{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"2.0.0","last_updated_on":"2026-07-28","out_of_network":[{"name":"Proprietary Laboratory Analysis (PLA) code for the Guardant Shield  test,","billing_code_type":"CPT","billing_code_type_version":"2025","billing_code":"0537U","description":"Proprietary Laboratory Analysis (PLA) code for the Guardant Shield  test,","allowed_amounts":[{"tin":{"type":"ein","value":"883933025"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38199.55,"providers":[{"billed_charge":84640.00,"npi":[1538857099]}]}]}]},{"name":"RESIDENTIAL TREATMENT - CHEM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"710391252"},"service_code":["56","21"],"billing_class":"institutional","payments":[{"allowed_amount":349500.00,"providers":[{"billed_charge":354000.00,"npi":[1922166123]}]},{"allowed_amount":6000.00,"providers":[{"billed_charge":6000.00,"npi":[1922166123]}]}]},{"tin":{"type":"ein","value":"844037448"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":38610.00,"providers":[{"billed_charge":538200.00,"npi":[1285273219]}]}]},{"tin":{"type":"ein","value":"872135681"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":15147.00,"providers":[{"billed_charge":188811.00,"npi":[1568132140]}]}]},{"tin":{"type":"ein","value":"825128901"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":32500.00,"providers":[{"billed_charge":254540.00,"npi":[1740771195]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":122430.00,"providers":[{"billed_charge":122430.00,"npi":[1447099056]}]}]},{"tin":{"type":"ein","value":"264282327"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":22440.00,"providers":[{"billed_charge":34000.00,"npi":[1467196386]}]}]}]},{"name":"PSTAY/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"124","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"205395878"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":117957.00,"providers":[{"billed_charge":301400.00,"npi":[1790925972]}]}]}]},{"name":"DETOX/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"126","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -DETOXIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"934312932"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":2175.00,"providers":[{"billed_charge":9000.00,"npi":[1275388761]}]}]},{"tin":{"type":"ein","value":"844037448"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":65975.00,"providers":[{"billed_charge":455000.00,"npi":[1285273219]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":291.39,"providers":[{"billed_charge":534.56,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":501.48,"providers":[{"billed_charge":1671.59,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":219.17,"providers":[{"billed_charge":32287.30,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":508.16,"providers":[{"billed_charge":79001.02,"npi":[1295736734]}]},{"allowed_amount":1415.84,"providers":[{"billed_charge":49092.26,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.61,"providers":[{"billed_charge":1241.06,"npi":[1972070993]}]}]}]},{"name":"DRUGS/INCIDNT RAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"255","description":"PHARMACY - DRUGS INCIDENT TO RADIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":79.87,"providers":[{"billed_charge":266.22,"npi":[1558365890]}]}]}]},{"name":"IV SOLUTIONS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"258","description":"PHARMACY - IV SOLUTIONS","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":94.96,"providers":[{"billed_charge":316.42,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":64.87,"providers":[{"billed_charge":3018.40,"npi":[1972070993]}]}]}]},{"name":"DRUGS/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"259","description":"PHARMACY - OTHER PHARMACY","allowed_amounts":[{"tin":{"type":"ein","value":"440577118"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":54.59,"providers":[{"billed_charge":181.99,"npi":[1093740128]}]}]}]},{"name":"IV THERAPY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"260","description":"IV THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":806.87,"providers":[{"billed_charge":3375.30,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6741.59,"providers":[{"billed_charge":24905.94,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5913.57,"providers":[{"billed_charge":10139.00,"npi":[1558365890]}]},{"allowed_amount":1397.60,"providers":[{"billed_charge":5369.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8340.92,"providers":[{"billed_charge":123346.32,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":972.61,"providers":[{"billed_charge":4189.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5487.56,"providers":[{"billed_charge":49140.00,"npi":[1295736734]}]},{"allowed_amount":535.10,"providers":[{"billed_charge":89684.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10864.95,"providers":[{"billed_charge":66431.91,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9458.73,"providers":[{"billed_charge":63924.49,"npi":[1104551134]}]}]}]},{"name":"IV THERAPY/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"269","description":"IV THERAPY - OTHER IV THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2180.00,"providers":[{"billed_charge":8772.26,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8559.92,"providers":[{"billed_charge":68708.87,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9609.74,"providers":[{"billed_charge":79555.27,"npi":[1104551134]}]}]}]},{"name":"MED-SUR SUPPLIES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"270","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":295.98,"providers":[{"billed_charge":986.50,"npi":[1972070993]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":32910.24,"providers":[{"billed_charge":83340.50,"npi":[1164234308]}]},{"allowed_amount":529.15,"providers":[{"billed_charge":6469.54,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":12.00,"providers":[{"billed_charge":450.00,"npi":[1558365890]}]},{"allowed_amount":1862.09,"providers":[{"billed_charge":4303.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":7020.87,"providers":[{"billed_charge":12681.84,"npi":[1760443980]}]},{"allowed_amount":235.22,"providers":[{"billed_charge":2398.41,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"991142081"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":716.66,"providers":[{"billed_charge":822.95,"npi":[1376391177]}]}]},{"tin":{"type":"ein","value":"750974351"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":73.10,"providers":[{"billed_charge":2076.00,"npi":[1124092036]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":29474.50,"providers":[{"billed_charge":130455.28,"npi":[1972070993]}]},{"allowed_amount":10.56,"providers":[{"billed_charge":411.93,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":665.74,"providers":[{"billed_charge":665.74,"npi":[1275799645]}]},{"allowed_amount":339.47,"providers":[{"billed_charge":339.47,"npi":[1275799645]}]},{"allowed_amount":21.86,"providers":[{"billed_charge":21.86,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":213.95,"providers":[{"billed_charge":124236.68,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":82.29,"providers":[{"billed_charge":295.00,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":129.80,"providers":[{"billed_charge":102819.97,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1341.60,"providers":[{"billed_charge":2693.22,"npi":[1093740128]}]},{"allowed_amount":3.00,"providers":[{"billed_charge":161.40,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":805.84,"providers":[{"billed_charge":244062.00,"npi":[1295736734]}]},{"allowed_amount":2126.12,"providers":[{"billed_charge":84073.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"831173631"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":547.45,"providers":[{"billed_charge":1194.00,"npi":[1427536325]}]},{"allowed_amount":164.67,"providers":[{"billed_charge":677.00,"npi":[1427536325]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20393.84,"providers":[{"billed_charge":138662.44,"npi":[1104551134]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":986.72,"providers":[{"billed_charge":1846.00,"npi":[1386709871]}]},{"allowed_amount":8648.32,"providers":[{"billed_charge":12711.00,"npi":[1558365890]}]},{"allowed_amount":5.18,"providers":[{"billed_charge":72.00,"npi":[1386709871]}]},{"allowed_amount":270.90,"providers":[{"billed_charge":9048.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13534.73,"providers":[{"billed_charge":27735.19,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20.82,"providers":[{"billed_charge":12014.00,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"390806181"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":561.51,"providers":[{"billed_charge":1670.00,"npi":[1861447179]}]}]},{"tin":{"type":"ein","value":"461481133"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5.11,"providers":[{"billed_charge":1654.00,"npi":[1801990825]}]},{"allowed_amount":195.18,"providers":[{"billed_charge":2480.00,"npi":[1801990825]}]}]},{"tin":{"type":"ein","value":"561933245"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1274.04,"providers":[{"billed_charge":9839.25,"npi":[1558653212]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7526.42,"providers":[{"billed_charge":53779.58,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":909.92,"providers":[{"billed_charge":909.92,"npi":[1275799645]}]},{"allowed_amount":3091.98,"providers":[{"billed_charge":3091.98,"npi":[1659388965]}]},{"allowed_amount":237.72,"providers":[{"billed_charge":237.72,"npi":[1275799645]}]},{"allowed_amount":2849.55,"providers":[{"billed_charge":2849.55,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"736060835"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":331.76,"providers":[{"billed_charge":855.66,"npi":[1396767158]}]},{"allowed_amount":301.54,"providers":[{"billed_charge":492.60,"npi":[1396767158]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":146.39,"providers":[{"billed_charge":245.86,"npi":[1275506115]}]},{"allowed_amount":310.83,"providers":[{"billed_charge":975.90,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":49.64,"providers":[{"billed_charge":400.06,"npi":[1093740128]}]},{"allowed_amount":136.92,"providers":[{"billed_charge":241.81,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"730717979"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2643.09,"providers":[{"billed_charge":2643.09,"npi":[1659347623]}]}]},{"tin":{"type":"ein","value":"436003859"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":132.51,"providers":[{"billed_charge":455.05,"npi":[1699769901]}]}]},{"tin":{"type":"ein","value":"710744870"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2665.54,"providers":[{"billed_charge":54633.76,"npi":[1619926268]}]},{"allowed_amount":382.07,"providers":[{"billed_charge":2011.56,"npi":[1619926268]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":37.00,"providers":[{"billed_charge":351.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"756004221"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7.15,"providers":[{"billed_charge":6597.00,"npi":[1932123247]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2399.48,"providers":[{"billed_charge":24038.96,"npi":[1104551134]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"730757033"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":22.94,"providers":[{"billed_charge":22.94,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1916.21,"providers":[{"billed_charge":3221.00,"npi":[1558365890]}]},{"allowed_amount":43.15,"providers":[{"billed_charge":2055.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2272.66,"providers":[{"billed_charge":3973.66,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710744870"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":70.82,"providers":[{"billed_charge":502.32,"npi":[1619926268]}]},{"allowed_amount":81.59,"providers":[{"billed_charge":2623.60,"npi":[1619926268]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3525.03,"providers":[{"billed_charge":40909.32,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2703.66,"providers":[{"billed_charge":28381.50,"npi":[1104551134]}]}]}]},{"name":"LAB/BACT-MIRCO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"306","description":"LABORATORY - BACTERIOLOGY & MICROBIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":427.56,"providers":[{"billed_charge":427.56,"npi":[1275799645]}]},{"allowed_amount":1551.48,"providers":[{"billed_charge":1551.48,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":189.75,"providers":[{"billed_charge":1784.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2933.64,"providers":[{"billed_charge":34089.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26.08,"providers":[{"billed_charge":216.58,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":328.65,"providers":[{"billed_charge":3036.48,"npi":[1104551134]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4.98,"providers":[{"billed_charge":62.00,"npi":[1558365890]}]},{"allowed_amount":470.30,"providers":[{"billed_charge":546.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":725.38,"providers":[{"billed_charge":1286.80,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":967.44,"providers":[{"billed_charge":18575.53,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":695.19,"providers":[{"billed_charge":12350.06,"npi":[1104551134]}]}]}]},{"name":"DX X-RAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"320","description":"RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2678.35,"providers":[{"billed_charge":73761.00,"npi":[1295736734]}]},{"allowed_amount":6244.91,"providers":[{"billed_charge":69930.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1893.70,"providers":[{"billed_charge":30957.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1450.81,"providers":[{"billed_charge":22128.00,"npi":[1104551134]}]}]}]},{"name":"DX X-RAY/CHEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"324","description":"RADIOLOGY - DIAGNOSTIC - CHEST X-RAY","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1485.09,"providers":[{"billed_charge":5156.10,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1164.47,"providers":[{"billed_charge":2784.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1741.36,"providers":[{"billed_charge":38586.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1384.32,"providers":[{"billed_charge":17746.00,"npi":[1104551134]}]}]}]},{"name":"RADIATION RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"RADIOLOGY--THERAPEUTIC - RADIATION THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":12567.17,"providers":[{"billed_charge":138429.00,"npi":[1295736734]}]}]}]},{"name":"CHEMOTHERP-IV","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"335","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--IV","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9458.73,"providers":[{"billed_charge":41250.00,"npi":[1295736734]}]}]}]},{"name":"CT SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"350","description":"CT SCAN - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":17786.62,"providers":[{"billed_charge":547056.00,"npi":[1295736734]}]},{"allowed_amount":4836.20,"providers":[{"billed_charge":106958.00,"npi":[1295736734]}]}]}]},{"name":"CT SCAN/HEAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"351","description":"CT SCAN - HEAD SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1238.14,"providers":[{"billed_charge":29596.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2281.25,"providers":[{"billed_charge":32802.60,"npi":[1104551134]}]}]}]},{"name":"CT SCAN/BODY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"CT SCAN - BODY SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11092.16,"providers":[{"billed_charge":30707.88,"npi":[1164234308]}]},{"allowed_amount":318.46,"providers":[{"billed_charge":1099.26,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3966.09,"providers":[{"billed_charge":114633.00,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":12432.28,"providers":[{"billed_charge":51900.00,"npi":[1558365890]}]},{"allowed_amount":405.01,"providers":[{"billed_charge":3394.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15940.30,"providers":[{"billed_charge":21970.68,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":39495.24,"providers":[{"billed_charge":630041.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":28946.81,"providers":[{"billed_charge":439589.00,"npi":[1104551134]}]},{"allowed_amount":95.43,"providers":[{"billed_charge":1897.10,"npi":[1104551134]}]}]}]},{"name":"OR SERVICES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"360","description":"OPERATING ROOM SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":17782.43,"providers":[{"billed_charge":39977.00,"npi":[1295736734]}]},{"allowed_amount":87995.28,"providers":[{"billed_charge":126390.50,"npi":[1295736734]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3395.28,"providers":[{"billed_charge":36448.56,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":231.25,"providers":[{"billed_charge":280.00,"npi":[1477321917]}]},{"allowed_amount":19.85,"providers":[{"billed_charge":56.00,"npi":[1891544888]}]}]},{"tin":{"type":"ein","value":"730685955"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":33.28,"providers":[{"billed_charge":312.00,"npi":[1649821448]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":24.88,"providers":[{"billed_charge":80.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":15.88,"providers":[{"billed_charge":28.00,"npi":[1407629264]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.22,"providers":[{"billed_charge":81.66,"npi":[1417707662]}]},{"allowed_amount":117.42,"providers":[{"billed_charge":160.86,"npi":[1023996600]}]},{"allowed_amount":89.36,"providers":[{"billed_charge":147.28,"npi":[1275105983]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3005.04,"providers":[{"billed_charge":12672.16,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":31.20,"providers":[{"billed_charge":128.00,"npi":[1275132474]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.84,"providers":[{"billed_charge":177.72,"npi":[1356179436]}]},{"allowed_amount":14.40,"providers":[{"billed_charge":14.40,"npi":[1932831880]}]}]}]},{"name":"MAMMOGRAPHY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"401","description":"OTHER IMAGING SERVICES - MAMMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":558.19,"providers":[{"billed_charge":8634.00,"npi":[1295736734]}]},{"allowed_amount":131.11,"providers":[{"billed_charge":1851.00,"npi":[1295736734]}]}]}]},{"name":"ULTRASOUND","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"402","description":"OTHER IMAGING SERVICES - ULTRASOUND","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6224.74,"providers":[{"billed_charge":60112.00,"npi":[1295736734]}]},{"allowed_amount":1652.92,"providers":[{"billed_charge":24147.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":749.98,"providers":[{"billed_charge":12229.00,"npi":[1104551134]}]},{"allowed_amount":95.43,"providers":[{"billed_charge":478.30,"npi":[1104551134]}]}]}]},{"name":"SCRN MAMMOGRAPHY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"403","description":"OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2801.02,"providers":[{"billed_charge":17730.00,"npi":[1295736734]}]}]}]},{"name":"RESPIRATORY SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"410","description":"RESPIRATORY SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":579.52,"providers":[{"billed_charge":4584.00,"npi":[1972070993]}]}]}]},{"name":"PHYSICAL THERP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"420","description":"PHYSICAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"730757033"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4519.05,"providers":[{"billed_charge":4519.05,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"742225672"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1295.67,"providers":[{"billed_charge":9638.09,"npi":[1629089966]}]}]},{"tin":{"type":"ein","value":"991142081"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1572.62,"providers":[{"billed_charge":2781.90,"npi":[1376391177]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3573.60,"providers":[{"billed_charge":40524.00,"npi":[1295736734]}]}]}]},{"name":"PHYS THERP/HOUR","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"422","description":"PHYSICAL THERAPY - HOURLY CHARGE","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8313.27,"providers":[{"billed_charge":73640.00,"npi":[1295736734]}]}]}]},{"name":"PHYS THERP/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"424","description":"PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":358.05,"providers":[{"billed_charge":2287.00,"npi":[1295736734]}]}]}]},{"name":"OCCUPATION THER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"430","description":"OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1908.69,"providers":[{"billed_charge":16972.00,"npi":[1295736734]}]}]}]},{"name":"EMERG ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":80410.60,"providers":[{"billed_charge":271328.87,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":43881.49,"providers":[{"billed_charge":77424.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":66871.98,"providers":[{"billed_charge":401695.10,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":72.06,"providers":[{"billed_charge":107.53,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":44527.42,"providers":[{"billed_charge":335120.01,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5495.71,"providers":[{"billed_charge":10960.38,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":66041.10,"providers":[{"billed_charge":135554.56,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710744870"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":261.29,"providers":[{"billed_charge":1348.86,"npi":[1619926268]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":183275.58,"providers":[{"billed_charge":1161549.