": { "type": "ein", "value": "853163633" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16500.49, "providers": [{ "billed_charge": 154908.71, "npi": [1063011898] } ] } ] }, { "tin": { "type": "ein", "value": "920971049" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14720.77, "providers": [{ "billed_charge": 18500.00, "npi": [1952189086] } ] } ] } ] }, { "name": "URINALYSIS AUTO W/SCOPE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81001", "description": "URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, 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"billing_class": "professional", "payments": [{ "allowed_amount": 90.25, "providers": [{ "billed_charge": 11.00, "npi": [1316984388] } ] }, { "allowed_amount": 400.65, "providers": [{ "billed_charge": 62.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 530.39, "providers": [{ "billed_charge": 70.35, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.48, "providers": [{ "billed_charge": 72.99, "npi": [1356409379] } ] }, { "allowed_amount": 1686.35, "providers": [{ "billed_charge": 121.65, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2885.18, "providers": [{ "billed_charge": 1086.04, "npi": [1043256886] } ] } ] } 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[1487214698] } ] } ] } ] }, { "name": "FMR1 GENE DETECTION", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81243", "description": "FMR1 (FRAGILE X MENTAL RETARDATION 1) (EG, FRAGILE X MENTAL RETARDATION) GENE ANALYSIS; EVALUATION T", "allowed_amounts": [{ "tin": { "type": "ein", "value": "811082020" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 759.05, "providers": [{ "billed_charge": 456.32, "npi": [1598314437] } ] } ] } ] }, { "name": "FETAL CHRMOML ANEUPLOIDY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81420", "description": "FETAL CHROMOSOMAL ANEUPLOIDY (EG, TRISOMY 21, MONOSOMY X) GENOMIC SEQUENCE ANALYSIS PANEL, CIRCULATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "811082020" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14021.05, "providers": [{ "billed_charge": 27325.80, "npi": [1598314437] } ] } ] } ] }, { "name": "FETAL CHRMOML MICRODELTJ", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81422", "description": "FETAL CHROMOSOMAL MICRODELETION(S) GENOMIC SEQUENCE ANALYSIS (EG, DIGEORGE SYNDROME, CRI-DU-CHAT SYN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "811082020" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4800.17, "providers": [{ "billed_charge": 9108.60, "npi": [1598314437] } ] } ] } ] }, { "name": "UNLISTED MOLECULAR PATHOLOGY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81479", "description": "UNLISTED MOLECULAR PATHOLOGY PROCEDURE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "465193717" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30670.55, "providers": [{ "billed_charge": 1266.75, "npi": [1467850859] } ] } ] } ] }, { "name": "NFCT DS BV RNA VAG FLU ALG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "81513", "description": "NFCT DS BACTERAL VAGINOSIS RNA VAGINAL-FLUID ALG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46893.15, "providers": [{ "billed_charge": 40935.22, "npi": [1720279805] } ] } ] } ] }, { "name": "HEMO/OP OR HOME", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "820", "description": "HEMODIALYSIS - OUTPT OR HOME - GENERAL CLASSIFICATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "237290564" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 5002431.55, "providers": [{ "billed_charge": 374216.50, "npi": [1912446865] } ] } ] } ] }, { "name": "MICROALBUMIN, QUANTITATIVE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82043", "description": 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"service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 953827.07, "providers": [{ "billed_charge": 144564.55, "npi": [1124682166] } ] } ] }, { "tin": { "type": "ein", "value": "863535292" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 1617844.36, "providers": [{ "billed_charge": 108288.00, "npi": [1255016747] } ] } ] }, { "tin": { "type": "ein", "value": "770487672" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 901800.00, "providers": [{ "billed_charge": 121000.00, "npi": [0] } ] } ] }, { "tin": { "type": "ein", "value": "921747520" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 1879431.93, "providers": [{ "billed_charge": 201958.24, "npi": [1457037384] } ] } ] }, { "tin": { "type": "ein", "value": "811669007" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 884921.69, "providers": [{ "billed_charge": 73728.00, "npi": [1295312197] } ] } ] }, { "tin": { "type": "ein", "value": "204399694" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 342859.00, "providers": [{ "billed_charge": 360320.00, "npi": [1689693319] } ] } ] }, { "tin": { "type": "ein", "value": "932693873" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 4973307.47, "providers": [{ "billed_charge": 338002.00, "npi": [1194502815] } ] } ] }, { "tin": { "type": "ein", "value": "272150922" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 184224.00, "providers": [{ "billed_charge": 300288.00, "npi": [1609217157] } ] } ] }, { "tin": { "type": "ein", "value": "264687094" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 5470432.98, "providers": [{ "billed_charge": 386288.00, "npi": [1326282484] } ] } ] }, { "tin": { "type": "ein", "value": "932718345" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 9600.00, "providers": [{ "billed_charge": 12071.50, "npi": [1538946397] } ] } ] }, { "tin": { "type": "ein", "value": "921365464" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 2352419.20, "providers": [{ "billed_charge": 110592.00, "npi": [1588445316] } ] } ] }, { "tin": { "type": "ein", "value": "770462755" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 2645051.20, "providers": [{ "billed_charge": 247500.00, "npi": [0] } ] } ] }, { "tin": { "type": "ein", "value": "203344171" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 479840.00, "providers": [{ "billed_charge": 282628.00, "npi": [1194916205] } ] } ] }, { "tin": { "type": "ein", "value": "931236337" }, "service_code": ["99"], "billing_class": "professional", "payments": [{ "allowed_amount": 5293375.19, "providers": [{ "billed_charge": 282624.00, "npi": [1386180859] } ] } ] } ] }, { "name": "ASSAY OF APOLIPOPROTEIN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82172", "description": "APOLIPOPROTEIN, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17576.35, "providers": [{ "billed_charge": 5536.50, "npi": [1720279805] } ] } ] } ] }, { "name": "BILIRUBIN, DIRECT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82248", "description": "BILIRUBIN; DIRECT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3100.52, "providers": [{ "billed_charge": 386.54, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY TEST FOR BLOOD, FECAL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82274", "description": "BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE, FECES, 1-3 SIMULTANEOU", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 204.03, "providers": [{ "billed_charge": 111.44, "npi": [1720279805] } ] } ] } ] }, { "name": "VITAMIN D 25 HYDROXY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82306", "description": "VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2635.21, "providers": [{ "billed_charge": 1734.46, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1050.88, "providers": [{ "billed_charge": 632.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 94318.10, "providers": [{ "billed_charge": 43926.40, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1151.07, "providers": [{ "billed_charge": 2006.55, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3599.83, "providers": [{ "billed_charge": 5746.95, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "954524103" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.52, "providers": [{ "billed_charge": 137.50, "npi": [1548225428] } ] } ] } ] }, { "name": "ASSAY OF CK (CPK)", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82550", "description": "CREATINE KINASE (CK), (CPK); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1098.70, "providers": [{ "billed_charge": 91.16, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY OF URINE CREATININE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82570", "description": "CREATININE; OTHER SOURCE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 916.70, "providers": [{ "billed_charge": 345.35, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20974.76, "providers": [{ "billed_charge": 2103.08, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 362.91, "providers": [{ "billed_charge": 206.73, "npi": [1043256886] } ] } ] } ] }, { "name": "VITAMIN B-12", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82607", "description": "CYANOCOBALAMIN (VITAMIN B-12);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 586.98, "providers": [{ "billed_charge": 367.00, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 601.07, "providers": [{ "billed_charge": 305.