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":98711.20,"providers":[{"billed_charge":1072203.65,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":76302.12,"providers":[{"billed_charge":824655.71,"npi":[1104551134]}]}]}]},{"name":"AMBUL SURG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"490","description":"AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"743052826"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":117590.99,"providers":[{"billed_charge":377154.25,"npi":[1598758153]}]}]}]},{"name":"OTHER CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"519","description":"CLINIC - OTHER CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"730717979"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":21476.00,"providers":[{"billed_charge":21476.00,"npi":[1659347623]}]}]}]},{"name":"RURAL/CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"521","description":"FREE-STANDING CLINIC - RURAL HEALTH-CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"273046997"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":10378.07,"providers":[{"billed_charge":22012.81,"npi":[1982381752]}]}]}]},{"name":"DRUG/SNGL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"631","description":"DRUGS REQUIRING SPECIFIC IDENTIFICATION - SINGLE SOURCE DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2291.11,"providers":[{"billed_charge":2291.11,"npi":[1275799645]}]},{"allowed_amount":1386.75,"providers":[{"billed_charge":1386.75,"npi":[1275799645]}]}]}]},{"name":"DRUG/DETAIL CODE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"DRUGS REQ SPEC IDENTIFICATION - DRUGS REQ DETAILED CODING*","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1538.23,"providers":[{"billed_charge":4357.60,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":269.50,"providers":[{"billed_charge":754.27,"npi":[1558365890]}]},{"allowed_amount":2.80,"providers":[{"billed_charge":10.48,"npi":[1386709871]}]},{"allowed_amount":10995.57,"providers":[{"billed_charge":54594.05,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":42.04,"providers":[{"billed_charge":25685.58,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"821883948"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26.58,"providers":[{"billed_charge":88.60,"npi":[1649794157]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":373.88,"providers":[{"billed_charge":1620.77,"npi":[1093740128]}]},{"allowed_amount":773.18,"providers":[{"billed_charge":1588.45,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":829.14,"providers":[{"billed_charge":2763.63,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"590724459"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":0.87,"providers":[{"billed_charge":2366.37,"npi":[1306938071]}]}]},{"tin":{"type":"ein","value":"710744870"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":86.83,"providers":[{"billed_charge":197.25,"npi":[1619926268]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5030.27,"providers":[{"billed_charge":86059.96,"npi":[1295736734]}]},{"allowed_amount":97419.72,"providers":[{"billed_charge":1958982.84,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8804.62,"providers":[{"billed_charge":80828.76,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10574.62,"providers":[{"billed_charge":68764.10,"npi":[1104551134]}]}]}]},{"name":"CT HEAD/BRAIN W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70450","description":"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"710395194"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":66.91,"providers":[{"billed_charge":140.00,"npi":[1063478113]}]},{"allowed_amount":669.10,"providers":[{"billed_charge":1400.00,"npi":[1063478113]}]}]},{"tin":{"type":"ein","value":"871439061"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":221.75,"providers":[{"billed_charge":825.00,"npi":[1285840819]}]},{"allowed_amount":88.70,"providers":[{"billed_charge":330.00,"npi":[1285840819]}]},{"allowed_amount":44.35,"providers":[{"billed_charge":165.00,"npi":[1285840819]}]},{"allowed_amount":133.04,"providers":[{"billed_charge":660.00,"npi":[1285840819]}]}]}]},{"name":"X-RAY EXAM CHEST 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71045","description":"RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"710395194"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":99.54,"providers":[{"billed_charge":217.00,"npi":[1922560747]}]},{"allowed_amount":71.10,"providers":[{"billed_charge":155.00,"npi":[1922560747]}]},{"allowed_amount":270.18,"providers":[{"billed_charge":589.00,"npi":[1063973618]}]},{"allowed_amount":255.68,"providers":[{"billed_charge":558.00,"npi":[1922560747]}]},{"allowed_amount":113.76,"providers":[{"billed_charge":248.00,"npi":[1063973618]}]},{"allowed_amount":383.94,"providers":[{"billed_charge":837.00,"npi":[1063973618]}]}]},{"tin":{"type":"ein","value":"871439061"},"service_code":["22","11","23","21"],"billing_class":"professional","payments":[{"allowed_amount":19.06,"providers":[{"billed_charge":52.00,"npi":[1285840819,1215170790,1699169771]}]},{"allowed_amount":247.78,"providers":[{"billed_charge":676.00,"npi":[1285840819]}]},{"allowed_amount":114.36,"providers":[{"billed_charge":312.00,"npi":[1679715130]}]},{"allowed_amount":28.59,"providers":[{"billed_charge":78.00,"npi":[1215170790,1689986390]}]},{"allowed_amount":57.18,"providers":[{"billed_charge":156.00,"npi":[1679715130]}]},{"allowed_amount":9.53,"providers":[{"billed_charge":26.00,"npi":[1215170790,1699169771,1841497757]}]},{"allowed_amount":171.54,"providers":[{"billed_charge":468.00,"npi":[1285840819]}]},{"allowed_amount":47.65,"providers":[{"billed_charge":130.00,"npi":[1689986390]}]},{"allowed_amount":162.01,"providers":[{"billed_charge":442.00,"npi":[1679715130,1285840819]}]}]}]},{"name":"X-RAY EXAM CHEST 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71046","description":"RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"710395194"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":50.85,"providers":[{"billed_charge":111.00,"npi":[1063973618]}]},{"allowed_amount":85.30,"providers":[{"billed_charge":185.00,"npi":[1063973618]}]}]},{"tin":{"type":"ein","value":"871439061"},"service_code":["11","22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":34.08,"providers":[{"billed_charge":93.00,"npi":[1689986390]}]},{"allowed_amount":79.52,"providers":[{"billed_charge":217.00,"npi":[1285840819,1689986390]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":31.00,"npi":[1285840819,1689986390]}]},{"allowed_amount":90.88,"providers":[{"billed_charge":248.00,"npi":[1285840819]}]},{"allowed_amount":159.04,"providers":[{"billed_charge":434.00,"npi":[1285840819]}]}]}]},{"name":"X-RAY EXAM L-S SPINE 2/3 VWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72100","description":"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; 2 OR 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"871439061"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":12.10,"providers":[{"billed_charge":44.00,"npi":[1841497757]}]}]}]},{"name":"EKG/ECG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"730","description":"EKG/ECG - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1987.39,"providers":[{"billed_charge":13628.40,"npi":[1164234308]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2402.25,"providers":[{"billed_charge":5655.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":56.58,"providers":[{"billed_charge":397.36,"npi":[1760443980]}]},{"allowed_amount":968.50,"providers":[{"billed_charge":1986.80,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":236.82,"providers":[{"billed_charge":7389.00,"npi":[1295736734]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1647.98,"providers":[{"billed_charge":20536.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1066.23,"providers":[{"billed_charge":10872.00,"npi":[1104551134]}]}]}]},{"name":"X-RAY EXAM OF FOOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73630","description":"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"710837110"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":109.17,"providers":[{"billed_charge":195.00,"npi":[1699778407]}]}]}]},{"name":"X-RAY EXAM ABDOMEN 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74018","description":"RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"871439061"},"service_code":["11","22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":19.06,"providers":[{"billed_charge":52.00,"npi":[1285840819]}]},{"allowed_amount":28.59,"providers":[{"billed_charge":78.00,"npi":[1285840819]}]},{"allowed_amount":9.53,"providers":[{"billed_charge":26.00,"npi":[1285840819]}]}]}]},{"name":"CT ABD & PELV W/CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74177","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"710395194"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1138.32,"providers":[{"billed_charge":2368.00,"npi":[1063478113]}]}]}]},{"name":"TREATMENT ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"761","description":"TREATMENT OR OBSERVATION ROOM - TREATMENT ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1150.12,"providers":[{"billed_charge":6036.00,"npi":[1295736734]}]}]}]},{"name":"ULTRASOUND BREAST LIMITED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76642","description":"ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED;","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":2319.72,"providers":[{"billed_charge":4768.00,"npi":[1235317496]}]}]}]},{"name":"BREAST TOMOSYNTHESIS UNI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77061","description":"DIGITAL BREAST TOMOSYNTHESIS; UNILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":179.80,"providers":[{"billed_charge":234.00,"npi":[1235317496]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77062","description":"DIGITAL BREAST TOMOSYNTHESIS; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":664.20,"providers":[{"billed_charge":1404.00,"npi":[1235317496]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77063","description":"SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P","allowed_amounts":[{"tin":{"type":"ein","value":"710781138"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":374.22,"providers":[{"billed_charge":819.00,"npi":[1003025594]}]}]},{"tin":{"type":"ein","value":"710395194"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":3156.52,"providers":[{"billed_charge":7738.00,"npi":[1740644038]}]},{"allowed_amount":3348.24,"providers":[{"billed_charge":10500.00,"npi":[1740644038]}]}]},{"tin":{"type":"ein","value":"203962574"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":350.70,"providers":[{"billed_charge":630.00,"npi":[1508032988]}]}]},{"tin":{"type":"ein","value":"871439061"},"service_code":["22","15","19"],"billing_class":"professional","payments":[{"allowed_amount":41.58,"providers":[{"billed_charge":120.00,"npi":[1922426642]}]},{"allowed_amount":1081.08,"providers":[{"billed_charge":3120.00,"npi":[1568585230]}]},{"allowed_amount":665.28,"providers":[{"billed_charge":1920.00,"npi":[1922426642]}]},{"allowed_amount":374.22,"providers":[{"billed_charge":1080.00,"npi":[1568585230]}]},{"allowed_amount":457.38,"providers":[{"billed_charge":1320.00,"npi":[1568585230]}]},{"allowed_amount":124.74,"providers":[{"billed_charge":360.00,"npi":[1922426642]}]}]},{"tin":{"type":"ein","value":"620809858"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":2384.28,"providers":[{"billed_charge":4752.00,"npi":[1235317496]}]},{"allowed_amount":66.23,"providers":[{"billed_charge":132.00,"npi":[1235317496]}]}]}]},{"name":"DX MAMMO INCL CAD UNI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77065","description":"DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1258.60,"providers":[{"billed_charge":2506.00,"npi":[1235317496]}]}]}]},{"name":"DX MAMMO INCL CAD BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77066","description":"DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1107.00,"providers":[{"billed_charge":2200.00,"npi":[1235317496]}]}]}]},{"name":"SCR MAMMO BI INCL CAD","billing_code_type":"CPT","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":"710781138"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":473.49,"providers":[{"billed_charge":1584.00,"npi":[1003025594]}]}]},{"tin":{"type":"ein","value":"710395194"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":4212.67,"providers":[{"billed_charge":9702.00,"npi":[1740644038]}]},{"allowed_amount":7878.80,"providers":[{"billed_charge":14800.00,"npi":[1740644038]}]}]},{"tin":{"type":"ein","value":"203962574"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":1367.70,"providers":[{"billed_charge":2150.00,"npi":[1508032988]}]}]},{"tin":{"type":"ein","value":"871439061"},"service_code":["22","15","19"],"billing_class":"professional","payments":[{"allowed_amount":631.32,"providers":[{"billed_charge":1644.00,"npi":[1922426642]}]},{"allowed_amount":683.93,"providers":[{"billed_charge":1781.00,"npi":[1568585230]}]},{"allowed_amount":210.44,"providers":[{"billed_charge":548.00,"npi":[1922426642]}]},{"allowed_amount":1210.03,"providers":[{"billed_charge":3151.00,"npi":[1568585230]}]},{"allowed_amount":526.10,"providers":[{"billed_charge":1370.00,"npi":[1568585230]}]}]},{"tin":{"type":"ein","value":"620809858"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":83.68,"providers":[{"billed_charge":168.00,"npi":[1235317496]}]},{"allowed_amount":3096.16,"providers":[{"billed_charge":6216.00,"npi":[1235317496]}]}]}]},{"name":"GUIDANCE FOR RADIAJ TX DLVR","billing_code_type":"CPT","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":"710787860"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":649.55,"providers":[{"billed_charge":1256.09,"npi":[1992983498]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1252.44,"providers":[{"billed_charge":8757.16,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":274.32,"providers":[{"billed_charge":2528.10,"npi":[1234567893]}]}]}]},{"name":"ELECTROLYTE PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80051","description":"ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (BICARBONATE) (82374) CHLORI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":34.09,"providers":[{"billed_charge":172.57,"npi":[1265418669]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"CPT","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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1840.64,"providers":[{"billed_charge":3514.88,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32873.54,"providers":[{"billed_charge":206394.33,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":74.00,"npi":[1174160089]}]},{"allowed_amount":28.28,"providers":[{"billed_charge":148.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":17.96,"providers":[{"billed_charge":88.00,"npi":[1730479668]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.38,"providers":[{"billed_charge":60.00,"npi":[1275132474]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6718.81,"providers":[{"billed_charge":58726.74,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"710836622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":116.16,"providers":[{"billed_charge":275.00,"npi":[1518840370]}]},{"allowed_amount":21.57,"providers":[{"billed_charge":75.00,"npi":[1427311919]}]}]}]},{"name":"LIPID PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80061","description":"LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DI","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":138.56,"providers":[{"billed_charge":278.56,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27615.25,"providers":[{"billed_charge":267012.44,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5650.11,"providers":[{"billed_charge":50494.34,"npi":[1234567893]}]}]}]},{"name":"ACUTE HEPATITIS PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80074","description":"ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9130.08,"providers":[{"billed_charge":110938.79,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3631.04,"providers":[{"billed_charge":6935.04,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":792.91,"providers":[{"billed_charge":9616.12,"npi":[1234567893]}]}]}]},{"name":"HEPATIC FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80076","description":"HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":573.68,"providers":[{"billed_charge":3951.42,"npi":[1265418669]}]}]}]},{"name":"OBSTETRIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80081","description":"OBSTETRIC PANEL (INCLUDES HIV TESTING)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2911.44,"providers":[{"billed_charge":28432.22,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF LITHIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80178","description":"LITHIUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.77,"providers":[{"billed_charge":223.65,"npi":[1265418669]}]}]}]},{"name":"DRUG TEST PRSMV DIR OPT OBS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80305","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE ","allowed_amounts":[{"tin":{"type":"ein","value":"611810471"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":119.70,"providers":[{"billed_charge":209.44,"npi":[1225518384]}]}]},{"tin":{"type":"ein","value":"61833974"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":478.80,"providers":[{"billed_charge":700.00,"npi":[1831635093]}]}]}]},{"name":"DRUG TEST PRSMV CHEM ANLYZR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80307","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":757.83,"providers":[{"billed_charge":3587.76,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2547.74,"providers":[{"billed_charge":102500.00,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1242.80,"providers":[{"billed_charge":3500.00,"npi":[1811536931]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1003.58,"providers":[{"billed_charge":3800.00,"npi":[1154194579]}]},{"allowed_amount":264.10,"providers":[{"billed_charge":1000.00,"npi":[1487422572]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9085.04,"providers":[{"billed_charge":43000.00,"npi":[1427772714]}]},{"allowed_amount":6976.32,"providers":[{"billed_charge":32250.00,"npi":[1124687157]}]}]},{"tin":{"type":"ein","value":"760182737"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":745.68,"providers":[{"billed_charge":3200.00,"npi":[1104839380]}]}]},{"tin":{"type":"ein","value":"452215107"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9518.08,"providers":[{"billed_charge":32809.92,"npi":[1801226543]}]}]},{"tin":{"type":"ein","value":"262358356"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1284.14,"providers":[{"billed_charge":11477.00,"npi":[1285724757]}]},{"allowed_amount":1700.89,"providers":[{"billed_charge":18463.00,"npi":[1609979426]}]},{"allowed_amount":301.40,"providers":[{"billed_charge":1996.00,"npi":[1720289945]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17088.50,"providers":[{"billed_charge":42900.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"472303825"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":217.49,"providers":[{"billed_charge":1365.00,"npi":[1740675297]}]}]},{"tin":{"type":"ein","value":"991629650"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":52.82,"providers":[{"billed_charge":186.42,"npi":[1871986315]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1008.79,"providers":[{"billed_charge":5417.33,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"920971049"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":54.08,"providers":[{"billed_charge":500.00,"npi":[1952189086]}]}]}]},{"name":"ALCOHOLS BIOMARKERS 1OR 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80321","description":"ALCOHOL BIOMARKERS; 1 OR 2","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6560.76,"providers":[{"billed_charge":21869.20,"npi":[1154720662]}]}]}]},{"name":"ALKALOIDS NOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80323","description":"ALKALOIDS, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":557.43,"providers":[{"billed_charge":6658.56,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":206.60,"providers":[{"billed_charge":3000.00,"npi":[1811536931]}]}]}]},{"name":"AMPHETAMINES 3OR 4","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80325","description":"AMPHETAMINES; 3 OR 4","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2131.92,"providers":[{"billed_charge":7106.40,"npi":[1154720662]}]}]}]},{"name":"ANTIDEPRESSANTS CLASS 1 OR 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80332","description":"ANTIDEPRESSANTS, SEROTONERGIC CLASS; 1 OR 2","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":623.01,"providers":[{"billed_charge":11108.16,"npi":[1154720662]}]}]}]},{"name":"ANTIDEPRESSANT TRICYCLIC 1/2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80335","description":"ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS; 1 OR 2","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":206.60,"providers":[{"billed_charge":3000.00,"npi":[1811536931]}]}]}]},{"name":"ANTIDEPRESSANT TRICYCLIC 3-5","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80336","description":"ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS; 3-5","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10377.36,"providers":[{"billed_charge":34591.20,"npi":[1154720662]}]}]}]},{"name":"ANTIDEPRESSANT NOT SPECIFIED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80338","description":"ANTIDEPRESSANTS, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4646.30,"providers":[{"billed_charge":15486.90,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1620.00,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING BARBITURATES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80345","description":"BARBITURATES","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":206.60,"providers":[{"billed_charge":3000.00,"npi":[1811536931]}]}]}]},{"name":"BENZODIAZEPINES1-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80346","description":"BENZODIAZEPINES; 1-12","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32.79,"providers":[{"billed_charge":1812.24,"npi":[1154720662]}]}]}]},{"name":"DRUG SCREENING BUPRENORPHINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80348","description":"BUPRENORPHINE","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4440.26,"providers":[{"billed_charge":14800.84,"npi":[1154720662]}]}]}]},{"name":"CANNABINOIDS, NATURAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80349","description":"CANNABINOIDS, NATURAL","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":174.88,"providers":[{"billed_charge":1569.28,"npi":[1154720662]}]}]}]},{"name":"DRUG SCREENING COCAINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80353","description":"COCAINE","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":131.16,"providers":[{"billed_charge":989.76,"npi":[1154720662]}]}]}]},{"name":"DRUG SCREENING FENTANYL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80354","description":"FENTANYL","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":131.16,"providers":[{"billed_charge":1271.04,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"GABAPENTIN, NON-BLOOD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80355","description":"GABAPENTIN, NON-BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":699.52,"providers":[{"billed_charge":4615.68,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"KETAMINE AND NORKETAMINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80357","description":"KETAMINE AND NORKETAMINE","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.64,"providers":[{"billed_charge":1200.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING METHADONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80358","description":"METHADONE","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":206.60,"providers":[{"billed_charge":3000.00,"npi":[1811536931]}]}]}]},{"name":"METHYLPHENIDATE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80360","description":"METHYLPHENIDATE","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.86,"providers":[{"billed_charge":135.04,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"OPIATES, 1 OR MORE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80361","description":"OPIATES, 1 OR MORE","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":196.74,"providers":[{"billed_charge":9532.80,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":103.30,"providers":[{"billed_charge":1500.00,"npi":[1811536931]}]}]}]},{"name":"OPIOIDS & OPIATE ANALOGS 3/4","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80363","description":"OPIOIDS AND OPIATE ANALOGS; 3 OR 4","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1620.00,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING OXYCODONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80365","description":"OXYCODONE","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":76.51,"providers":[{"billed_charge":1482.88,"npi":[1154720662]}]}]}]},{"name":"DRUG SCREENING PREGABALIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80366","description":"PREGABALIN","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":688.59,"providers":[{"billed_charge":4697.28,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING PROPOXYPHENE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80367","description":"PROPOXYPHENE","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.64,"providers":[{"billed_charge":1200.00,"npi":[1811536931]}]}]}]},{"name":"SKELETAL MUSCLE RELAXANT 1/2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80369","description":"SKELETAL MUSCLE RELAXANTS; 1 OR 2","allowed_amounts":[{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"STIMULANTS, SYNTHETIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80371","description":"STIMULANTS, SYNTHETIC","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32.79,"providers":[{"billed_charge":1271.04,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.64,"providers":[{"billed_charge":1200.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING TAPENTADOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80372","description":"TAPENTADOL","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":295.11,"providers":[{"billed_charge":2859.84,"npi":[1154720662]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":5400.00,"npi":[1811536931]}]}]}]},{"name":"DRUG SCREENING TRAMADOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80373","description":"TRAMADOL","allowed_amounts":[{"tin":{"type":"ein","value":"465221867"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":229.53,"providers":[{"billed_charge":2224.32,"npi":[1154720662]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":596.20,"providers":[{"billed_charge":10993.00,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":118.32,"providers":[{"billed_charge":1920.08,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS NONAUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81002","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"710850123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.06,"providers":[{"billed_charge":26.00,"npi":[1275132474]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":54.60,"providers":[{"billed_charge":1086.21,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"237128104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":173.25,"providers":[{"billed_charge":462.00,"npi":[1720617616]}]}]}]},{"name":"MICROSCOPIC EXAM OF URINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81015","description":"URINALYSIS; MICROSCOPIC ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":42.47,"providers":[{"billed_charge":744.00,"npi":[1234567893]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"237128104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":172.20,"providers":[{"billed_charge":300.00,"npi":[1720617616]}]}]}]},{"name":"BRCA1&2 SEQ & FULL DUP/DEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81162","description":"BRCA1, BRCA2 (BREAST CANCER 1 AND 2) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; FULL ","allowed_amounts":[{"tin":{"type":"ein","value":"330892453"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4379.70,"providers":[{"billed_charge":19740.00,"npi":[1861568784]}]}]}]},{"name":"HLA I TYPING 1 ANTIGEN LR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81374","description":"HLA CLASS I TYPING, LOW RESOLUTION (EG, ANTIGEN EQUIVALENTS); ONE ANTIGEN EQUIVALENT (EG, B*27), EAC","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1060.92,"providers":[{"billed_charge":4504.73,"npi":[1265418669]}]}]}]},{"name":"NFCT DS CHRNC HCV 6 ASSAYS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81596","description":"NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":496.32,"providers":[{"billed_charge":3661.35,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF ACTH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82024","description":"ADRENOCORTICOTROPIC HORMONE (ACTH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":965.52,"providers":[{"billed_charge":7709.90,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF SERUM ALBUMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82040","description":"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":205.50,"providers":[{"billed_charge":521.92,"npi":[1265418669]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3528.38,"providers":[{"billed_charge":65669.76,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":582.40,"providers":[{"billed_charge":8463.89,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF BREATH ETHANOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82075","description":"ALCOHOL (ETHANOL), BREATH","allowed_amounts":[{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.08,"providers":[{"billed_charge":1920.00,"npi":[1124687157]}]},{"allowed_amount":1249.50,"providers":[{"billed_charge":5880.00,"npi":[1427772714]}]}]}]},{"name":"ASSAY OF ALDOLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82085","description":"ALDOLASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":121.32,"providers":[{"billed_charge":1587.60,"npi":[1265418669]}]}]}]},{"name":"HEMO/COMPOSITE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"HEMODIALYSIS - OUTPT OR HOME - HEMODIALYSIS/COMPOSITE RATE","allowed_amounts":[{"tin":{"type":"ein","value":"710728066"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":13200.00,"providers":[{"billed_charge":423936.00,"npi":[1285746180]}]}]}]},{"name":"ALPHA-FETOPROTEIN, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82105","description":"ALPHA-FETOPROTEIN (AFP); SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":547.55,"providers":[{"billed_charge":5053.88,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":202.50,"providers":[{"billed_charge":2690.09,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20.44,"providers":[{"billed_charge":215.56,"npi":[1234567893]}]}]}]},{"name":"chemistry test for anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82166","description":"chemistry test for anti-mullerian hormone (AMH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":217.26,"providers":[{"billed_charge":1554.37,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF APOLIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82172","description":"APOLIPOPROTEIN, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":131.80,"providers":[{"billed_charge":346.44,"npi":[1265418669]}]}]}]},{"name":"BILIRUBIN, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82247","description":"BILIRUBIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":149.12,"providers":[{"billed_charge":186.12,"npi":[1265418669]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":386.28,"providers":[{"billed_charge":1128.26,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":68.40,"providers":[{"billed_charge":130.60,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":56.50,"providers":[{"billed_charge":228.51,"npi":[1234567893]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":120.90,"providers":[{"billed_charge":214.92,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":37799.28,"providers":[{"billed_charge":395611.57,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5487.84,"providers":[{"billed_charge":15162.60,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82310","description":"CALCIUM; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":154.44,"providers":[{"billed_charge":300.04,"npi":[1265418669]}]}]}]},{"name":"ASSAY, BLOOD CARBON DIOXIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82374","description":"CARBON DIOXIDE (BICARBONATE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":84.75,"providers":[{"billed_charge":87.19,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF CERULOPLASMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82390","description":"CERULOPLASMIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7.46,"providers":[{"billed_charge":92.13,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF BLOOD CHLORIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82435","description":"CHLORIDE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":111.94,"providers":[{"billed_charge":122.20,"npi":[1265418669]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":984.84,"providers":[{"billed_charge":9158.14,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29.36,"providers":[{"billed_charge":330.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF CK (CPK)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82550","description":"CREATINE KINASE (CK), (CPK); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":316.40,"providers":[{"billed_charge":2585.57,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82565","description":"CREATININE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":893.42,"providers":[{"billed_charge":4847.95,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82570","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3222.68,"providers":[{"billed_charge":59575.97,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":566.19,"providers":[{"billed_charge":8335.62,"npi":[1234567893]}]}]}]},{"name":"VITAMIN B-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82607","description":"CYANOCOBALAMIN (VITAMIN B-12);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9497.82,"providers":[{"billed_charge":96029.14,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1520.96,"providers":[{"billed_charge":18820.88,"npi":[1234567893]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82626","description":"DEHYDROEPIANDROSTERONE (DHEA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":87.75,"providers":[{"billed_charge":1149.75,"npi":[1265418669]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82627","description":"DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1451.36,"providers":[{"billed_charge":13547.74,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":177.42,"providers":[{"billed_charge":2035.60,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF ESTRADIOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82670","description":"ESTRADIOL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7035.40,"providers":[{"billed_charge":63034.90,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2105.28,"providers":[{"billed_charge":20166.12,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF ESTROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82672","description":"ESTROGENS; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":919.27,"providers":[{"billed_charge":9720.62,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5838.67,"providers":[{"billed_charge":47375.50,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":839.81,"providers":[{"billed_charge":8695.56,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FOLIC ACID SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82746","description":"FOLIC ACID; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4973.70,"providers":[{"billed_charge":50253.84,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":680.68,"providers":[{"billed_charge":1299.48,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":662.00,"providers":[{"billed_charge":8686.34,"npi":[1234567893]}]}]}]},{"name":"ASSAY IGA/IGD/IGG/IGM EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82784","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":814.29,"providers":[{"billed_charge":8808.70,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF IGE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82785","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":42.55,"providers":[{"billed_charge":465.19,"npi":[1234567893]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82947","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":194.55,"providers":[{"billed_charge":1155.84,"npi":[1265418669]}]}]}]},{"name":"GLUCOSE TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82950","description":"GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":184.24,"providers":[{"billed_charge":1829.99,"npi":[1265418669]}]}]}]},{"name":"GLUCOSE TOLERANCE TEST (GTT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82951","description":"GLUCOSE; TOLERANCE TEST (GTT), 3 SPECIMENS (INCLUDES GLUCOSE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.94,"providers":[{"billed_charge":104.57,"npi":[1265418669]}]}]}]},{"name":"GTT-ADDED SAMPLES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82952","description":"GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2.73,"providers":[{"billed_charge":31.93,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF GGT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82977","description":"GLUTAMYLTRANSFERASE, GAMMA (GGT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":205.00,"providers":[{"billed_charge":1371.50,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (FSH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83001","description":"GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3446.97,"providers":[{"billed_charge":32644.87,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":909.09,"providers":[{"billed_charge":9762.87,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (LH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83002","description":"GONADOTROPIN; LUTEINIZING HORMONE (LH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2096.18,"providers":[{"billed_charge":19194.03,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":264.42,"providers":[{"billed_charge":2968.18,"npi":[1234567893]}]}]}]},{"name":"HEMOGLOBIN ELECTROPHORESIS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83020","description":"HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (EG, A2, S, C, AND/OR F)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.46,"providers":[{"billed_charge":1115.10,"npi":[1265418669]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11755.82,"providers":[{"billed_charge":115886.42,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":92.54,"providers":[{"billed_charge":176.82,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2630.74,"providers":[{"billed_charge":30463.05,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF HOMOCYSTINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83090","description":"HOMOCYSTEINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":58.55,"providers":[{"billed_charge":982.08,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROGESTERONE 17-D","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83498","description":"HYDROXYPROGESTERONE, 17-D","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":132.09,"providers":[{"billed_charge":1211.79,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY NONANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83516","description":"IMMUNOASSAY FOR ANALYTE OTH THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE ","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":712.64,"providers":[{"billed_charge":14696.95,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY QUANT NOS NONAB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83520","description":"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":129.49,"providers":[{"billed_charge":2280.87,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF INSULIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83525","description":"INSULIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":936.92,"providers":[{"billed_charge":11517.51,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.84,"providers":[{"billed_charge":373.72,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2705.67,"providers":[{"billed_charge":18007.34,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":579.09,"providers":[{"billed_charge":4522.18,"npi":[1234567893]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83550","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2999.81,"providers":[{"billed_charge":20823.27,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":660.24,"providers":[{"billed_charge":4892.47,"npi":[1234567893]}]}]}]},{"name":"LACTATE (LD) (LDH) ENZYME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83615","description":"LACTATE DEHYDROGENASE (LD), (LDH);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.12,"providers":[{"billed_charge":508.85,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF LIPASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83690","description":"LIPASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":305.92,"providers":[{"billed_charge":3494.69,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31.00,"providers":[{"billed_charge":285.08,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF BLOOD LIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83721","description":"LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":59.67,"providers":[{"billed_charge":878.85,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1120.65,"providers":[{"billed_charge":9528.30,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":788.88,"providers":[{"billed_charge":1506.83,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":226.50,"providers":[{"billed_charge":2301.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF NATRIURETIC PEPTIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83880","description":"NATRIURETIC PEPTIDE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1570.56,"providers":[{"billed_charge":14771.12,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":477.09,"providers":[{"billed_charge":3755.55,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PARATHORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83970","description":"PARATHORMONE (PARATHYROID HORMONE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1318.36,"providers":[{"billed_charge":7237.02,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":353.02,"providers":[{"billed_charge":2868.62,"npi":[1234567893]}]}]}]},{"name":"ASSAY ALKALINE PHOSPHATASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84075","description":"PHOSPHATASE, ALKALINE;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":162.25,"providers":[{"billed_charge":266.23,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84100","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":82.13,"providers":[{"billed_charge":730.25,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.39,"providers":[{"billed_charge":90.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF SERUM POTASSIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84132","description":"POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.11,"providers":[{"billed_charge":280.50,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROGESTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84144","description":"PROGESTERONE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3303.72,"providers":[{"billed_charge":29834.89,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":868.43,"providers":[{"billed_charge":8292.27,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1130.63,"providers":[{"billed_charge":11059.28,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.44,"providers":[{"billed_charge":128.66,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PSA, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84153","description":"PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2466.54,"providers":[{"billed_charge":23858.87,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1239.86,"providers":[{"billed_charge":9812.97,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PSA, FREE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84154","description":"PROSTATE SPECIFIC ANTIGEN (PSA); FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12.78,"providers":[{"billed_charge":107.62,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.56,"providers":[{"billed_charge":135.60,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PROTEIN SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84155","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":257.90,"providers":[{"billed_charge":1430.03,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROTEIN, URINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84156","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":73.66,"providers":[{"billed_charge":1045.94,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":49.50,"providers":[{"billed_charge":895.80,"npi":[1234567893]}]}]}]},{"name":"PROTEIN E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84165","description":"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":566.96,"providers":[{"billed_charge":4950.92,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF SEX HORMONE GLOBUL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84270","description":"SEX HORMONE BINDING GLOBULIN (SHBG)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1267.56,"providers":[{"billed_charge":10428.78,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1354.38,"providers":[{"billed_charge":13510.73,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF SERUM SODIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84295","description":"SODIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":113.62,"providers":[{"billed_charge":120.53,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF FREE TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84402","description":"TESTOSTERONE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6138.43,"providers":[{"billed_charge":62170.35,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF TOTAL TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84403","description":"TESTOSTERONE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10820.19,"providers":[{"billed_charge":100947.95,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2954.57,"providers":[{"billed_charge":27916.18,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF TOTAL THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84436","description":"THYROXINE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1819.97,"providers":[{"billed_charge":15706.76,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":169.60,"providers":[{"billed_charge":357.60,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":123.60,"providers":[{"billed_charge":1414.50,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5101.90,"providers":[{"billed_charge":76641.15,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":893.20,"providers":[{"billed_charge":13453.98,"npi":[1234567893]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84443","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":33375.99,"providers":[{"billed_charge":295055.87,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":594.88,"providers":[{"billed_charge":1135.68,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":22.51,"providers":[{"billed_charge":78.