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34426.85, "providers": [{ "billed_charge": 7125.30, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 222.02, "providers": [{ "billed_charge": 106.82, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 521.97, "providers": [{ "billed_charge": 433.74, "npi": [1043256886] } ] } ] } ] }, { "name": "ASSAY OF ESTRADIOL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82670", "description": "ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7877.77, "providers": [{ "billed_charge": 3050.50, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1043.43, "providers": [{ "billed_charge": 794.49, "npi": [1043256886] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82728", "description": "FERRITIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 42581.03, "providers": [{ "billed_charge": 10209.94, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 499.03, "providers": [{ "billed_charge": 246.53, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 947.24, "providers": [{ "billed_charge": 405.36, "npi": [1043256886] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID SERUM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82746", "description": "FOLIC ACID; SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10127.61, "providers": [{ "billed_charge": 1955.10, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY IGA/IGD/IGG/IGM EACH", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82784", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 802.08, "providers": [{ "billed_charge": 406.60, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY, GLUCOSE, BLOOD QUANT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82947", "description": "GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1193.07, "providers": [{ "billed_charge": 157.41, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 15842.07, "providers": [{ "billed_charge": 5480.85, "npi": [1356409379] } ] }, { "allowed_amount": 12.57, "providers": [{ "billed_charge": 29.95, "npi": [1356409379] } ] } ] } ] }, { "name": "REAGENT STRIP/BLOOD GLUCOSE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "82948", "description": "GLUCOSE; BLOOD, REAGENT STRIP", "allowed_amounts": [{ "tin": { "type": "ein", "value": "911879977" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.60, "providers": [{ "billed_charge": 87.45, "npi": [1730119553] } ] }, { "allowed_amount": 2843.18, "providers": [{ "billed_charge": 52.47, "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": 983.43, "providers": [{ "billed_charge": 275.10, "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": 5425.64, "providers": [{ "billed_charge": 2828.92, "npi": [1730119553] } ] }, { "allowed_amount": 64.28, "providers": [{ "billed_charge": 799.08, "npi": [1730119553] } ] } ] } ] }, { "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": 9402.58, "providers": [{ "billed_charge": 1885.87, "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": 3170.46, "providers": [{ "billed_charge": 648.20, "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": "455080644" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 345.97, "providers": [{ "billed_charge": 90.00, "npi": [1861413023] } ] } ] }, { "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3963.10, "providers": [{ "billed_charge": 2860.08, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1867.84, "providers": [{ "billed_charge": 1516.40, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 121292.70, "providers": [{ "billed_charge": 21855.57, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 260.89, "providers": [{ "billed_charge": 174.30, "npi": [1932184322] } ] }, { "allowed_amount": 994.43, "providers": [{ "billed_charge": 844.20, "npi": [1538144910] } ] }, { "allowed_amount": 3797.87, "providers": [{ "billed_charge": 1778.02, "npi": [1063497451] } ] }, { "allowed_amount": 884.91, "providers": [{ "billed_charge": 554.40, "npi": [1295726032] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8185.54, "providers": [{ "billed_charge": 4549.20, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "954524103" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 268.95, "providers": [{ "billed_charge": 231.00, "npi": [1548225428] } ] } ] }, { "tin": { "type": "ein", "value": "161387862" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1949.91, "providers": [{ "billed_charge": 1873.20, "npi": [1932145778] } ] } ] } ] }, { "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": 40374.33, "providers": [{ "billed_charge": 4190.25, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 564.83, "providers": [{ "billed_charge": 99.15, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 642.27, "providers": [{ "billed_charge": 104.90, "npi": [1043256886] } ] } ] } ] }, { "name": "IRON BINDING