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6348.45,"providers":[{"billed_charge":59873.25,"npi":[1234567893]}]}]}]},{"name":"TRANSFERASE (AST) (SGOT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84450","description":"TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":754.50,"providers":[{"billed_charge":6102.65,"npi":[1265418669]}]}]}]},{"name":"ALANINE AMINO (ALT) (SGPT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84460","description":"TRANSFERASE; ALANINE AMINO (ALT) (SGPT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":781.95,"providers":[{"billed_charge":6198.91,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF TRANSFERRIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84466","description":"TRANSFERRIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":336.68,"providers":[{"billed_charge":4227.71,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF THYROID (T3 OR T4)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84479","description":"THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":194.04,"providers":[{"billed_charge":370.48,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1118.01,"providers":[{"billed_charge":9311.10,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.73,"providers":[{"billed_charge":102.43,"npi":[1234567893]}]}]}]},{"name":"ASSAY, TRIIODOTHYRONINE (T3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84480","description":"TRIIODOTHYRONINE T3; TOTAL (TT-3)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1308.72,"providers":[{"billed_charge":15844.32,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":108.46,"providers":[{"billed_charge":1169.02,"npi":[1234567893]}]}]}]},{"name":"FREE ASSAY (FT-3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84481","description":"TRIIODOTHYRONINE T3; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":749.45,"providers":[{"billed_charge":1431.95,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3269.28,"providers":[{"billed_charge":63802.01,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1440.18,"providers":[{"billed_charge":20387.59,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF UREA NITROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84520","description":"UREA NITROGEN; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":611.91,"providers":[{"billed_charge":3640.50,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84550","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":747.23,"providers":[{"billed_charge":8422.28,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":97.44,"providers":[{"billed_charge":1218.78,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF C-PEPTIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84681","description":"C-PEPTIDE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":231.36,"providers":[{"billed_charge":2098.90,"npi":[1265418669]}]}]}]},{"name":"CHORIONIC GONADOTROPIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84702","description":"GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1119.22,"providers":[{"billed_charge":8829.81,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.54,"providers":[{"billed_charge":150.00,"npi":[1234567893]}]}]}]},{"name":"HEMATOCRIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85014","description":"BLOOD COUNT; HEMATOCRIT (HCT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.12,"providers":[{"billed_charge":194.92,"npi":[1265418669]}]}]}]},{"name":"HEMOGLOBIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85018","description":"BLOOD COUNT; HEMOGLOBIN (HGB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14.76,"providers":[{"billed_charge":176.09,"npi":[1265418669]}]}]}]},{"name":"COMPLETE CBC W/AUTO DIFF WBC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85025","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1380.69,"providers":[{"billed_charge":2638.71,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21345.28,"providers":[{"billed_charge":123059.86,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13.20,"providers":[{"billed_charge":60.00,"npi":[1730479668]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.40,"providers":[{"billed_charge":27.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":68.80,"providers":[{"billed_charge":125.00,"npi":[1275132474]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3991.68,"providers":[{"billed_charge":34205.92,"npi":[1234567893]}]}]}]},{"name":"COMPLETE CBC, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85027","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1037.19,"providers":[{"billed_charge":6596.59,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":293.91,"providers":[{"billed_charge":2835.44,"npi":[1234567893]}]}]}]},{"name":"AUTOMATED RETICULOCYTE COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85045","description":"BLOOD COUNT; RETICULOCYTE, AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":466.76,"providers":[{"billed_charge":6799.53,"npi":[1265418669]}]}]}]},{"name":"PROTHROMBIN TIME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85610","description":"PROTHROMBIN TIME;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":324.87,"providers":[{"billed_charge":4439.56,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1.93,"providers":[{"billed_charge":25.00,"npi":[1234567893]}]}]}]},{"name":"RBC SED RATE, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85652","description":"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":893.00,"providers":[{"billed_charge":18850.44,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":102.48,"providers":[{"billed_charge":2070.77,"npi":[1234567893]}]}]}]},{"name":"RBC SICKLE CELL TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85660","description":"SICKLING OF RBC, REDUCTION","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":68.94,"providers":[{"billed_charge":1120.64,"npi":[1265418669]}]}]}]},{"name":"THROMBOPLASTIN TIME, PARTIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85730","description":"THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":75.06,"providers":[{"billed_charge":1172.00,"npi":[1265418669]}]}]}]},{"name":"ACTIN ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86015","description":"ACTIN SMOOTH MUSCLE ANTIBODY EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":97.89,"providers":[{"billed_charge":1355.67,"npi":[1265418669]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86038","description":"ANTINUCLEAR ANTIBODIES (ANA);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3270.71,"providers":[{"billed_charge":35213.19,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":435.20,"providers":[{"billed_charge":5727.99,"npi":[1234567893]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES (ANA)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86039","description":"ANTINUCLEAR ANTIBODIES (ANA); TITER","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.14,"providers":[{"billed_charge":367.64,"npi":[1234567893]}]}]}]},{"name":"C-REACTIVE PROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86140","description":"C-REACTIVE PROTEIN;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1935.01,"providers":[{"billed_charge":34841.62,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":149.12,"providers":[{"billed_charge":2473.71,"npi":[1234567893]}]}]}]},{"name":"C-REACTIVE PROTEIN, HS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86141","description":"C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":26.97,"providers":[{"billed_charge":196.75,"npi":[1265418669]}]}]}]},{"name":"CARDIOLIPIN ANTIBODY EA IG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86147","description":"CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2633.79,"providers":[{"billed_charge":23842.37,"npi":[1265418669]}]}]}]},{"name":"COMPLEMENT, ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86160","description":"COMPLEMENT; ANTIGEN, EACH COMPONENT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2099.19,"providers":[{"billed_charge":23282.94,"npi":[1265418669]}]}]}]},{"name":"CCP ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86200","description":"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1168.70,"providers":[{"billed_charge":13929.80,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.66,"providers":[{"billed_charge":139.20,"npi":[1234567893]}]}]}]},{"name":"DNA ANTIBODY NATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86225","description":"DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1478.70,"providers":[{"billed_charge":15538.23,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":43.26,"providers":[{"billed_charge":567.75,"npi":[1234567893]}]}]}]},{"name":"NUCLEAR ANTIGEN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86235","description":"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13751.65,"providers":[{"billed_charge":141898.22,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":411.50,"providers":[{"billed_charge":5554.95,"npi":[1234567893]}]}]}]},{"name":"IMMUNOASSAY INFECTIOUS AGENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86317","description":"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1176.33,"providers":[{"billed_charge":10159.19,"npi":[1265418669]}]}]}]},{"name":"IMMUNOFIX E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86334","description":"IMMUNOFIXATION ELECTROPHORESIS; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":77.60,"providers":[{"billed_charge":744.64,"npi":[1265418669]}]}]}]},{"name":"T CELL, ABSOLUTE COUNT/RATIO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86360","description":"T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":163.15,"providers":[{"billed_charge":1537.48,"npi":[1265418669]}]}]}]},{"name":"T CELL, ABSOLUTE COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86361","description":"T CELLS; ABSOLUTE CD4 COUNT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1357.07,"providers":[{"billed_charge":12759.16,"npi":[1265418669]}]}]}]},{"name":"TISS TRNSGLTMNASE EA IG CLAS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86364","description":"TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":173.01,"providers":[{"billed_charge":3182.44,"npi":[1265418669]}]}]}]},{"name":"MICROSOMAL ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86376","description":"MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3181.53,"providers":[{"billed_charge":30692.19,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":602.60,"providers":[{"billed_charge":8282.22,"npi":[1234567893]}]}]}]},{"name":"MITOCHONDRIAL ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86381","description":"MITOCHONDRIAL ANTIBODY EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":286.38,"providers":[{"billed_charge":2526.58,"npi":[1265418669]}]}]}]},{"name":"RHEUMATOID FACTOR, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86431","description":"RHEUMATOID FACTOR; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1087.44,"providers":[{"billed_charge":16789.21,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":130.05,"providers":[{"billed_charge":1837.16,"npi":[1234567893]}]}]}]},{"name":"TB TEST CELL IMMUN MEASURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86480","description":"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5164.80,"providers":[{"billed_charge":30812.08,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1031.93,"providers":[{"billed_charge":9412.80,"npi":[1234567893]}]}]}]},{"name":"SYPHILIS TEST NON-TREP QUAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86592","description":"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":544.17,"providers":[{"billed_charge":2141.15,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1394.56,"providers":[{"billed_charge":19194.60,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":215.04,"providers":[{"billed_charge":3712.96,"npi":[1234567893]}]}]}]},{"name":"SYPHILIS TEST NON-TREP QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86593","description":"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":177.47,"providers":[{"billed_charge":2279.70,"npi":[1265418669]}]}]}]},{"name":"HERPES SIMPLEX TYPE 1 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86695","description":"ANTIBODY; HERPES SIMPLEX, TYPE 1","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1146.56,"providers":[{"billed_charge":10694.79,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":231.66,"providers":[{"billed_charge":3003.80,"npi":[1234567893]}]}]}]},{"name":"HERPES SIMPLEX TYPE 2 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86696","description":"ANTIBODY; HERPES SIMPLEX, TYPE 2","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1800.96,"providers":[{"billed_charge":16662.20,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":357.11,"providers":[{"billed_charge":4614.18,"npi":[1234567893]}]}]}]},{"name":"HEP B CORE ANTIBODY, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86704","description":"HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2075.76,"providers":[{"billed_charge":23523.01,"npi":[1265418669]}]}]}]},{"name":"HEP B CORE ANTIBODY, IGM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86705","description":"HEPATITIS B CORE ANTIBODY (HBCAB); IGM ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":73.62,"providers":[{"billed_charge":982.80,"npi":[1265418669]}]}]}]},{"name":"HEP B SURFACE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86706","description":"HEPATITIS B SURFACE ANTIBODY (HBSAB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1491.99,"providers":[{"billed_charge":16574.70,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9.66,"providers":[{"billed_charge":180.00,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS A ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86708","description":"HEPATITIS A ANTIBODY (HAAB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":438.60,"providers":[{"billed_charge":4853.73,"npi":[1265418669]}]}]}]},{"name":"RUBELLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86762","description":"ANTIBODY; RUBELLA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":239.76,"providers":[{"billed_charge":2188.82,"npi":[1265418669]}]}]}]},{"name":"TREPONEMA PALLIDUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86780","description":"ANTIBODY; TREPONEMA PALLIDUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1645.06,"providers":[{"billed_charge":18755.73,"npi":[1265418669]}]}]}]},{"name":"VARICELLA-ZOSTER ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86787","description":"ANTIBODY; VARICELLA-ZOSTER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":71.52,"providers":[{"billed_charge":862.41,"npi":[1265418669]}]}]}]},{"name":"THYROGLOBULIN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86800","description":"THYROGLOBULIN ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":772.80,"providers":[{"billed_charge":7047.45,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7.16,"providers":[{"billed_charge":114.00,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5054.10,"providers":[{"billed_charge":50375.40,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":807.27,"providers":[{"billed_charge":12007.43,"npi":[1234567893]}]}]}]},{"name":"RBC ANTIBODY SCREEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86850","description":"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":256.62,"providers":[{"billed_charge":2646.55,"npi":[1265418669]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86900","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":85.28,"providers":[{"billed_charge":1425.08,"npi":[1265418669]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC RH(D)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86901","description":"BLOOD TYPING, SEROLOGIC; RH (D)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":85.28,"providers":[{"billed_charge":1471.28,"npi":[1265418669]}]}]}]},{"name":"CULTURE OTHR SPECIMN AEROBIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87070","description":"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":424.58,"providers":[{"billed_charge":5355.65,"npi":[1265418669]}]}]}]},{"name":"CULTR BACTERIA, EXCEPT BLOOD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87075","description":"CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATIO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":98.70,"providers":[{"billed_charge":1496.87,"npi":[1265418669]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":718.08,"providers":[{"billed_charge":3115.00,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.85,"providers":[{"billed_charge":3180.00,"npi":[1234567893]}]}]}]},{"name":"CULTURE SCREEN ONLY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87081","description":"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":690.00,"providers":[{"billed_charge":6997.78,"npi":[1265418669]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4775.73,"providers":[{"billed_charge":46169.68,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":653.40,"providers":[{"billed_charge":8837.52,"npi":[1234567893]}]}]}]},{"name":"URINE BACTERIA CULTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87088","description":"CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1413.62,"providers":[{"billed_charge":7243.13,"npi":[1265418669]}]}]}]},{"name":"DNA/RNA AMPLIFIED PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87150","description":"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, AMPLIFIED PROBE TECHNIQUE, PER C","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":804.21,"providers":[{"billed_charge":3901.63,"npi":[1265418669]}]}]}]},{"name":"OVA AND PARASITES SMEARS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87177","description":"OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12.36,"providers":[{"billed_charge":86.43,"npi":[1265418669]}]}]}]},{"name":"MICROBE SUSCEPTIBLE MIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87186","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONC","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1594.45,"providers":[{"billed_charge":19899.26,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":159.54,"providers":[{"billed_charge":1230.00,"npi":[1234567893]}]}]}]},{"name":"SMEAR, COMPLEX STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87209","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; COMPLEX SPECIAL STAIN (EG, TRICHROME, IRON HEMOTOXYLIN) F","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.96,"providers":[{"billed_charge":220.16,"npi":[1265418669]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2154.00,"providers":[{"billed_charge":22710.17,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":73.20,"providers":[{"billed_charge":893.72,"npi":[1234567893]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11945.03,"providers":[{"billed_charge":115114.80,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1474.24,"providers":[{"billed_charge":10883.60,"npi":[1234567893]}]}]}]},{"name":"SARSCOV & INF VIR A&B AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","allowed_amounts":[{"tin":{"type":"ein","value":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":149.35,"providers":[{"billed_charge":1000.00,"npi":[1255405379]}]}]}]},{"name":"AG DETECT POLYVAL IA MULT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87451","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE; MULTIPLE STEP METHOD, EACH POLYVALENT A","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":137.17,"providers":[{"billed_charge":1160.00,"npi":[1234567893]}]}]}]},{"name":"CANDIDA, DNA, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87480","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, DIRECT PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":198.44,"providers":[{"billed_charge":1496.00,"npi":[1234567893]}]}]}]},{"name":"CANDIDA, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87481","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18177.66,"providers":[{"billed_charge":45584.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14686.20,"providers":[{"billed_charge":27060.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":350.92,"providers":[{"billed_charge":880.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7720.55,"providers":[{"billed_charge":30879.20,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":701.87,"providers":[{"billed_charge":2807.20,"npi":[1588498091]}]}]}]},{"name":"CHYLMD PNEUM, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87486","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1298.70,"providers":[{"billed_charge":5193.32,"npi":[1104631415]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87491","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19093.34,"providers":[{"billed_charge":97708.31,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3369.60,"providers":[{"billed_charge":8448.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4131.24,"providers":[{"billed_charge":7612.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":184.40,"providers":[{"billed_charge":396.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3562.65,"providers":[{"billed_charge":14246.54,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"716007358"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":263.90,"providers":[{"billed_charge":1267.37,"npi":[1275173544]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":333.45,"providers":[{"billed_charge":1333.42,"npi":[1588498091]}]}]}]},{"name":"VANOMYCIN DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87500","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); VANCOMYCIN RESISTANCE (EG, ENTEROCOCCUS SPE","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3071.25,"providers":[{"billed_charge":7700.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3032.76,"providers":[{"billed_charge":5588.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":52.65,"providers":[{"billed_charge":132.00,"npi":[1487429874]}]}]}]},{"name":"INFLUENZA DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87502","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-","allowed_amounts":[{"tin":{"type":"ein","value":"710850123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.60,"providers":[{"billed_charge":233.00,"npi":[1275132474]}]}]}]},{"name":"GARDNER VAG, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87511","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1544.40,"providers":[{"billed_charge":3872.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2817.84,"providers":[{"billed_charge":5192.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1491.75,"providers":[{"billed_charge":5965.30,"npi":[1104631415]}]}]}]},{"name":"HEPATITIS C REVRS TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87522","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION, INCLUDES REVER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3094.00,"providers":[{"billed_charge":55961.64,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.80,"providers":[{"billed_charge":2500.00,"npi":[1234567893]}]}]}]},{"name":"HSV, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87529","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6298.78,"providers":[{"billed_charge":15796.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8214.72,"providers":[{"billed_charge":15136.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":228.11,"providers":[{"billed_charge":572.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3474.06,"providers":[{"billed_charge":13895.64,"npi":[1104631415]}]}]}]},{"name":"HIV-1 QUANT&REVRSE TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87536","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION, INCLUDES REVERSE TRA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5554.46,"providers":[{"billed_charge":47183.58,"npi":[1265418669]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1491.24,"providers":[{"billed_charge":7032.54,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3474.90,"providers":[{"billed_charge":8712.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3032.82,"providers":[{"billed_charge":7656.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.95,"providers":[{"billed_charge":396.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1316.25,"providers":[{"billed_charge":5263.50,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":105.30,"providers":[{"billed_charge":421.08,"npi":[1588498091]}]}]}]},{"name":"M.PNEUMON, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87581","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1333.80,"providers":[{"billed_charge":5333.68,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.10,"providers":[{"billed_charge":140.36,"npi":[1588498091]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87591","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19008.60,"providers":[{"billed_charge":97038.01,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3369.60,"providers":[{"billed_charge":8448.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4131.24,"providers":[{"billed_charge":7612.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.95,"providers":[{"billed_charge":396.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3474.90,"providers":[{"billed_charge":13895.64,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"716007358"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":263.90,"providers":[{"billed_charge":962.00,"npi":[1275173544]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":333.45,"providers":[{"billed_charge":1333.42,"npi":[1588498091]}]}]}]},{"name":"HPV HIGH-RISK TYPES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87624","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"813919645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":358.20,"providers":[{"billed_charge":2460.00,"npi":[1760681381]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5678.21,"providers":[{"billed_charge":31906.18,"npi":[1265418669]}]}]}]},{"name":"Infectious Agent Antigen Detection","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87626","description":"the detection of human papillomavirus (HPV) by nucleic acid (DNA or RNA) tests, specifically reporting separately the high-risk types (16, 18, 31, 45, 51, and 52) and any high-risk pooled results.","allowed_amounts":[{"tin":{"type":"ein","value":"760611317"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.40,"providers":[{"billed_charge":1200.00,"npi":[1699744144]}]}]},{"tin":{"type":"ein","value":"812532457"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":140.40,"providers":[{"billed_charge":1200.00,"npi":[1295331221]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1042.47,"providers":[{"billed_charge":4791.66,"npi":[1234567893]}]}]}]},{"name":"RESP VIRUS 3-5 TARGETS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87631","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5349.00,"providers":[{"billed_charge":21394.50,"npi":[1104631415]}]}]}]},{"name":"STAPH A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87640","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":456.30,"providers":[{"billed_charge":1144.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":716.40,"providers":[{"billed_charge":1320.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1316.25,"providers":[{"billed_charge":5263.50,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":491.40,"providers":[{"billed_charge":1965.04,"npi":[1588498091]}]}]}]},{"name":"MR-STAPH DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87641","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, METHICILLIN RESISTAN","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3194.10,"providers":[{"billed_charge":8008.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3008.88,"providers":[{"billed_charge":5544.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":52.65,"providers":[{"billed_charge":132.00,"npi":[1487429874]}]}]}]},{"name":"STREP A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87651","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3983.85,"providers":[{"billed_charge":9988.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4131.24,"providers":[{"billed_charge":7612.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":342.35,"providers":[{"billed_charge":792.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":789.75,"providers":[{"billed_charge":3158.10,"npi":[1104631415]}]}]}]},{"name":"STREP B, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87653","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3983.85,"providers":[{"billed_charge":9988.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4131.24,"providers":[{"billed_charge":7612.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":315.90,"providers":[{"billed_charge":792.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1421.55,"providers":[{"billed_charge":5684.58,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":561.60,"providers":[{"billed_charge":2245.76,"npi":[1588498091]}]}]}]},{"name":"TRICHOMONAS VAGIN, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87660","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, DIRECT PROBE TECHNIQ","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27.06,"providers":[{"billed_charge":204.00,"npi":[1234567893]}]}]}]},{"name":"TRICHOMONAS VAGINALIS AMPLIF","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87661","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":15011.92,"providers":[{"billed_charge":76449.96,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3369.60,"providers":[{"billed_charge":8448.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"334512023"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4107.36,"providers":[{"billed_charge":7568.00,"npi":[1225666175]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.95,"providers":[{"billed_charge":396.00,"npi":[1487429874]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3246.75,"providers":[{"billed_charge":12983.30,"npi":[1104631415]}]}]},{"tin":{"type":"ein","value":"994655411"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":333.45,"providers":[{"billed_charge":1333.42,"npi":[1588498091]}]}]},{"tin":{"type":"ein","value":"716007358"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":243.60,"providers":[{"billed_charge":584.88,"npi":[1275173544]}]}]}]},{"name":"DETECT AGNT MULT, DNA, AMPLI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87801","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5180.76,"providers":[{"billed_charge":51643.15,"npi":[1234567893]}]}]}]},{"name":"INFLUENZA ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87804","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA","allowed_amounts":[{"tin":{"type":"ein","value":"452901217"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":182.91,"providers":[{"billed_charge":308.75,"npi":[1063396737]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["11","72","20"],"billing_class":"professional","payments":[{"allowed_amount":5.21,"providers":[{"billed_charge":31.16,"npi":[1427666346]}]},{"allowed_amount":16.55,"providers":[{"billed_charge":31.16,"npi":[1578026027]}]},{"allowed_amount":10.42,"providers":[{"billed_charge":62.32,"npi":[1578141180]}]},{"allowed_amount":70.35,"providers":[{"billed_charge":155.80,"npi":[1043028939,1043931793]}]},{"allowed_amount":128.73,"providers":[{"billed_charge":654.36,"npi":[1033659677]}]},{"allowed_amount":15.63,"providers":[{"billed_charge":93.48,"npi":[1578141180]}]},{"allowed_amount":203.19,"providers":[{"billed_charge":1215.24,"npi":[1669933370]}]},{"allowed_amount":21.09,"providers":[{"billed_charge":93.48,"npi":[1396191136]}]},{"allowed_amount":31.26,"providers":[{"billed_charge":186.96,"npi":[1285327452]}]},{"allowed_amount":98.99,"providers":[{"billed_charge":592.04,"npi":[1285327452,1376006585]}]},{"allowed_amount":161.51,"providers":[{"billed_charge":965.96,"npi":[1790404499]}]},{"allowed_amount":28.12,"providers":[{"billed_charge":124.64,"npi":[1396191136]}]},{"allowed_amount":33.10,"providers":[{"billed_charge":62.32,"npi":[1578026027]}]},{"allowed_amount":224.03,"providers":[{"billed_charge":1339.88,"npi":[1174034565]}]},{"allowed_amount":56.28,"providers":[{"billed_charge":124.64,"npi":[1407629264]}]},{"allowed_amount":14.07,"providers":[{"billed_charge":31.16,"npi":[1407629264]}]},{"allowed_amount":119.83,"providers":[{"billed_charge":716.68,"npi":[1316510043,1063870467]}]},{"allowed_amount":49.04,"providers":[{"billed_charge":249.28,"npi":[1033659677]}]},{"allowed_amount":112.56,"providers":[{"billed_charge":249.28,"npi":[1043028939]}]},{"allowed_amount":20.84,"providers":[{"billed_charge":124.64,"npi":[1669933370]}]},{"allowed_amount":67.73,"providers":[{"billed_charge":405.08,"npi":[1689240913]}]}]}]},{"name":"SARS-COV-2 COVID19 W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87811","description":"IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"461235939"},"service_code":["11","72","20"],"billing_class":"professional","payments":[{"allowed_amount":18.17,"providers":[{"billed_charge":201.00,"npi":[1285327452,1669933370,1063870467]}]},{"allowed_amount":64.14,"providers":[{"billed_charge":603.00,"npi":[1033659677]}]},{"allowed_amount":21.38,"providers":[{"billed_charge":201.00,"npi":[1033659677]}]},{"allowed_amount":72.68,"providers":[{"billed_charge":804.00,"npi":[1316510043,1790404499]}]},{"allowed_amount":36.34,"providers":[{"billed_charge":402.00,"npi":[1285327452,1376006585]}]},{"allowed_amount":145.36,"providers":[{"billed_charge":1608.00,"npi":[1174034565]}]},{"allowed_amount":90.85,"providers":[{"billed_charge":1005.00,"npi":[1669933370]}]}]}]},{"name":"STREP A ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87880","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GR","allowed_amounts":[{"tin":{"type":"ein","value":"461235939"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":5.21,"providers":[{"billed_charge":31.16,"npi":[1669933370,1063870467]}]},{"allowed_amount":119.83,"providers":[{"billed_charge":716.68,"npi":[1669933370]}]},{"allowed_amount":156.30,"providers":[{"billed_charge":934.80,"npi":[1174034565]}]}]}]},{"name":"GENOTYPE DNA/RNA HEP C","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87902","description":"INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C VIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2324.14,"providers":[{"billed_charge":9193.60,"npi":[1265418669]}]}]}]},{"name":"CYTOPATH C/V THIN LAYER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88142","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"813919645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1315.20,"providers":[{"billed_charge":5952.00,"npi":[1760681381]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":386.40,"providers":[{"billed_charge":1845.11,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"760611317"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":119.79,"providers":[{"billed_charge":1080.00,"npi":[1699744144]}]}]},{"tin":{"type":"ein","value":"812532457"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":159.72,"providers":[{"billed_charge":1440.00,"npi":[1295331221]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":720.93,"providers":[{"billed_charge":6638.65,"npi":[1234567893]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1493.56,"providers":[{"billed_charge":5210.00,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"332098148"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":277.32,"providers":[{"billed_charge":800.00,"npi":[1891511309]}]},{"allowed_amount":970.62,"providers":[{"billed_charge":2800.00,"npi":[1891511309]}]}]},{"tin":{"type":"ein","value":"431451388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":321.20,"providers":[{"billed_charge":3099.00,"npi":[1285838847]}]}]},{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":724.85,"providers":[{"billed_charge":1330.00,"npi":[1831169762]}]},{"allowed_amount":3815.00,"providers":[{"billed_charge":7000.00,"npi":[1164955928]}]},{"allowed_amount":915.60,"providers":[{"billed_charge":1680.00,"npi":[1003073628]}]}]}]},{"name":"SPECIAL STAINS GROUP 1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88312","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":327.60,"providers":[{"billed_charge":600.00,"npi":[1164955928]}]}]}]},{"name":"SPECIAL STAINS GROUP 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88313","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":293.52,"providers":[{"billed_charge":552.00,"npi":[1164955928]}]}]}]},{"name":"IMMUNOHISTO ANTB 1ST STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88342","description":"IMMUNOHISTOCHEMISTRY OR IMMUNOCYTOCHEMISTRY, PER SPECIMEN; INITIAL SINGLE ANTIBODY STAIN PROCEDURE","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1112.54,"providers":[{"billed_charge":2847.00,"npi":[1164955928]}]}]}]},{"name":"BH/INTENS OP/PSYCH","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"905","description":"INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"710386402"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":220.00,"npi":[1063551265]}]}]}]},{"name":"BH/INTENS OP/CHEM DEP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"906","description":"INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"844037448"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":28680.00,"providers":[{"billed_charge":764800.00,"npi":[1285273219]}]}]},{"tin":{"type":"ein","value":"861790384"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10200.00,"providers":[{"billed_charge":188496.00,"npi":[1912670068]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9024.00,"providers":[{"billed_charge":37600.00,"npi":[1447723143]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3120.00,"providers":[{"billed_charge":3760.00,"npi":[1447099056]}]}]},{"tin":{"type":"ein","value":"264282327"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":20160.00,"providers":[{"billed_charge":33600.00,"npi":[1467196386]}]}]},{"tin":{"type":"ein","value":"993998533"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":192.00,"providers":[{"billed_charge":3400.00,"npi":[1326916503]}]}]}]},{"name":"PSYTX COMPLEX INTERACTIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90785","description":"INTERACTIVE COMPLEXITY (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)","allowed_amounts":[{"tin":{"type":"ein","value":"462017854"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":57.84,"providers":[{"billed_charge":150.00,"npi":[1487167045]}]}]},{"tin":{"type":"ein","value":"273532705"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":32.54,"providers":[{"billed_charge":50.00,"npi":[1285190686]}]},{"allowed_amount":146.43,"providers":[{"billed_charge":225.00,"npi":[1285190686]}]}]},{"tin":{"type":"ein","value":"931482298"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":65.08,"providers":[{"billed_charge":88.00,"npi":[1720538069]}]}]},{"tin":{"type":"ein","value":"824235522"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":488.10,"providers":[{"billed_charge":900.00,"npi":[1134248164]}]}]}]},{"name":"PSYCH DIAGNOSTIC EVALUATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90791","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":2382.90,"providers":[{"billed_charge":2405.00,"npi":[1265657274]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":382.72,"providers":[{"billed_charge":834.74,"npi":[1326389891]}]}]}]},{"name":"PSYCH DIAG EVAL W/MED SRVCS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90792","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"710408284"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1877.13,"providers":[{"billed_charge":2662.24,"npi":[1629163274]}]}]}]},{"name":"PSYTX W PT 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90832","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":219.11,"providers":[{"billed_charge":410.76,"npi":[1336022615]}]}]},{"tin":{"type":"ein","value":"710360221"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":540.00,"providers":[{"billed_charge":540.00,"npi":[1275960700]}]},{"allowed_amount":1800.00,"providers":[{"billed_charge":1800.00,"npi":[1275960700]}]},{"allowed_amount":90.00,"providers":[{"billed_charge":90.00,"npi":[1639137458]}]},{"allowed_amount":1440.00,"providers":[{"billed_charge":1440.00,"npi":[1235170382]}]},{"allowed_amount":270.00,"providers":[{"billed_charge":270.00,"npi":[1235170382]}]},{"allowed_amount":360.00,"providers":[{"billed_charge":360.00,"npi":[1275960700]}]},{"allowed_amount":990.00,"providers":[{"billed_charge":990.00,"npi":[1639137458]}]}]},{"tin":{"type":"ein","value":"710417329"},"service_code":["11","12","53","10"],"billing_class":"professional","payments":[{"allowed_amount":170.00,"providers":[{"billed_charge":170.00,"npi":[1326220856]}]},{"allowed_amount":680.00,"providers":[{"billed_charge":680.00,"npi":[1720391188]}]},{"allowed_amount":85.00,"providers":[{"billed_charge":85.00,"npi":[1326220856]}]},{"allowed_amount":340.00,"providers":[{"billed_charge":340.00,"npi":[1326220856]}]},{"allowed_amount":394.15,"providers":[{"billed_charge":425.00,"npi":[1720391188]}]},{"allowed_amount":1360.00,"providers":[{"billed_charge":1360.00,"npi":[1720391188]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":569.82,"providers":[{"billed_charge":840.00,"npi":[1194242099]}]},{"allowed_amount":189.94,"providers":[{"billed_charge":280.00,"npi":[1427633163]}]},{"allowed_amount":1044.67,"providers":[{"billed_charge":1540.00,"npi":[1427633163]}]}]},{"tin":{"type":"ein","value":"824561401"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":4463.59,"providers":[{"billed_charge":5640.00,"npi":[1336408533]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2467.30,"providers":[{"billed_charge":3836.04,"npi":[1295378289]}]},{"allowed_amount":379.88,"providers":[{"billed_charge":590.16,"npi":[1295378289]}]},{"allowed_amount":759.76,"providers":[{"billed_charge":1180.32,"npi":[1073801338]}]},{"allowed_amount":567.88,"providers":[{"billed_charge":885.24,"npi":[1073801338]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":2277.34,"providers":[{"billed_charge":3898.80,"npi":[1770605057]}]}]}]},{"name":"PSYTX W PT W E/M 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90833","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"710290019"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":904.32,"providers":[{"billed_charge":1395.00,"npi":[1437803814]}]},{"allowed_amount":301.44,"providers":[{"billed_charge":465.00,"npi":[1437803814]}]},{"allowed_amount":100.48,"providers":[{"billed_charge":155.00,"npi":[1437803814]}]}]},{"tin":{"type":"ein","value":"831529526"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3982.45,"providers":[{"billed_charge":5697.90,"npi":[1386397651]}]},{"allowed_amount":1950.30,"providers":[{"billed_charge":2785.64,"npi":[1386397651]}]}]},{"tin":{"type":"ein","value":"461893699"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":804.20,"providers":[{"billed_charge":1560.00,"npi":[1073099198]}]},{"allowed_amount":201.05,"providers":[{"billed_charge":390.00,"npi":[1073099198]}]}]},{"tin":{"type":"ein","value":"931397886"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1649.75,"providers":[{"billed_charge":1649.75,"npi":[1417600099]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2238.34,"providers":[{"billed_charge":2860.00,"npi":[1376664342]}]},{"allowed_amount":22379.40,"providers":[{"billed_charge":28600.00,"npi":[1831206341]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":7267.60,"providers":[{"billed_charge":12300.00,"npi":[1487422572]}]},{"allowed_amount":7623.90,"providers":[{"billed_charge":12900.00,"npi":[1487299525]}]},{"allowed_amount":88.65,"providers":[{"billed_charge":150.00,"npi":[1487299525]}]},{"allowed_amount":3634.65,"providers":[{"billed_charge":6150.00,"npi":[1417238981]}]},{"allowed_amount":709.20,"providers":[{"billed_charge":1200.00,"npi":[1154194579]}]},{"allowed_amount":177.30,"providers":[{"billed_charge":300.00,"npi":[1487422572,1417238981]}]},{"allowed_amount":8865.00,"providers":[{"billed_charge":15000.00,"npi":[1154194579]}]},{"allowed_amount":443.25,"providers":[{"billed_charge":750.00,"npi":[1487299525]}]}]},{"tin":{"type":"ein","value":"993161677"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":709.20,"providers":[{"billed_charge":1000.00,"npi":[1598417511]}]}]},{"tin":{"type":"ein","value":"333151160"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1502.35,"providers":[{"billed_charge":4625.00,"npi":[1346339066]}]},{"allowed_amount":393.40,"providers":[{"billed_charge":1295.00,"npi":[1346339066]}]}]},{"tin":{"type":"ein","value":"710772737"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1794.00,"providers":[{"billed_charge":1794.00,"npi":[1629784251]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":125.84,"providers":[{"billed_charge":230.00,"npi":[1932336054]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2765.93,"providers":[{"billed_charge":3520.00,"npi":[1194242099]}]}]},{"tin":{"type":"ein","value":"710717967"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":755.04,"providers":[{"billed_charge":1002.00,"npi":[1720029523]}]},{"allowed_amount":251.68,"providers":[{"billed_charge":334.00,"npi":[1720029523]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":2013.44,"providers":[{"billed_charge":3283.52,"npi":[1275769903]}]}]},{"tin":{"type":"ein","value":"831159576"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":251.68,"providers":[{"billed_charge":300.00,"npi":[1629463385]}]}]}]},{"name":"PSYTX W PT W E/M 45 