TEST", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83550", "description": "IRON BINDING CAPACITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 432.38, "providers": [{ "billed_charge": 89.30, "npi": [1063497451] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 675.16, "providers": [{ "billed_charge": 61.75, "npi": [1043256886] } ] } ] } ] }, { "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": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 17488.48, "providers": [{ "billed_charge": 1778.40, "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": "911879977" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.06, "providers": [{ "billed_charge": 38.87, "npi": [1730119553] } ] }, { "allowed_amount": 41.86, "providers": [{ "billed_charge": 38.87, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 191.40, "providers": [{ "billed_charge": 60.00, "npi": [1174113534] } ] }, { "allowed_amount": 314.00, "providers": [{ "billed_charge": 30.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 675.88, "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": 17379.61, "providers": [{ "billed_charge": 3809.12, "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": 1084.80, "providers": [{ "billed_charge": 1036.00, "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": 550.79, "providers": [{ "billed_charge": 146.50, "npi": [1730119553] } ] }, { "allowed_amount": 771.13, "providers": [{ "billed_charge": 455.60, "npi": [1730119553] } ] }, { "allowed_amount": 30725.59, "providers": [{ "billed_charge": 4085.10, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 770.20, "providers": [{ "billed_charge": 114.00, "npi": [1174113534] } ] }, { "allowed_amount": 26774.94, "providers": [{ "billed_charge": 930.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1109.71, "providers": [{ "billed_charge": 140.70, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 634.19, "providers": [{ "billed_charge": 48.00, "npi": [1316984388] } ] }, { "allowed_amount": 841.12, "providers": [{ "billed_charge": 96.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 29119.16, "providers": [{ "billed_charge": 4297.62, "npi": [1356409379] } ] }, { "allowed_amount": 314.48, "providers": [{ "billed_charge": 209.64, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1527.52, "providers": [{ "billed_charge": 389.22, "npi": [1942257191] } ] } ] }, { "tin": { "type": "ein", "value": "830565295" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 936.20, "providers": [{ "billed_charge": 79.08, "npi": [1972080752] } ] } ] } ] }, { "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": 3177.29, "providers": [{ "billed_charge": 2311.68, "npi": [1720279805] } ] } ] } ] }, { "name": "ASSAY FOR CALPROTECTIN FECAL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "83993", "description": "CALPROTECTIN, FECAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.00, "providers": [{ "billed_charge": 70.00, "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": 500.77, "providers": [{ "billed_charge": 65.76, "npi": [1730119553] } ] }, { "allowed_amount": 13501.41, "providers": [{ "billed_charge": 288.00, "npi": [1730119553] } ] }, { "allowed_amount": 191.73, "providers": [{ "billed_charge": 10.35, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 116.23, "providers": [{ "billed_charge": 74.88, "npi": [1356409379] } ] }, { "allowed_amount": 14893.26, "providers": [{ "billed_charge": 1535.04, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 102.86, "providers": [{ "billed_charge": 21.52, "npi": [1942257191] } ] }, { "allowed_amount": 513.86, "providers": [{ "billed_charge": 129.12, "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": 1784.65, "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": 2313.53, "providers": [{ "billed_charge": 1058.46, "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": 637.33, "providers": [{ "billed_charge": 451.68, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23408.74, "providers": [{ "billed_charge": 9019.16, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 660.81, "providers": [{ "billed_charge": 737.97, "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": 360.44, "providers": [{ "billed_charge": 57.68, "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": 603.34, "providers": [{ "billed_charge": 151.06, "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": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1271.11, "providers": [{ "billed_charge": 576.31, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 742.52, "providers": [{ "billed_charge": 217.00, "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": 2990.34, "providers": [{ "billed_charge": 2004.69, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6848.35, "providers": [{ "billed_charge": 2753.86, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1604.45, "providers": [{ "billed_charge": 1357.66, "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": 724.02, "providers": [{ "billed_charge": 583.15, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39402.99, "providers": [{ "billed_charge": 6029.87, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 525.56, "providers": [{ "billed_charge": 160.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4436.76, "providers": [{ "billed_charge": 3688.44, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "161387862" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 249.75, "providers": [{ "billed_charge": 526.92, "npi": [1932145778] } ] } ] } ] }, { "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": 526.66, "providers": [{ "billed_charge": 380.87, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27515.24, "providers": [{ "billed_charge": 9408.00, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 315.99, "providers": [{ "billed_charge": 470.22, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 363.80, "providers": [{ "billed_charge": 626.96, "npi": [1043256886] } ] } ] } ] }, { "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": 39507.63, "providers": [{ "billed_charge": 8172.78, "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": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 490.63, "providers": [{ "billed_charge": 115.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 286.67, "providers": [{ "billed_charge": 177.87, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 362.59, "providers": [{ "billed_charge": 543.18, "npi": [1043256886] } ] } ] } ] }, { "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": 67.25, "providers": [{ "billed_charge": 95.78, "npi": [1730119553] } ] }, { "allowed_amount": 3882.38, "providers": [{ "billed_charge": 301.03, "npi": [1730119553] } ] }, { "allowed_amount": 380.92, "providers": [{ "billed_charge": 64.51, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 527.60, "providers": [{ "billed_charge": 70.00, "npi": [1174113534] } ] }, { "allowed_amount": 1012.20, "providers": [{ "billed_charge": 420.00, "npi": [1174113534] } ] } ] } ] }, { "name": "ASSAY OF BLOOD/URIC ACID", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84550", "description": "URIC ACID; BLOOD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4007.70, "providers": [{ "billed_charge": 348.04, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 2508.89, "providers": [{ "billed_charge": 284.48, "npi": [1356409379] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN TEST", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "84702", "description": "GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 622.70, "providers": [{ "billed_charge": 368.76, "npi": [1720279805] } ] } ] } ] }, { "name": "BL SMEAR W/DIFF WBC COUNT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "85007", "description": "BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITH MANUAL DIFFERENTIAL WBC COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 9568.57, "providers": [{ "billed_charge": 576.40, "npi": [1356409379] } ] } ] } ] }, { "name": "COMPLETE CBC W/AUTO DIFF WBC", "billing_code_type": "HCPCS", "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": "911879977" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 49548.12, "providers": [{ "billed_charge": 2481.44, "npi": [1730119553] } ] }, { "allowed_amount": 2495.58, "providers": [{ "billed_charge": 488.76, "npi": [1730119553] } ] }, { "allowed_amount": 945.68, "providers": [{ "billed_charge": 365.16, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 98.26, "providers": [{ "billed_charge": 90.00, "npi": [1174113534] } ] }, { "allowed_amount": 8436.54, "providers": [{ "billed_charge": 690.00, "npi": [1174113534] } ] }, { "allowed_amount": 4995.42, "providers": [{ "billed_charge": 1158.