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90836","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":337.23,"providers":[{"billed_charge":600.00,"npi":[1487422572]}]}]}]},{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90837","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"208182251"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":1225.00,"providers":[{"billed_charge":1225.00,"npi":[1407137029]}]},{"allowed_amount":1050.00,"providers":[{"billed_charge":1050.00,"npi":[1568034668]}]},{"allowed_amount":3675.00,"providers":[{"billed_charge":3675.00,"npi":[1407137029]}]},{"allowed_amount":2275.00,"providers":[{"billed_charge":2275.00,"npi":[1992844310]}]},{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[1568034668]}]}]},{"tin":{"type":"ein","value":"331180453"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":434.92,"providers":[{"billed_charge":840.00,"npi":[1407951247]}]},{"allowed_amount":761.11,"providers":[{"billed_charge":1470.00,"npi":[1407951247]}]}]},{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":952.40,"npi":[1669056305]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":238.10,"npi":[1780045153]}]}]},{"tin":{"type":"ein","value":"931952443"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":217.46,"providers":[{"billed_charge":1000.00,"npi":[1598980831]}]}]},{"tin":{"type":"ein","value":"710448650"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":960.00,"npi":[1235739194]}]},{"allowed_amount":3141.26,"providers":[{"billed_charge":4080.00,"npi":[1235739194]}]}]},{"tin":{"type":"ein","value":"273366569"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14405.35,"providers":[{"billed_charge":16380.00,"npi":[1316957830]}]}]},{"tin":{"type":"ein","value":"831722673"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14043.28,"providers":[{"billed_charge":17100.00,"npi":[1184132417]}]}]},{"tin":{"type":"ein","value":"810844380"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2032.58,"providers":[{"billed_charge":2420.00,"npi":[1376122622]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":220.00,"npi":[1023248317,1982856142]}]},{"allowed_amount":3869.07,"providers":[{"billed_charge":4620.00,"npi":[1376122622]}]}]},{"tin":{"type":"ein","value":"842836141"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1382.37,"providers":[{"billed_charge":1600.00,"npi":[1477298677]}]},{"allowed_amount":1422.98,"providers":[{"billed_charge":1600.00,"npi":[1477298677]}]}]},{"tin":{"type":"ein","value":"431654413"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5323.52,"providers":[{"billed_charge":6400.00,"npi":[1376818674]}]},{"allowed_amount":332.72,"providers":[{"billed_charge":400.00,"npi":[1376818674]}]}]},{"tin":{"type":"ein","value":"331430091"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1304.76,"providers":[{"billed_charge":2400.00,"npi":[1720360381]}]},{"allowed_amount":761.11,"providers":[{"billed_charge":1400.00,"npi":[1720360381]}]}]},{"tin":{"type":"ein","value":"264248303"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2028.81,"providers":[{"billed_charge":2475.00,"npi":[1447620844]}]},{"allowed_amount":2948.94,"providers":[{"billed_charge":3615.00,"npi":[1184752412]}]},{"allowed_amount":4619.50,"providers":[{"billed_charge":5700.00,"npi":[1184752412]}]}]},{"tin":{"type":"ein","value":"823611843"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1871994145]}]},{"allowed_amount":8307.56,"providers":[{"billed_charge":9000.00,"npi":[1871994145]}]}]},{"tin":{"type":"ein","value":"823349994"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1293.46,"providers":[{"billed_charge":1575.00,"npi":[1316127301]}]}]},{"tin":{"type":"ein","value":"830857052"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1376774216]}]},{"allowed_amount":7014.10,"providers":[{"billed_charge":7600.00,"npi":[1376774216]}]}]},{"tin":{"type":"ein","value":"844483896"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2625.00,"providers":[{"billed_charge":2625.00,"npi":[1215104740]}]}]},{"tin":{"type":"ein","value":"263442072"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":18034.63,"providers":[{"billed_charge":22576.00,"npi":[1861639940]}]}]},{"tin":{"type":"ein","value":"263447487"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2691.24,"providers":[{"billed_charge":3000.00,"npi":[1326090440]}]},{"allowed_amount":1121.35,"providers":[{"billed_charge":1250.00,"npi":[1326090440]}]},{"allowed_amount":953.15,"providers":[{"billed_charge":1250.00,"npi":[1134410467]}]}]},{"tin":{"type":"ein","value":"812793571"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":29187.75,"providers":[{"billed_charge":35515.00,"npi":[1174094825]}]},{"allowed_amount":916.36,"providers":[{"billed_charge":1125.00,"npi":[1174094825]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":940.00,"npi":[1932540192]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":235.00,"npi":[1073752275]}]},{"allowed_amount":1663.02,"providers":[{"billed_charge":2115.00,"npi":[1932540192,1073752275]}]},{"allowed_amount":2217.36,"providers":[{"billed_charge":2820.00,"npi":[1932540192]}]}]},{"tin":{"type":"ein","value":"812632214"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":10147.96,"providers":[{"billed_charge":15250.00,"npi":[1275960700]}]}]},{"tin":{"type":"ein","value":"710715998"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":369.56,"providers":[{"billed_charge":450.86,"npi":[1972939304]}]},{"allowed_amount":1256.52,"providers":[{"billed_charge":1352.58,"npi":[1437460615]}]}]},{"tin":{"type":"ein","value":"571176963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3913.02,"providers":[{"billed_charge":5400.00,"npi":[1275784506]}]}]},{"tin":{"type":"ein","value":"474151500"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":195.72,"providers":[{"billed_charge":221.59,"npi":[1295910974]}]},{"allowed_amount":6263.04,"providers":[{"billed_charge":7090.88,"npi":[1295910974]}]}]},{"tin":{"type":"ein","value":"993141896"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":1575.00,"providers":[{"billed_charge":1575.00,"npi":[1831127075]}]},{"allowed_amount":350.00,"providers":[{"billed_charge":350.00,"npi":[1902933104]}]},{"allowed_amount":2450.00,"providers":[{"billed_charge":2450.00,"npi":[1831127075]}]},{"allowed_amount":3150.00,"providers":[{"billed_charge":3150.00,"npi":[1841557840]}]},{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[1841557840]}]}]},{"tin":{"type":"ein","value":"822126642"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":550.57,"providers":[{"billed_charge":600.00,"npi":[1639658594]}]},{"allowed_amount":1108.68,"providers":[{"billed_charge":1200.00,"npi":[1679029201]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1639658594]}]},{"allowed_amount":1474.47,"providers":[{"billed_charge":1600.00,"npi":[1679029201]}]}]},{"tin":{"type":"ein","value":"710853242"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10521.15,"providers":[{"billed_charge":12630.63,"npi":[1568773356]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":554.34,"providers":[{"billed_charge":600.00,"npi":[1427026541]}]}]},{"tin":{"type":"ein","value":"474826984"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2402.14,"providers":[{"billed_charge":2880.28,"npi":[1154960946]}]},{"allowed_amount":8130.32,"providers":[{"billed_charge":9748.64,"npi":[1154960946]}]},{"allowed_amount":1847.80,"providers":[{"billed_charge":2215.60,"npi":[1790166403]}]}]},{"tin":{"type":"ein","value":"853814336"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2956.48,"providers":[{"billed_charge":3600.00,"npi":[1467578088]}]},{"allowed_amount":8300.02,"providers":[{"billed_charge":10125.00,"npi":[1467578088]}]}]},{"tin":{"type":"ein","value":"710296619"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":900.00,"providers":[{"billed_charge":900.00,"npi":[1831459098]}]},{"allowed_amount":1648.68,"providers":[{"billed_charge":1650.00,"npi":[1811164551]}]},{"allowed_amount":919.12,"providers":[{"billed_charge":920.00,"npi":[1811164551]}]}]},{"tin":{"type":"ein","value":"273532705"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1478.24,"providers":[{"billed_charge":2000.00,"npi":[1861797227,1285190686]}]},{"allowed_amount":217.39,"providers":[{"billed_charge":250.00,"npi":[1639400294]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":500.00,"npi":[1548607161,1730386970]}]},{"allowed_amount":8499.88,"providers":[{"billed_charge":11500.00,"npi":[1104066299]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":250.00,"npi":[1730386970]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":750.00,"npi":[1073764304,1427305663]}]},{"allowed_amount":4434.72,"providers":[{"billed_charge":6000.00,"npi":[1861797227]}]},{"allowed_amount":739.12,"providers":[{"billed_charge":1000.00,"npi":[1548607161,1427305663]}]},{"allowed_amount":5543.40,"providers":[{"billed_charge":7500.00,"npi":[1073764304]}]},{"allowed_amount":11086.80,"providers":[{"billed_charge":15000.00,"npi":[1699193110]}]},{"allowed_amount":6956.48,"providers":[{"billed_charge":8000.00,"npi":[1639400294]}]},{"allowed_amount":3695.60,"providers":[{"billed_charge":5000.00,"npi":[1285190686]}]},{"allowed_amount":2217.36,"providers":[{"billed_charge":3000.00,"npi":[1831408947]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1250.00,"npi":[1528601135]}]}]},{"tin":{"type":"ein","value":"812549778"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3141.26,"providers":[{"billed_charge":3655.00,"npi":[1295861649]}]}]},{"tin":{"type":"ein","value":"824561401"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":3326.04,"providers":[{"billed_charge":4500.00,"npi":[1336408533]}]}]},{"tin":{"type":"ein","value":"873695970"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":4989.06,"providers":[{"billed_charge":5400.00,"npi":[1245995398]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1245995398]}]},{"allowed_amount":11807.07,"providers":[{"billed_charge":12800.00,"npi":[1245995398]}]}]},{"tin":{"type":"ein","value":"832504107"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":4423.41,"providers":[{"billed_charge":5445.00,"npi":[1154570521]}]},{"allowed_amount":1663.02,"providers":[{"billed_charge":2040.00,"npi":[1154570521]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1140.00,"npi":[1225508047]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":690.00,"npi":[1225508047]}]}]},{"tin":{"type":"ein","value":"432395130"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1847.80,"providers":[{"billed_charge":2200.00,"npi":[1770638355]}]}]},{"tin":{"type":"ein","value":"842581036"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":900.00,"npi":[1477076222]}]},{"allowed_amount":1739.68,"providers":[{"billed_charge":3600.00,"npi":[1659911980]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":225.00,"npi":[1184840068]}]},{"allowed_amount":108.73,"providers":[{"billed_charge":225.00,"npi":[1659911980]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":2672.00,"providers":[{"billed_charge":5616.00,"npi":[1427333624]}]}]},{"tin":{"type":"ein","value":"824019156"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1700.00,"providers":[{"billed_charge":1700.00,"npi":[1821746116]}]},{"allowed_amount":1360.00,"providers":[{"billed_charge":1360.00,"npi":[1376235804]}]},{"allowed_amount":8160.00,"providers":[{"billed_charge":8160.00,"npi":[1376235804]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":871.72,"npi":[1912529207,1730491598,1285679738]}]},{"allowed_amount":2032.58,"providers":[{"billed_charge":2397.23,"npi":[1912529207]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":435.86,"npi":[1730491598]}]},{"allowed_amount":3876.61,"providers":[{"billed_charge":4576.53,"npi":[1285679738]}]}]},{"tin":{"type":"ein","value":"923180531"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":369.56,"providers":[{"billed_charge":400.00,"npi":[1912156928]}]},{"allowed_amount":8002.08,"providers":[{"billed_charge":8550.00,"npi":[1902352115]}]}]},{"tin":{"type":"ein","value":"842515764"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":923.95,"providers":[{"billed_charge":1000.00,"npi":[1528290863]}]}]},{"tin":{"type":"ein","value":"831287025"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2700.00,"providers":[{"billed_charge":2700.00,"npi":[1174771091]}]},{"allowed_amount":3150.00,"providers":[{"billed_charge":3150.00,"npi":[1174771091]}]}]},{"tin":{"type":"ein","value":"842185036"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2213.59,"providers":[{"billed_charge":2520.00,"npi":[1861959066]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":630.00,"npi":[1861959066]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3510.82,"providers":[{"billed_charge":5700.00,"npi":[1639629207]}]},{"allowed_amount":1844.03,"providers":[{"billed_charge":3000.00,"npi":[1215059993]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":900.00,"npi":[1679724504]}]}]},{"tin":{"type":"ein","value":"710859088"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":904.34,"providers":[{"billed_charge":935.00,"npi":[1124535638]}]},{"allowed_amount":1478.24,"providers":[{"billed_charge":1560.00,"npi":[1124535638]}]}]},{"tin":{"type":"ein","value":"882760550"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":5543.40,"providers":[{"billed_charge":6000.00,"npi":[1659542686]}]},{"allowed_amount":1847.80,"providers":[{"billed_charge":2000.00,"npi":[1659542686,1780706473]}]}]},{"tin":{"type":"ein","value":"832952547"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":9180.00,"providers":[{"billed_charge":9180.00,"npi":[1790398311]}]},{"allowed_amount":680.00,"providers":[{"billed_charge":680.00,"npi":[1639237712,1386290443]}]},{"allowed_amount":2550.00,"providers":[{"billed_charge":2550.00,"npi":[1265845788]}]},{"allowed_amount":340.00,"providers":[{"billed_charge":340.00,"npi":[1790398311]}]},{"allowed_amount":510.00,"providers":[{"billed_charge":510.00,"npi":[1619579448]}]},{"allowed_amount":850.00,"providers":[{"billed_charge":850.00,"npi":[1386290443,1265845788]}]},{"allowed_amount":7310.00,"providers":[{"billed_charge":7310.00,"npi":[1639237712]}]}]},{"tin":{"type":"ein","value":"824235522"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":6087.96,"providers":[{"billed_charge":6895.00,"npi":[1134248164]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":630.00,"npi":[1134248164]}]}]},{"tin":{"type":"ein","value":"203396304"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":645.00,"providers":[{"billed_charge":645.00,"npi":[1285914432]}]},{"allowed_amount":6652.13,"providers":[{"billed_charge":7740.00,"npi":[1962783852]}]},{"allowed_amount":4412.10,"providers":[{"billed_charge":5160.00,"npi":[1962783852]}]},{"allowed_amount":9457.96,"providers":[{"billed_charge":9460.00,"npi":[1285914432]}]}]},{"tin":{"type":"ein","value":"205386448"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":880.00,"npi":[1609413111]}]},{"allowed_amount":2402.14,"providers":[{"billed_charge":2860.00,"npi":[1609413111]}]}]},{"tin":{"type":"ein","value":"822914567"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":495.00,"providers":[{"billed_charge":495.00,"npi":[1396139275]}]}]},{"tin":{"type":"ein","value":"874033729"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7576.03,"providers":[{"billed_charge":8200.00,"npi":[1396158564]}]}]},{"tin":{"type":"ein","value":"842209520"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":235.00,"npi":[1477195576]}]},{"allowed_amount":1663.02,"providers":[{"billed_charge":2115.00,"npi":[1477195576]}]}]},{"tin":{"type":"ein","value":"873364225"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2032.58,"providers":[{"billed_charge":2200.00,"npi":[1780177113]}]},{"allowed_amount":1663.12,"providers":[{"billed_charge":1800.00,"npi":[1780177113]}]}]},{"tin":{"type":"ein","value":"621673656"},"service_code":["11","03"],"billing_class":"professional","payments":[{"allowed_amount":1829.96,"providers":[{"billed_charge":1829.96,"npi":[1164062147]}]},{"allowed_amount":166.36,"providers":[{"billed_charge":166.36,"npi":[1164062147]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":923.90,"providers":[{"billed_charge":1500.00,"npi":[1588090526]}]}]},{"tin":{"type":"ein","value":"824467994"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2162.68,"providers":[{"billed_charge":3900.00,"npi":[1548362353]}]},{"allowed_amount":1663.60,"providers":[{"billed_charge":3000.00,"npi":[1770280521]}]},{"allowed_amount":4325.36,"providers":[{"billed_charge":7800.00,"npi":[1548362353]}]},{"allowed_amount":166.36,"providers":[{"billed_charge":300.00,"npi":[1770280521]}]}]},{"tin":{"type":"ein","value":"862364975"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1346501327]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":3510.82,"providers":[{"billed_charge":4609.21,"npi":[1770605057]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":7753.22,"providers":[{"billed_charge":9240.00,"npi":[1194242099]}]},{"allowed_amount":2767.93,"providers":[{"billed_charge":3300.00,"npi":[1427633163]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":220.00,"npi":[1770136095]}]},{"allowed_amount":8130.32,"providers":[{"billed_charge":9680.00,"npi":[1588640551]}]},{"allowed_amount":2398.37,"providers":[{"billed_charge":2860.00,"npi":[1588640551]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":660.00,"npi":[1154579977]}]},{"allowed_amount":3326.04,"providers":[{"billed_charge":3960.00,"npi":[1427633163]}]},{"allowed_amount":739.12,"providers":[{"billed_charge":880.00,"npi":[1154998136]}]},{"allowed_amount":735.35,"providers":[{"billed_charge":880.00,"npi":[1154998136]}]},{"allowed_amount":13662.41,"providers":[{"billed_charge":16280.00,"npi":[1902220668]}]},{"allowed_amount":3141.26,"providers":[{"billed_charge":3740.00,"npi":[1598039075]}]},{"allowed_amount":2952.71,"providers":[{"billed_charge":3520.00,"npi":[1598039075]}]},{"allowed_amount":1847.80,"providers":[{"billed_charge":2200.00,"npi":[1073102604]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1100.00,"npi":[1154579977,1770136095]}]}]},{"tin":{"type":"ein","value":"993888211"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":4615.73,"providers":[{"billed_charge":5539.75,"npi":[1023666351]}]}]},{"tin":{"type":"ein","value":"863198947"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6454.40,"providers":[{"billed_charge":6454.40,"npi":[1467861385]}]}]},{"tin":{"type":"ein","value":"710828877"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":1020.00,"npi":[1437328960]}]},{"allowed_amount":1478.24,"providers":[{"billed_charge":2040.00,"npi":[1780851048]}]},{"allowed_amount":1108.68,"providers":[{"billed_charge":1530.00,"npi":[1780851048]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":255.00,"npi":[1780851048]}]},{"allowed_amount":4430.95,"providers":[{"billed_charge":6120.00,"npi":[1124563234]}]},{"allowed_amount":4427.18,"providers":[{"billed_charge":6120.00,"npi":[1124563234]}]}]},{"tin":{"type":"ein","value":"237198398"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1478.24,"providers":[{"billed_charge":1917.76,"npi":[1841760675]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1198.60,"npi":[1841760675]}]}]},{"tin":{"type":"ein","value":"874108485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7700.00,"providers":[{"billed_charge":7700.00,"npi":[1477720951]}]}]},{"tin":{"type":"ein","value":"621658502"},"service_code":["11","12","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3510.82,"providers":[{"billed_charge":3534.00,"npi":[1740981364]}]},{"allowed_amount":1478.24,"providers":[{"billed_charge":1488.00,"npi":[1740981364]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":372.00,"npi":[1104078104,1134947369]}]},{"allowed_amount":13858.50,"providers":[{"billed_charge":13950.00,"npi":[1801372198]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":186.00,"npi":[1114882545,1750695631,1104078104,1801372198]}]},{"allowed_amount":7014.10,"providers":[{"billed_charge":7068.00,"npi":[1134947369]}]},{"allowed_amount":1293.46,"providers":[{"billed_charge":1302.00,"npi":[1750044798,1962870618]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":930.00,"npi":[1962870618]}]},{"allowed_amount":4434.72,"providers":[{"billed_charge":4464.00,"npi":[1750695631]}]}]},{"tin":{"type":"ein","value":"710416869"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3137.49,"providers":[{"billed_charge":4075.24,"npi":[1053675686]}]},{"allowed_amount":1478.24,"providers":[{"billed_charge":1917.76,"npi":[1053675686]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":479.44,"npi":[1053675686]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":239.72,"npi":[1306147806,1710149604]}]}]},{"tin":{"type":"ein","value":"270742061"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":500.00,"providers":[{"billed_charge":500.00,"npi":[1952307548]}]},{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1952307548]}]}]},{"tin":{"type":"ein","value":"823428904"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1663.02,"providers":[{"billed_charge":2250.00,"npi":[1558377267]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":750.00,"npi":[1558377267]}]}]},{"tin":{"type":"ein","value":"853720009"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1293.46,"providers":[{"billed_charge":1400.00,"npi":[1245842764]}]}]},{"tin":{"type":"ein","value":"814908293"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3723.00,"providers":[{"billed_charge":4250.00,"npi":[1861907644]}]},{"allowed_amount":219.00,"providers":[{"billed_charge":250.00,"npi":[1861907644]}]}]},{"tin":{"type":"ein","value":"844183033"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3691.83,"providers":[{"billed_charge":4431.80,"npi":[1720007339]}]}]},{"tin":{"type":"ein","value":"841975348"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":800.00,"npi":[1528412269]}]},{"allowed_amount":1108.68,"providers":[{"billed_charge":1200.00,"npi":[1528412269]}]}]},{"tin":{"type":"ein","value":"881221742"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":7934.23,"providers":[{"billed_charge":9675.00,"npi":[1437362803]}]}]},{"tin":{"type":"ein","value":"854094783"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5901.70,"providers":[{"billed_charge":7070.00,"npi":[1104957414]}]},{"allowed_amount":4249.94,"providers":[{"billed_charge":5360.00,"npi":[1104957414]}]}]},{"tin":{"type":"ein","value":"822551204"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5543.40,"providers":[{"billed_charge":6000.00,"npi":[1801101126]}]},{"allowed_amount":7575.98,"providers":[{"billed_charge":8200.00,"npi":[1801101126]}]}]},{"tin":{"type":"ein","value":"462017854"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4818.00,"providers":[{"billed_charge":5940.00,"npi":[1417243361]}]},{"allowed_amount":2190.00,"providers":[{"billed_charge":2700.00,"npi":[1811134653]}]},{"allowed_amount":1752.00,"providers":[{"billed_charge":2160.00,"npi":[1417243361,1053562389]}]},{"allowed_amount":5694.00,"providers":[{"billed_charge":7020.00,"npi":[1487167045]}]},{"allowed_amount":4380.00,"providers":[{"billed_charge":5400.00,"npi":[1487167045,1053562389,1811134653]}]}]},{"tin":{"type":"ein","value":"272253123"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1094.34,"providers":[{"billed_charge":1140.00,"npi":[1821472655]}]},{"allowed_amount":3638.24,"providers