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "455080644" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 91.04, "providers": [{ "billed_charge": 24.00, "npi": [1861413023] } ] } ] }, { "tin": { "type": "ein", "value": "860872873" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3564.32, "providers": [{ "billed_charge": 1055.30, "npi": [1538105366] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 3394.63, "providers": [{ "billed_charge": 1614.00, "npi": [1316984388] } ] }, { "allowed_amount": 1285.10, "providers": [{ "billed_charge": 309.00, "npi": [1316984388] } ] }, { "allowed_amount": 185.70, "providers": [{ "billed_charge": 140.00, "npi": [1316984388] } ] } ] }, { "tin": { "type": "ein", "value": "330652678" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 577.37, "providers": [{ "billed_charge": 224.00, "npi": [1750348033] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1741.63, "providers": [{ "billed_charge": 1916.80, "npi": [1356409379] } ] }, { "allowed_amount": 23597.90, "providers": [{ "billed_charge": 5570.70, "npi": [1356409379] } ] }, { "allowed_amount": 5.60, "providers": [{ "billed_charge": 59.90, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "953501085" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.20, "providers": [{ "billed_charge": 31.80, "npi": [1912991597] } ] }, { "allowed_amount": 528.90, "providers": [{ "billed_charge": 95.40, "npi": [1912991597] } ] }, { "allowed_amount": 2200.20, "providers": [{ "billed_charge": 286.20, "npi": [1912991597] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 330.53, "providers": [{ "billed_charge": 166.79, "npi": [1942257191] } ] }, { "allowed_amount": 142.72, "providers": [{ "billed_charge": 26.45, "npi": [1942257191] } ] }, { "allowed_amount": 3699.69, "providers": [{ "billed_charge": 998.56, "npi": [1942257191] } ] } ] }, { "tin": { "type": "ein", "value": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 161.86, "providers": [{ "billed_charge": 288.00, "npi": [1811944101] } ] } ] }, { "tin": { "type": "ein", "value": "954126874" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.80, "providers": [{ "billed_charge": 18.00, "npi": [1053305797] } ] }, { "allowed_amount": 80.90, "providers": [{ "billed_charge": 36.00, "npi": [1053305797] } ] }, { "allowed_amount": 45.75, "providers": [{ "billed_charge": 36.00, "npi": [1053305797] } ] } ] }, { "tin": { "type": "ein", "value": "830565295" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1073.38, "providers": [{ "billed_charge": 170.34, "npi": [1972080752] } ] }, { "allowed_amount": 24.57, "providers": [{ "billed_charge": 28.39, "npi": [1972080752] } ] } ] }, { "tin": { "type": "ein", "value": "952645519" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 525.62, "providers": [{ "billed_charge": 272.28, "npi": [1568431088] } ] }, { "allowed_amount": 185.00, "providers": [{ "billed_charge": 136.14, "npi": [1568431088] } ] }, { "allowed_amount": 1047.13, "providers": [{ "billed_charge": 272.28, "npi": [1568431088] } ] } ] }, { "tin": { "type": "ein", "value": "332932965" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 117.60, "providers": [{ "billed_charge": 90.76, "npi": [1790597524] } ] }, { "allowed_amount": 156.98, "providers": [{ "billed_charge": 226.90, "npi": [1790597524] } ] }, { "allowed_amount": 155.57, "providers": [{ "billed_charge": 136.14, "npi": [1790597524] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2315.05, "providers": [{ "billed_charge": 870.40, "npi": [1861018574] } ] }, { "allowed_amount": 53537.28, "providers": [{ "billed_charge": 10417.60, "npi": [1720279805] } ] }, { "allowed_amount": 2336.98, "providers": [{ "billed_charge": 1115.20, "npi": [1578549044] } ] } ] }, { "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 430.55, "providers": [{ "billed_charge": 437.20, "npi": [1609812445] } ] } ] }, { "tin": { "type": "ein", "value": "475583986" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1427.97, "providers": [{ "billed_charge": 645.00, "npi": [1699120857] } ] } ] }, { "tin": { "type": "ein", "value": "133757370" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1319.95, "providers": [{ "billed_charge": 423.15, "npi": [1063497451] } ] }, { "allowed_amount": 610.93, "providers": [{ "billed_charge": 292.95, "npi": [1538144910] } ] } ] }, { "tin": { "type": "ein", "value": "880099333" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1968.15, "providers": [{ "billed_charge": 765.10, "npi": [1043256886] } ] } ] }, { "tin": { "type": "ein", "value": "591723249" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 158.00, "providers": [{ "billed_charge": 21.00, "npi": [1790732360] } ] } ] } ] }, { "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": 113.06, "providers": [{ "billed_charge": 17.94, "npi": [1730119553] } ] }, { "allowed_amount": 19.23, "providers": [{ "billed_charge": 31.74, "npi": [1730119553] } ] }, { "allowed_amount": 11056.54, "providers": [{ "billed_charge": 683.10, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 770.78, "providers": [{ "billed_charge": 90.00, "npi": [1174113534] } ] }, { "allowed_amount": 14.73, "providers": [{ "billed_charge": 30.00, "npi": [1174113534] } ] }, { "allowed_amount": 20003.31, "providers": [{ "billed_charge": 630.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "952645519" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.93, "providers": [{ "billed_charge": 34.34, "npi": [1568431088] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 223.09, "providers": [{ "billed_charge": 67.95, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "954457756" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 306.89, "providers": [{ "billed_charge": 46.00, "npi": [1316984388] } ] }, { "allowed_amount": 35.75, "providers": [{ "billed_charge": 24.00, "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": 14315.61, "providers": [{ "billed_charge": 2577.54, "npi": [1356409379] } ] } ] }, { "tin": { "type": "ein", "value": "952584668" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 641.13, "providers": [{ "billed_charge": 260.45, "npi": [1942257191] } ] }, { "allowed_amount": 131.20, "providers": [{ "billed_charge": 19.73, "npi": [1942257191] } ] }, { "allowed_amount": 118.32, "providers": [{ "billed_charge": 59.19, "npi": [1942257191] } ] } ] }, { "tin": { "type": "ein", "value": "371925902" }, "service_code": ["23"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.11, "providers": [{ "billed_charge": 27.00, "npi": [1356993703] } ] } ] }, { "tin": { "type": "ein", "value": "830565295" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 953.99, "providers": [{ "billed_charge": 97.36, "npi": [1972080752] } ] } ] } ] }, { "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": 12562414.79, "providers": [{ "billed_charge": 381578.00, "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": 849.03, "providers": [{ "billed_charge": 74.28, "npi": [1730119553] } ] }, { "allowed_amount": 7082.46, "providers": [{ "billed_charge": 216.60, "npi": [1730119553] } ] } ] }, { "tin": { "type": "ein", "value": "853392173" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1008.64, "providers": [{ "billed_charge": 90.00, "npi": [1174113534] } ] }, { "allowed_amount": 212.40, "providers": [{ "billed_charge": 54.00, "npi": [1174113534] } ] } ] }, { "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1204.83, "providers": [{ "billed_charge": 285.38, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 193.42, "providers": [{ "billed_charge": 29.95, "npi": [1356409379] } ] } ] } ] }, { "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": 9943.90, "providers": [{ "billed_charge": 704.52, "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", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 219.00, "providers": [{ "billed_charge": 58.29, "npi": [1730119553] } ] }, { "allowed_amount": 4066.14, "providers": [{ "billed_charge": 148.66, "npi": [1730119553] } ] } ] } ] }, { "name": "ANTINUCLEAR ANTIBODIES", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86038", "description": "ANTINUCLEAR ANTIBODIES (ANA);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "870737749" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2480.06, "providers": [{ "billed_charge": 211.60, "npi": [1720279805] } ] } ] } ] }, { "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": 9271.20, "providers": [{ "billed_charge": 1009.40, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 343.24, "providers": [{ "billed_charge": 235.86, "npi": [1356409379] } ] }, { "allowed_amount": 9366.42, "providers": [{ "billed_charge": 904.13, "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": 4504.22, "providers": [{ "billed_charge": 770.61, "npi": [1720279805] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, SCREEN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "86255", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "431039532" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1560.84, "providers": [{ "billed_charge": 775.18, "npi": [1609812445] } ] } ] } ] }, { "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": 461.29, "providers": [{ "billed_charge": 166.00, "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": 20490.30, "providers": [{ "billed_charge": 18222.12, "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": 5596.22, "providers": [{ "billed_charge": 448.50, "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": 2311.92, "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": 4856.35, "providers": [{ "billed_charge": 957.03, "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": 33537.37, "providers": [{ "billed_charge": 5977.86, "npi": [1720279805] } ] } ] }, { "tin": { "type": "ein", "value": "952697418" }, "service_code": ["23"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.12, "providers": [{ "billed_charge": 14.97, "npi": [1356409379] } ] } ] } ] }, { "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": 3020.71, "providers": [{ "billed_charge": 631.12, "npi": [1720279805] } ] } ] } ] }, { "name": "HEPATITIS C AB TEST", "billing_code_type": "HCPCS", "billing_code_type_version": 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}, { "tin": { "type": "ein", "value": "821053156" }, "service_code": ["31"], "billing_class": "professional", "payments": [{ "allowed_amount": 376.14, "providers": [{ "billed_charge": 150.00, "npi": [1699288993] } ] } ] }, { "tin": { "type": "ein", "value": "842599550" }, "service_code": ["31"], "billing_class": "professional", "payments": [{ "allowed_amount": 6818.66, "providers": [{ "billed_charge": 2600.00, "npi": [1447806278] } ] } ] }, { "tin": { "type": "ein", "value": "923467328" }, "service_code": ["31"], "billing_class": "professional", "payments": [{ "allowed_amount": 5135.40, "providers": [{ "billed_charge": 2260.00, "npi": [1154010072] } ] } ] }, { "tin": { "type": "ein", "value": "883982344" }, "service_code": ["31", "32"], "billing_class": "professional", "payments": [{ "allowed_amount": 154.14, "providers": [{ "billed_charge": 168.00, "npi": [1669192472] } ] }, { "allowed_amount": 755.93, "providers": [{ "billed_charge": 840.00, "npi": [1669192472] } ] } ] }, { "tin": { 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"value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1437.18, "providers": [{ "billed_charge": 407.60, "npi": [1477222834] } ] } ] } ] }, { "name": "CAP BRST PUMP BOTLE REPLCMNT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4283", "description": "CAP FOR BREAST PUMP BOTTLE, REPLACEMENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1198.47, "providers": [{ "billed_charge": 73.31, "npi": [1477222834] } ] } ] } ] }, { "name": "BRST SHIELD&SPLSH PROTCTR PU", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4284", "description": "BREAST SHIELD AND SPLASH PROTECTOR FOR USE WITH BREAST PUMP, REPLACEMENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1423.00, "providers": [{ "billed_charge": 159.78, "npi": [1477222834] } ] } ] } ] }, { "name": "POLYCARBATE BOTTLE BRST PUMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4285", "description": "POLYCARBONATE BOTTLE FOR USE WITH BREAST PUMP, REPLACEMENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1467.68, "providers": [{ "billed_charge": 152.82, "npi": [1477222834] } ] } ] } ] }, { "name": "LOCKING RING BRST PUMP REPLC", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4286", "description": "LOCKING RING FOR BREAST PUMP, REPLACEMENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1274.47, "providers": [{ "billed_charge": 115.60, "npi": [1477222834] } ] } ] } ] }, 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["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 31582.44, "providers": [{ "billed_charge": 26450.00, "npi": [1093525552] } ] } ] } ] }, { "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": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 8288.79, "providers": [{ "billed_charge": 3025.56, "npi": [1477222834] } ] } ] } ] }, { "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": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 8625.83, "providers": [{ "billed_charge": 3534.87, "npi": [1477222834] } ] } ] }, { "tin": { "type": "ein", "value": "452683127" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 483.34, "providers": [{ "billed_charge": 830.00, "npi": [1144767542] } ] } ] } ] }, { "name": "CUSHN NASAL MASK INTF REPL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A7032", "description": "CUSHION FOR USE ON NASAL MASK INTERFACE, REPLACEMENT ONLY, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1258.48, "providers": [{ "billed_charge": 646.36, "npi": [1477222834] } ] } ] }, { "tin": { "type": "ein", "value": "452683127" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 524.70, "providers": [{ "billed_charge": 1015.00, "npi": [1144767542] } ] } ] } ] }, { "name": "PILLW NASL 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"service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1718.30, "providers": [{ "billed_charge": 1112.01, "npi": [1174749972] } ] } ] }, { "tin": { "type": "ein", "value": "202536458" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 5671.29, "providers": [{ "billed_charge": 1868.50, "npi": [1477222834] } ] } ] }, { "tin": { "type": "ein", "value": "452683127" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2951.66, "providers": [{ "billed_charge": 1960.00, "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": 6413.09, 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