":[{"billed_charge":3760.00,"npi":[1902277924]}]},{"allowed_amount":734.34,"providers":[{"billed_charge":780.00,"npi":[1679806780]}]},{"allowed_amount":3614.34,"providers":[{"billed_charge":3660.00,"npi":[1679806780]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1861786436]}]},{"allowed_amount":7233.46,"providers":[{"billed_charge":7355.00,"npi":[1861786436]}]},{"allowed_amount":549.56,"providers":[{"billed_charge":580.00,"npi":[1902277924]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1015.00,"npi":[1629247564]}]},{"allowed_amount":9801.26,"providers":[{"billed_charge":10075.00,"npi":[1629247564]}]}]},{"tin":{"type":"ein","value":"922116792"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3296.70,"providers":[{"billed_charge":3450.00,"npi":[1134337744]}]},{"allowed_amount":23174.70,"providers":[{"billed_charge":24350.00,"npi":[1134337744]}]}]},{"tin":{"type":"ein","value":"261598119"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":660.00,"providers":[{"billed_charge":660.00,"npi":[1205003688]}]},{"allowed_amount":4125.00,"providers":[{"billed_charge":4125.00,"npi":[1063689560]}]},{"allowed_amount":330.00,"providers":[{"billed_charge":330.00,"npi":[1205003688]}]},{"allowed_amount":2310.00,"providers":[{"billed_charge":2310.00,"npi":[1356595540,1932247392]}]},{"allowed_amount":7755.00,"providers":[{"billed_charge":7755.00,"npi":[1932247392]}]},{"allowed_amount":5280.00,"providers":[{"billed_charge":5280.00,"npi":[1063689560]}]},{"allowed_amount":3300.00,"providers":[{"billed_charge":3300.00,"npi":[1356595540]}]}]},{"tin":{"type":"ein","value":"994127997"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":9601.02,"providers":[{"billed_charge":10400.00,"npi":[1659915577]}]}]},{"tin":{"type":"ein","value":"822571151"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":275.00,"npi":[1699199398]}]}]},{"tin":{"type":"ein","value":"200551714"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":225.00,"npi":[1154535169]}]},{"allowed_amount":108.73,"providers":[{"billed_charge":225.00,"npi":[1548712052]}]},{"allowed_amount":2217.36,"providers":[{"billed_charge":2700.00,"npi":[1154535169]}]}]},{"tin":{"type":"ein","value":"461893699"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4025.00,"providers":[{"billed_charge":4025.00,"npi":[1356458269]}]},{"allowed_amount":2275.00,"providers":[{"billed_charge":2275.00,"npi":[1356458269]}]}]},{"tin":{"type":"ein","value":"465146722"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":369.56,"providers":[{"billed_charge":440.00,"npi":[1518306158]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":220.00,"npi":[1518306158]}]}]},{"tin":{"type":"ein","value":"831555272"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":3691.83,"providers":[{"billed_charge":3700.00,"npi":[1912298811]}]}]},{"tin":{"type":"ein","value":"300760503"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":1108.68,"providers":[{"billed_charge":1140.00,"npi":[1760712186]}]}]},{"tin":{"type":"ein","value":"815312220"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":175.00,"providers":[{"billed_charge":175.00,"npi":[1760511489]}]}]},{"tin":{"type":"ein","value":"883668780"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1780432302]}]}]},{"tin":{"type":"ein","value":"831159576"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1293.51,"providers":[{"billed_charge":1400.00,"npi":[1679913743]}]},{"allowed_amount":1478.24,"providers":[{"billed_charge":1600.00,"npi":[1629463385]}]},{"allowed_amount":6833.09,"providers":[{"billed_charge":7400.00,"npi":[1629463385]}]},{"allowed_amount":1108.73,"providers":[{"billed_charge":1200.00,"npi":[1679913743]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":1255.28,"npi":[1295378289]}]},{"allowed_amount":2402.14,"providers":[{"billed_charge":4079.66,"npi":[1649884560]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":627.64,"npi":[1295004836]}]},{"allowed_amount":181.01,"providers":[{"billed_charge":313.82,"npi":[1649884560]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":941.46,"npi":[1639835499]}]}]},{"tin":{"type":"ein","value":"842610637"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":450.00,"providers":[{"billed_charge":450.00,"npi":[1295923878]}]},{"allowed_amount":2700.00,"providers":[{"billed_charge":2700.00,"npi":[1295923878]}]}]},{"tin":{"type":"ein","value":"920877585"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3141.26,"providers":[{"billed_charge":3740.00,"npi":[1861873929]}]},{"allowed_amount":1847.80,"providers":[{"billed_charge":2200.00,"npi":[1861873929]}]}]},{"tin":{"type":"ein","value":"922525306"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":18419.32,"providers":[{"billed_charge":19380.00,"npi":[1912115353]}]},{"allowed_amount":1808.68,"providers":[{"billed_charge":1870.00,"npi":[1912115353]}]}]},{"tin":{"type":"ein","value":"824818957"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2718.25,"providers":[{"billed_charge":6000.00,"npi":[1760076608]}]}]},{"tin":{"type":"ein","value":"814430335"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1700.00,"providers":[{"billed_charge":1700.00,"npi":[1659422160]}]}]},{"tin":{"type":"ein","value":"883432860"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4246.17,"providers":[{"billed_charge":4600.00,"npi":[1821743105]}]},{"allowed_amount":1663.02,"providers":[{"billed_charge":1800.00,"npi":[1821743105]}]}]},{"tin":{"type":"ein","value":"474270177"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":904.34,"providers":[{"billed_charge":950.00,"npi":[1477713659]}]},{"allowed_amount":350.00,"providers":[{"billed_charge":350.00,"npi":[1164010484]}]},{"allowed_amount":5339.06,"providers":[{"billed_charge":5750.00,"npi":[1164010484]}]},{"allowed_amount":1293.46,"providers":[{"billed_charge":1400.00,"npi":[1700244027]}]},{"allowed_amount":1838.02,"providers":[{"billed_charge":1975.00,"npi":[1700244027]}]},{"allowed_amount":1993.46,"providers":[{"billed_charge":2100.00,"npi":[1477713659]}]}]},{"tin":{"type":"ein","value":"464518730"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":195.72,"providers":[{"billed_charge":225.00,"npi":[1407029606]}]},{"allowed_amount":2935.80,"providers":[{"billed_charge":3375.00,"npi":[1407029606]}]}]},{"tin":{"type":"ein","value":"842463871"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":6299.88,"providers":[{"billed_charge":7250.00,"npi":[1215208392]}]}]},{"tin":{"type":"ein","value":"883048824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11025.00,"providers":[{"billed_charge":11025.00,"npi":[1942920947]}]}]},{"tin":{"type":"ein","value":"473259723"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":10902.02,"providers":[{"billed_charge":14750.00,"npi":[1902929417]}]},{"allowed_amount":2575.61,"providers":[{"billed_charge":3500.00,"npi":[1952798423]}]},{"allowed_amount":8122.83,"providers":[{"billed_charge":11000.00,"npi":[1902929417]}]},{"allowed_amount":9046.68,"providers":[{"billed_charge":12250.00,"npi":[1073110524]}]},{"allowed_amount":2209.82,"providers":[{"billed_charge":3000.00,"npi":[1902929417]}]},{"allowed_amount":1293.46,"providers":[{"billed_charge":1750.00,"npi":[1952798423]}]},{"allowed_amount":4057.62,"providers":[{"billed_charge":5500.00,"npi":[1073110524]}]},{"allowed_amount":923.90,"providers":[{"billed_charge":1250.00,"npi":[1124474556]}]}]},{"tin":{"type":"ein","value":"872003703"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":369.56,"providers":[{"billed_charge":400.00,"npi":[1760887236]}]}]},{"tin":{"type":"ein","value":"833960299"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1108.68,"providers":[{"billed_charge":1800.00,"npi":[1376915215]}]},{"allowed_amount":4246.17,"providers":[{"billed_charge":6900.00,"npi":[1376915215]}]}]},{"tin":{"type":"ein","value":"812870947"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":739.17,"providers":[{"billed_charge":900.00,"npi":[1558752634]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":225.00,"npi":[1558752634]}]}]},{"tin":{"type":"ein","value":"823884531"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":525.00,"providers":[{"billed_charge":525.00,"npi":[1073529491]}]},{"allowed_amount":2625.00,"providers":[{"billed_charge":2625.00,"npi":[1073529491]}]}]},{"tin":{"type":"ein","value":"823876873"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":700.00,"providers":[{"billed_charge":700.00,"npi":[1912079245]}]}]},{"tin":{"type":"ein","value":"830667220"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6093.97,"providers":[{"billed_charge":7260.00,"npi":[1891933826]}]}]},{"tin":{"type":"ein","value":"473599124"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4599.06,"providers":[{"billed_charge":6195.00,"npi":[1700412012]}]},{"allowed_amount":11160.14,"providers":[{"billed_charge":15045.00,"npi":[1942695572]}]},{"allowed_amount":2847.00,"providers":[{"billed_charge":3835.00,"npi":[1942695572]}]},{"allowed_amount":1533.00,"providers":[{"billed_charge":2065.00,"npi":[1851937171]}]},{"allowed_amount":2409.00,"providers":[{"billed_charge":3245.00,"npi":[1467890756]}]},{"allowed_amount":219.00,"providers":[{"billed_charge":295.00,"npi":[1700412012,1073012621]}]},{"allowed_amount":4380.00,"providers":[{"billed_charge":5900.00,"npi":[1295489987]}]},{"allowed_amount":438.00,"providers":[{"billed_charge":590.00,"npi":[1467890756]}]}]},{"tin":{"type":"ein","value":"454787259"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2027.80,"providers":[{"billed_charge":2680.00,"npi":[1003200270]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":500.00,"npi":[1558228023]}]},{"allowed_amount":1293.46,"providers":[{"billed_charge":1750.00,"npi":[1558228023]}]}]},{"tin":{"type":"ein","value":"822090910"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3510.82,"providers":[{"billed_charge":3800.00,"npi":[1972083319]}]},{"allowed_amount":6825.65,"providers":[{"billed_charge":7400.00,"npi":[1659418648]}]},{"allowed_amount":3326.09,"providers":[{"billed_charge":3600.00,"npi":[1184254120]}]}]},{"tin":{"type":"ein","value":"260728292"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":184.78,"providers":[{"billed_charge":217.93,"npi":[1801382957]}]}]},{"tin":{"type":"ein","value":"931482298"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":739.12,"providers":[{"billed_charge":800.00,"npi":[1720538069]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":200.00,"npi":[1720538069]}]}]},{"tin":{"type":"ein","value":"710526149"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1478.24,"providers":[{"billed_charge":1670.88,"npi":[1679026207]}]},{"allowed_amount":3137.49,"providers":[{"billed_charge":3550.62,"npi":[1033954201]}]},{"allowed_amount":1108.68,"providers":[{"billed_charge":1253.16,"npi":[1033954201]}]},{"allowed_amount":652.38,"providers":[{"billed_charge":1253.16,"npi":[1104791664]}]},{"allowed_amount":184.78,"providers":[{"billed_charge":208.86,"npi":[1679026207]}]},{"allowed_amount":108.73,"providers":[{"billed_charge":208.86,"npi":[1104791664]}]},{"allowed_amount":554.34,"providers":[{"billed_charge":626.58,"npi":[1992371249]}]}]},{"tin":{"type":"ein","value":"274969636"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1478.24,"providers":[{"billed_charge":1720.00,"npi":[1053720144]}]},{"allowed_amount":369.56,"providers":[{"billed_charge":430.00,"npi":[1053720144]}]}]},{"tin":{"type":"ein","value":"833367250"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2032.58,"providers":[{"billed_charge":2387.00,"npi":[1114409174]}]},{"allowed_amount":554.39,"providers":[{"billed_charge":651.00,"npi":[1316328685]}]},{"allowed_amount":1108.68,"providers":[{"billed_charge":1302.00,"npi":[1316328685]}]},{"allowed_amount":6648.31,"providers":[{"billed_charge":7812.00,"npi":[1114409174]}]}]},{"tin":{"type":"ein","value":"474972316"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1800.00,"providers":[{"billed_charge":1800.00,"npi":[1801234752]}]}]},{"tin":{"type":"ein","value":"273363386"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3780.00,"providers":[{"billed_charge":3780.00,"npi":[1942255336]}]},{"allowed_amount":180.00,"providers":[{"billed_charge":180.00,"npi":[1942255336]}]},{"allowed_amount":4860.00,"providers":[{"billed_charge":4860.00,"npi":[1942255336]}]}]},{"tin":{"type":"ein","value":"901498800"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":8318.00,"providers":[{"billed_charge":12850.00,"npi":[1184054819]}]},{"allowed_amount":3160.84,"providers":[{"billed_charge":4883.00,"npi":[1184054819]}]}]}]},{"name":"PSYTX W PT W E/M 60 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90838","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"993161677"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5492.76,"providers":[{"billed_charge":8325.00,"npi":[1598417511]}]}]}]},{"name":"FAMILY PSYTX W/PT 50 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90847","description":"FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT), 50 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"462017854"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":583.96,"providers":[{"billed_charge":1080.00,"npi":[1487167045]}]}]}]},{"name":"GROUP PSYCHOTHERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90853","description":"GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","allowed_amounts":[{"tin":{"type":"ein","value":"851940021"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":491.53,"providers":[{"billed_charge":1520.00,"npi":[1396946414]}]}]},{"tin":{"type":"ein","value":"710391252"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":267.60,"providers":[{"billed_charge":327.20,"npi":[1215775580]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":16406.82,"providers":[{"billed_charge":16406.82,"npi":[1770212219]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3545.70,"providers":[{"billed_charge":15900.00,"npi":[1588090526]}]}]},{"tin":{"type":"ein","value":"853231473"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":167.25,"providers":[{"billed_charge":250.00,"npi":[1720125578]}]}]},{"tin":{"type":"ein","value":"833367250"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":133.80,"providers":[{"billed_charge":868.00,"npi":[1316328685]}]}]}]},{"name":"TCRANIAL MAGN STIM TX DELI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90868","description":"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MA","allowed_amounts":[{"tin":{"type":"ein","value":"710772737"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1668.96,"providers":[{"billed_charge":2664.00,"npi":[1922066232]}]}]}]},{"name":"PSTAY/PARTIAL HOSP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"912","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - PARTIAL HOSPITALIZATION","allowed_amounts":[{"tin":{"type":"ein","value":"844037448"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":195300.00,"providers":[{"billed_charge":2669100.00,"npi":[1285273219]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4080.00,"providers":[{"billed_charge":8500.00,"npi":[1447723143]}]}]}]},{"name":"PSYCHIATRIC CARE INTENSIVE 4","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"913","description":"PSYCHIATRIC CARE INTENSIVE 4-6 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"833494125"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":760.00,"providers":[{"billed_charge":5990.00,"npi":[1609409762]}]}]},{"tin":{"type":"ein","value":"993814008"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":13680.00,"providers":[{"billed_charge":42750.00,"npi":[1104663889]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3600.00,"providers":[{"billed_charge":7500.00,"npi":[1447723143]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":126300.00,"providers":[{"billed_charge":128640.00,"npi":[1447099056]}]}]},{"tin":{"type":"ein","value":"264282327"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":103800.00,"providers":[{"billed_charge":138400.00,"npi":[1467196386]}]}]},{"tin":{"type":"ein","value":"461281853"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3465.00,"providers":[{"billed_charge":43945.00,"npi":[1457232589]}]}]},{"tin":{"type":"ein","value":"993998533"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8400.00,"providers":[{"billed_charge":94500.00,"npi":[1326916503]}]}]}]},{"name":"PSTAY/GROUP RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"915","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - GROUP THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"710744870"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":463.65,"providers":[{"billed_charge":1561.65,"npi":[1467402826]}]}]}]},{"name":"PERI VASCUL LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"921","description":"OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB","allowed_amounts":[{"tin":{"type":"ein","value":"752796815"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1236.40,"providers":[{"billed_charge":11002.00,"npi":[1295736734]}]}]}]},{"name":"SPEECH/HEARING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92507","description":"TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER; INDIVIDUAL","allowed_amounts":[{"tin":{"type":"ein","value":"461932718"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2081.98,"providers":[{"billed_charge":2643.28,"npi":[1083282834]}]}]},{"tin":{"type":"ein","value":"710259137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":154.64,"providers":[{"billed_charge":260.00,"npi":[1821872888]}]}]}]},{"name":"ELECTROCARDIOGRAM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93000","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"812831831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":155.25,"providers":[{"billed_charge":297.72,"npi":[1053305466]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"710236870"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":255.68,"providers":[{"billed_charge":580.00,"npi":[1811921455]}]}]},{"tin":{"type":"ein","value":"710290019"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":1068.88,"providers":[{"billed_charge":4340.00,"npi":[1811983398]}]},{"allowed_amount":17.24,"providers":[{"billed_charge":70.00,"npi":[1851324446]}]},{"allowed_amount":129.30,"providers":[{"billed_charge":525.00,"npi":[1003066846]}]},{"allowed_amount":8.62,"providers":[{"billed_charge":35.00,"npi":[1811983398]}]}]}]},{"name":"TTE W/DOPPLER COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93306","description":"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W IMG DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN","allowed_amounts":[{"tin":{"type":"ein","value":"716046242"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":450.24,"providers":[{"billed_charge":1554.00,"npi":[1104919182]}]}]}]},{"name":"CARDIAC REHAB/MONITOR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93798","description":"PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL SERVICES FOR OUTPATIENT CARDIAC REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"710704090"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":612.24,"providers":[{"billed_charge":1200.00,"npi":[1629181433]}]}]}]},{"name":"MEASURE BLOOD OXYGEN LEVEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"94762","description":"NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING (SEPARAT","allowed_amounts":[{"tin":{"type":"ein","value":"474761522"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":231.70,"providers":[{"billed_charge":1000.00,"npi":[1437525607]}]}]},{"tin":{"type":"ein","value":"203360918"},"service_code":["11","12"],"billing_class":"professional","payments":[{"allowed_amount":1375.50,"providers":[{"billed_charge":3000.00,"npi":[1518906940]}]},{"allowed_amount":25.12,"providers":[{"billed_charge":50.00,"npi":[1518906940]}]}]}]},{"name":"SLP STDY UNATTENDED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95800","description":"SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; HEART RATE, OXYGEN SATURATION, RESPIRATORY ANALYSIS","allowed_amounts":[{"tin":{"type":"ein","value":"262531558"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":7139.53,"providers":[{"billed_charge":51600.00,"npi":[1861655961]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"800264610"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":27.48,"providers":[{"billed_charge":150.00,"npi":[1790014447]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":110.39,"providers":[{"billed_charge":120.00,"npi":[1275558918]}]},{"allowed_amount":10.00,"providers":[{"billed_charge":10.00,"npi":[1861695132]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96372","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":483.12,"providers":[{"billed_charge":800.00,"npi":[1275558918]}]},{"allowed_amount":132.75,"providers":[{"billed_charge":240.00,"npi":[1861695132]}]}]},{"tin":{"type":"ein","value":"473988813"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":325.25,"providers":[{"billed_charge":480.24,"npi":[1043527336]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["72","20"],"billing_class":"professional","payments":[{"allowed_amount":229.59,"providers":[{"billed_charge":419.04,"npi":[1033659677]}]},{"allowed_amount":51.02,"providers":[{"billed_charge":93.12,"npi":[1033659677]}]},{"allowed_amount":325.22,"providers":[{"billed_charge":698.40,"npi":[1790404499]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.93,"providers":[{"billed_charge":32.40,"npi":[1861925331]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":31.86,"providers":[{"billed_charge":64.80,"npi":[1669868691]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":86.72,"providers":[{"billed_charge":137.96,"npi":[1124469887]}]}]}]},{"name":"MECHANICAL TRACTION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97012","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; TRACTION, MECHANICAL","allowed_amounts":[{"tin":{"type":"ein","value":"562646164"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.38,"providers":[{"billed_charge":52.00,"npi":[1922436864]}]}]}]},{"name":"ELECTRIC STIMULATION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97014","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED)","allowed_amounts":[{"tin":{"type":"ein","value":"271222951"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":388.08,"providers":[{"billed_charge":840.00,"npi":[1376698662]}]}]},{"tin":{"type":"ein","value":"710412695"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":471.25,"providers":[{"billed_charge":1000.00,"npi":[1205449527]}]}]}]},{"name":"ELECTRICAL STIMULATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97032","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.80,"providers":[{"billed_charge":176.00,"npi":[1629085931]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"710259137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":386.91,"providers":[{"billed_charge":1140.00,"npi":[1689340705]}]}]},{"tin":{"type":"ein","value":"621665314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1994.70,"providers":[{"billed_charge":2897.50,"npi":[1790430759]}]}]},{"tin":{"type":"ein","value":"710412695"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3292.56,"providers":[{"billed_charge":4560.00,"npi":[1205449527]}]}]},{"tin":{"type":"ein","value":"475240622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":33.98,"providers":[{"billed_charge":100.00,"npi":[1558170381]}]},{"allowed_amount":1741.49,"providers":[{"billed_charge":4800.00,"npi":[1427438720]}]}]}]},{"name":"NEUROMUSCULAR REEDUCATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97112","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALA","allowed_amounts":[{"tin":{"type":"ein","value":"631133454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":101.34,"providers":[{"billed_charge":135.00,"npi":[1316314479]}]}]}]},{"name":"MANUAL THERAPY 1/> REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97140","description":"MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTIO","allowed_amounts":[{"tin":{"type":"ein","value":"631133454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":555.30,"providers":[{"billed_charge":779.00,"npi":[1316314479]}]}]},{"tin":{"type":"ein","value":"710412695"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1128.97,"providers":[{"billed_charge":1680.00,"npi":[1205449527]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"710123680"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5730.00,"providers":[{"billed_charge":5730.00,"npi":[1912557315]}]}]}]},{"name":"THERAPEUTIC ACTIVITIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97530","description":"THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FU","allowed_amounts":[{"tin":{"type":"ein","value":"710259137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":158.37,"providers":[{"billed_charge":360.00,"npi":[1578229878]}]}]},{"tin":{"type":"ein","value":"621665314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":281.68,"providers":[{"billed_charge":380.00,"npi":[1699219717]}]}]},{"tin":{"type":"ein","value":"475240622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":209.61,"providers":[{"billed_charge":750.00,"npi":[1427438720]}]}]}]},{"name":"CHIROPRACT MANJ 1-2 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98940","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 1-2 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"710817843"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":198.73,"providers":[{"billed_charge":350.00,"npi":[1568508620]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98941","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"911947465"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":247.92,"providers":[{"billed_charge":414.00,"npi":[1306854625]}]}]},{"tin":{"type":"ein","value":"451744689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1891.76,"providers":[{"billed_charge":1938.00,"npi":[1922108000]}]}]},{"tin":{"type":"ein","value":"562646164"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":277.28,"providers":[{"billed_charge":360.00,"npi":[1922436864]}]}]},{"tin":{"type":"ein","value":"271222951"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":4421.24,"providers":[{"billed_charge":5457.00,"npi":[1376698662]}]}]},{"tin":{"type":"ein","value":"760824513"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":247.92,"providers":[{"billed_charge":330.00,"npi":[1306892963]}]}]},{"tin":{"type":"ein","value":"710817843"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":537.16,"providers":[{"billed_charge":650.00,"npi":[1568508620]}]}]},{"tin":{"type":"ein","value":"270130512"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.64,"providers":[{"billed_charge":130.00,"npi":[1598801003]}]}]}]},{"name":"CHIROPRACTIC MANJ 5 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98942","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1518.33,"providers":[{"billed_charge":1963.50,"npi":[1629085931]}]}]}]},{"name":"CHIROPRACT MANJ XTRSPINL 1/>","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98943","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); EXTRASPINAL, 1 OR MORE REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"451744689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":989.70,"providers":[{"billed_charge":1500.00,"npi":[1922108000]}]}]}]},{"name":"MED SERV EVE/WKEND/HOLIDAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99051","description":"SERVICE(S) PROVIDED IN THE OFFICE DURING REGULARLY SCHEDULED EVENING, WEEKEND, OR HOLIDAY OFFICE HOU","allowed_amounts":[{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.81,"providers":[{"billed_charge":60.00,"npi":[1063207538]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2401.92,"providers":[{"billed_charge":7110.00,"npi":[1255405379]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":877.27,"providers":[{"billed_charge":1200.00,"npi":[1275558918]}]},{"allowed_amount":3132.00,"providers":[{"billed_charge":4320.00,"npi":[1861695132]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99205","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"813521979"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":628.47,"providers":[{"billed_charge":1245.00,"npi":[1750328233]}]}]}]},{"name":"OFFICE OR OTH OUTPATIENT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99212","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"810576831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":638.69,"providers":[{"billed_charge":1054.00,"npi":[1861825911]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":371.45,"providers":[{"billed_charge":385.56,"npi":[1740762905]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":158.85,"providers":[{"billed_charge":370.80,"npi":[1770143604]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["02","50"],"billing_class":"professional","payments":[{"allowed_amount":53.15,"providers":[{"billed_charge":112.89,"npi":[1598286734]}]},{"allowed_amount":425.20,"providers":[{"billed_charge":903.12,"npi":[1598286734]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":344.04,"providers":[{"billed_charge":540.00,"npi":[1780497909]}]},{"allowed_amount":86.01,"providers":[{"billed_charge":135.00,"npi":[1043109432]}]}]},{"tin":{"type":"ein","value":"861082670"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":344.04,"providers":[{"billed_charge":460.00,"npi":[1811630304]}]}]},{"tin":{"type":"ein","value":"611570855"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2251.44,"providers":[{"billed_charge":3150.00,"npi":[1871172544]}]}]},{"tin":{"type":"ein","value":"710638760"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":73.30,"providers":[{"billed_charge":110.40,"npi":[1194293928]}]},{"allowed_amount":1539.30,"providers":[{"billed_charge":2318.40,"npi":[1194293928]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1977.11,"providers":[{"billed_charge":4636.80,"npi":[1861925331]}]},{"allowed_amount":344.04,"providers":[{"billed_charge":806.40,"npi":[1093238875,1023614880,1063296333]}]},{"allowed_amount":430.05,"providers":[{"billed_charge":1008.00,"npi":[1063207538]}]},{"allowed_amount":1376.22,"providers":[{"billed_charge":3225.60,"npi":[1669850384]}]},{"allowed_amount":2408.28,"providers":[{"billed_charge":5644.80,"npi":[1598440224]}]},{"allowed_amount":1031.06,"providers":[{"billed_charge":2419.20,"npi":[1275105983]}]},{"allowed_amount":946.11,"providers":[{"billed_charge":2217.60,"npi":[1871032003]}]},{"allowed_amount":602.07,"providers":[{"billed_charge":1411.20,"npi":[1023996600]}]},{"allowed_amount":1333.16,"providers":[{"billed_charge":3225.60,"npi":[1104169895]}]},{"allowed_amount":172.02,"providers":[{"billed_charge":403.20,"npi":[1033960265]}]}]},{"tin":{"type":"ein","value":"710787860"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2493.17,"providers":[{"billed_charge":4350.00,"npi":[1043611502]}]},{"allowed_amount":3009.23,"providers":[{"billed_charge":5250.00,"npi":[1154128676]}]}]},{"tin":{"type":"ein","value":"452901217"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1806.21,"providers":[{"billed_charge":2362.50,"npi":[1063396737]}]},{"allowed_amount":86.01,"providers":[{"billed_charge":112.50,"npi":[1063396737]}]}]},{"tin":{"type":"ein","value":"932686392"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":86.01,"providers":[{"billed_charge":201.60,"npi":[1588321376]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":29247.46,"providers":[{"billed_charge":32984.21,"npi":[1073099198]}]},{"allowed_amount":1099.50,"providers":[{"billed_charge":1405.65,"npi":[1033193966]}]}]},{"tin":{"type":"ein","value":"208881376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4759.15,"providers":[{"billed_charge":4759.39,"npi":[1609439611]}]}]},{"tin":{"type":"ein","value":"721332678"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":62.31,"providers":[{"billed_charge":185.44,"npi":[1871826958]}]},{"allowed_amount":747.72,"providers":[{"billed_charge":2200.88,"npi":[1871826958]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":511.84,"providers":[{"billed_charge":910.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"237128104"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":709.11,"providers":[{"billed_charge":1848.00,"npi":[1558594424]}]},{"allowed_amount":1922.61,"providers":[{"billed_charge":3192.00,"npi":[1427344647]}]},{"allowed_amount":101.19,"providers":[{"billed_charge":168.00,"npi":[1427344647]}]},{"allowed_amount":747.72,"providers":[{"billed_charge":2016.00,"npi":[1881256220]}]}]},{"tin":{"type":"ein","value":"716042625"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":659.70,"providers":[{"billed_charge":1215.00,"npi":[1346220449]}]}]},{"tin":{"type":"ein","value":"611810471"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":39.26,"providers":[{"billed_charge":39.26,"npi":[1225518384]}]},{"allowed_amount":78.52,"providers":[{"billed_charge":78.52,"npi":[1225518384]}]}]},{"tin":{"type":"ein","value":"831529526"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":255.79,"providers":[{"billed_charge":331.20,"npi":[1386397651]}]},{"allowed_amount":172.02,"providers":[{"billed_charge":220.80,"npi":[1386397651]}]}]},{"tin":{"type":"ein","value":"800264610"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":436.17,"providers":[{"billed_charge":952.00,"npi":[1790014447]}]}]},{"tin":{"type":"ein","value":"263442072"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":897.60,"providers":[{"billed_charge":1187.50,"npi":[1902683980]}]},{"allowed_amount":84.89,"providers":[{"billed_charge":115.00,"npi":[1902683980]}]}]},{"tin":{"type":"ein","value":"465020263"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":952.90,"providers":[{"billed_charge":1261.00,"npi":[1477540532]}]}]},{"tin":{"type":"ein","value":"710411459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":172.02,"providers":[{"billed_charge":248.00,"npi":[1861964447]}]}]},{"tin":{"type":"ein","value":"710433902"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1467.94,"providers":[{"billed_charge":2880.40,"npi":[1962903054]}]},{"allowed_amount":373.86,"providers":[{"billed_charge":909.60,"npi":[1740811793]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":10589.53,"providers":[{"billed_charge":15870.00,"npi":[1275558918]}]},{"allowed_amount":7294.96,"providers":[{"billed_charge":11270.00,"npi":[1861695132]}]},{"allowed_amount":659.70,"providers":[{"billed_charge":1035.00,"npi":[1275558918]}]},{"allowed_amount":568.88,"providers":[{"billed_charge":805.00,"npi":[1275558918]}]},{"allowed_amount":348.98,"providers":[{"billed_charge":460.00,"npi":[1386623049]}]},{"allowed_amount":73.30,"providers":[{"billed_charge":115.00,"npi":[1831353937]}]},{"allowed_amount":540.99,"providers":[{"billed_charge":805.00,"npi":[1861695132]}]},{"allowed_amount":1099.50,"providers":[{"billed_charge":1725.00,"npi":[1831353937]}]}]},{"tin":{"type":"ein","value":"710276839"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":404.76,"providers":[{"billed_charge":540.75,"npi":[1912647355]}]}]},{"tin":{"type":"ein","value":"261125131"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2559.20,"providers":[{"billed_charge":4550.00,"npi":[1417210543]}]}]},{"tin":{"type":"ein","value":"800537979"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":654.08,"providers":[{"billed_charge":1925.00,"npi":[1972820215]}]}]},{"tin":{"type":"ein","value":"954896822"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":249.24,"providers":[{"billed_charge":640.00,"npi":[1902427925]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":73.83,"providers":[{"billed_charge":113.99,"npi":[1891544888]}]},{"allowed_amount":1113.09,"providers":[{"billed_charge":1253.89,"npi":[1477321917]}]},{"allowed_amount":882.93,"providers":[{"billed_charge":1139.90,"npi":[1982082038]}]},{"allowed_amount":504.64,"providers":[{"billed_charge":569.95,"npi":[1598145948]}]}]},{"tin":{"type":"ein","value":"200817011"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":717.75,"providers":[{"billed_charge":1305.00,"npi":[1255992897]}]}]},{"tin":{"type":"ein","value":"334209442"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1744.68,"providers":[{"billed_charge":2844.80,"npi":[1265532899]}]}]},{"tin":{"type":"ein","value":"710837110"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2363.14,"providers":[{"billed_charge":2600.00,"npi":[1699778407]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["22","02"],"billing_class":"professional","payments":[{"allowed_amount":463.23,"providers":[{"billed_charge":1350.00,"npi":[1164083747]}]},{"allowed_amount":154.41,"providers":[{"billed_charge":450.00,"npi":[1164083747]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2924.34,"providers":[{"billed_charge":6854.40,"npi":[1780075473]}]},{"allowed_amount":344.04,"providers":[{"billed_charge":806.40,"npi":[1780075473]}]},{"allowed_amount":3095.30,"providers":[{"billed_charge":7257.60,"npi":[1669868691]}]},{"allowed_amount":258.03,"providers":[{"billed_charge":604.80,"npi":[1669868691]}]},{"allowed_amount":86.01,"providers":[{"billed_charge":201.60,"npi":[1356179436]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":186.93,"providers":[{"billed_charge":397.44,"npi":[1922632033]}]},{"allowed_amount":1290.15,"providers":[{"billed_charge":1987.20,"npi":[1831665744]}]},{"allowed_amount":934.65,"providers":[{"billed_charge":1987.20,"npi":[1245680321]}]},{"allowed_amount":5981.76,"providers":[{"billed_charge":12718.08,"npi":[1801373824]}]},{"allowed_amount":1744.68,"providers":[{"billed_charge":3709.44,"npi":[1831807650]}]},{"allowed_amount":602.07,"providers":[{"billed_charge":927.36,"npi":[1003531518]}]},{"allowed_amount":1204.14,"providers":[{"billed_charge":1854.72,"npi":[1003531518]}]},{"allowed_amount":2554.71,"providers":[{"billed_charge":5431.68,"npi":[1124469887]}]},{"allowed_amount":747.72,"providers":[{"billed_charge":1589.76,"npi":[1952993925]}]},{"allowed_amount":86.01,"providers":[{"billed_charge":132.48,"npi":[1831665744]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99214","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1717.94,"providers":[{"billed_charge":2310.00,"npi":[1780497909]}]},{"allowed_amount":653.28,"providers":[{"billed_charge":990.00,"npi":[1932840782]}]},{"allowed_amount":2743.03,"providers":[{"billed_charge":3135.00,"npi":[1528552130]}]},{"allowed_amount":1104.39,"providers":[{"billed_charge":1485.00,"npi":[1043109432]}]},{"allowed_amount":981.68,"providers":[{"billed_charge":1320.00,"npi":[1376996710]}]}]},{"tin":{"type":"ein","value":"912038569"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":719.91,"providers":[{"billed_charge":760.00,"npi":[1528257003]}]}]},{"tin":{"type":"ein","value":"843120559"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":368.13,"providers":[{"billed_charge":675.00,"npi":[1295386613]}]},{"allowed_amount":858.97,"providers":[{"billed_charge":1575.00,"npi":[1295386613]}]},{"allowed_amount":245.42,"providers":[{"billed_charge":450.00,"npi":[1295386613]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4246.32,"providers":[{"billed_charge":15405.00,"npi":[1124687157]}]},{"allowed_amount":6368.46,"providers":[{"billed_charge":16590.00,"npi":[1427772714]}]},{"allowed_amount":5879.52,"providers":[{"billed_charge":21330.00,"npi":[1124687157]}]},{"allowed_amount":20924.94,"providers":[{"billed_charge":54510.00,"npi":[1427772714]}]}]},{"tin":{"type":"ein","value":"261214372"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":418.50,"providers":[{"billed_charge":750.00,"npi":[1295372233]}]},{"allowed_amount":837.00,"providers":[{"billed_charge":1528.00,"npi":[1144836347]}]},{"allowed_amount":2259.90,"providers":[{"billed_charge":4106.00,"npi":[1962947200]}]},{"allowed_amount":397.05,"providers":[{"billed_charge":750.00,"npi":[1225214463]}]},{"allowed_amount":688.56,"providers":[{"billed_charge":1068.00,"npi":[1962947200]}]}]},{"tin":{"type":"ein","value":"710416869"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":122.71,"providers":[{"billed_charge":163.71,"npi":[1346997681]}]},{"allowed_amount":858.97,"providers":[{"billed_charge":1145.97,"npi":[1659548105]}]},{"allowed_amount":245.42,"providers":[{"billed_charge":327.42,"npi":[1659548105]}]}]},{"tin":{"type":"ein","value":"823428904"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":613.55,"providers":[{"billed_charge":1250.00,"npi":[1669155305]}]},{"allowed_amount":2575.26,"providers":[{"billed_charge":5250.00,"npi":[1669155305]}]}]},{"tin":{"type":"ein","value":"455497983"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.88,"providers":[{"billed_charge":180.00,"npi":[1609819077]}]}]},{"tin":{"type":"ein","value":"831529526"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3921.77,"providers":[{"billed_charge":5195.52,"npi":[1386397651]}]},{"allowed_amount":2208.78,"providers":[{"billed_charge":2922.48,"npi":[1386397651]}]}]},{"tin":{"type":"ein","value":"800264610"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":925.50,"providers":[{"billed_charge":1620.00,"npi":[1790014447]}]}]},{"tin":{"type":"ein","value":"263442072"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4903.45,"providers":[{"billed_charge":6760.00,"npi":[1902683980]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":4246.32,"providers":[{"billed_charge":6045.00,"npi":[1831353937]}]},{"allowed_amount":3193.01,"providers":[{"billed_charge":4495.00,"npi":[1275558918]}]},{"allowed_amount":288.74,"providers":[{"billed_charge":310.00,"npi":[1861695132]}]},{"allowed_amount":615.38,"providers":[{"billed_charge":775.00,"npi":[1386623049]}]},{"allowed_amount":108.88,"providers":[{"billed_charge":155.00,"npi":[1831353937]}]},{"allowed_amount":10394.64,"providers":[{"billed_charge":11160.00,"npi":[1922230614]}]},{"allowed_amount":4128.27,"providers":[{"billed_charge":5425.00,"npi":[1275558918]}]},{"allowed_amount":14385.96,"providers":[{"billed_charge":19065.00,"npi":[1861695132]}]},{"allowed_amount":664.60,"providers":[{"billed_charge":930.00,"npi":[1518949429]}]},{"allowed_amount":35653.05,"providers":[{"billed_charge":49290.00,"npi":[1275558918]}]}]},{"tin":{"type":"ein","value":"261125131"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2805.66,"providers":[{"billed_charge":5018.00,"npi":[1417210543]}]}]},{"tin":{"type":"ein","value":"710772737"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4331.10,"providers":[{"billed_charge":6960.00,"npi":[1922066232]}]},{"allowed_amount":2796.32,"providers":[{"billed_charge":5204.00,"npi":[1629784251]}]}]},{"tin":{"type":"ein","value":"461893699"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1569.63,"providers":[{"billed_charge":2080.00,"npi":[1073099198]}]},{"allowed_amount":277.65,"providers":[{"billed_charge":390.00,"npi":[1073099198]}]}]},{"tin":{"type":"ein","value":"861090156"},"service_code":["02","20"],"billing_class":"professional","payments":[{"allowed_amount":122.71,"providers":[{"billed_charge":304.00,"npi":[1235941766]}]},{"allowed_amount":736.26,"providers":[{"billed_charge":1824.00,"npi":[1518362227]}]},{"allowed_amount":2145.57,"providers":[{"billed_charge":6384.00,"npi":[1255405379]}]},{"allowed_amount":2706.80,"providers":[{"billed_charge":6688.00,"npi":[1619749330]}]},{"allowed_amount":1227.10,"providers":[{"billed_charge":3040.00,"npi":[1245948017]}]},{"allowed_amount":2699.62,"providers":[{"billed_charge":6688.00,"npi":[1235941766]}]},{"allowed_amount":185.10,"providers":[{"billed_charge":608.00,"npi":[1063143329]}]}]},{"tin":{"type":"ein","value":"710360221"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":122.71,"providers":[{"billed_charge":126.50,"npi":[1922315613]}]}]},{"tin":{"type":"ein","value":"621684203"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":370.20,"providers":[{"billed_charge":780.00,"npi":[1770695223]}]},{"allowed_amount":135.01,"providers":[{"billed_charge":195.00,"npi":[1649897687]}]}]},{"tin":{"type":"ein","value":"334209442"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":555.30,"providers":[{"billed_charge":860.16,"npi":[1265532899]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2945.04,"providers":[{"billed_charge":3120.00,"npi":[1356038368]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2454.20,"providers":[{"billed_charge":5688.00,"npi":[1932831880]}]},{"allowed_amount":6009.49,"providers":[{"billed_charge":13935.60,"npi":[1669868691]}]},{"allowed_amount":245.42,"providers":[{"billed_charge":568.80,"npi":[1356179436]}]},{"allowed_amount":6747.40,"providers":[{"billed_charge":15642.00,"npi":[1356179436]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1717.94,"providers":[{"billed_charge":2727.62,"npi":[1003531518]}]},{"allowed_amount":832.95,"providers":[{"billed_charge":1753.47,"npi":[1952993925]}]},{"allowed_amount":288.74,"providers":[{"billed_charge":389.66,"npi":[1003097841]}]},{"allowed_amount":7216.56,"providers":[{"billed_charge":9741.50,"npi":[1003097841]}]},{"allowed_amount":185.10,"providers":[{"billed_charge":389.66,"npi":[1922632033]}]},{"allowed_amount":2208.78,"providers":[{"billed_charge":3506.94,"npi":[1831665744]}]},{"allowed_amount":92.55,"providers":[{"billed_charge":194.83,"npi":[1922632033]}]}]},{"tin":{"type":"ein","value":"61833974"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4619.94,"providers":[{"billed_charge":6630.00,"npi":[1831635093]}]}]},{"tin":{"type":"ein","value":"844286440"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":721.85,"providers":[{"billed_charge":818.55,"npi":[1780666495]}]},{"allowed_amount":577.48,"providers":[{"billed_charge":654.84,"npi":[1780666495]}]}]},{"tin":{"type":"ein","value":"842116266"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1080.08,"providers":[{"billed_charge":1328.00,"npi":[1366432247]}]}]},{"tin":{"type":"ein","value":"861082670"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":433.11,"providers":[{"billed_charge":435.00,"npi":[1285862540]}]},{"allowed_amount":2699.62,"providers":[{"billed_charge":3190.00,"npi":[1821752825]}]}]},{"tin":{"type":"ein","value":"883432860"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":368.13,"providers":[{"billed_charge":600.00,"npi":[1104464445]}]},{"allowed_amount":490.84,"providers":[{"billed_charge":800.00,"npi":[1104464445]}]}]},{"tin":{"type":"ein","value":"473988813"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2036.10,"providers":[{"billed_charge":5918.00,"npi":[1043527336]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":2869.05,"providers":[{"billed_charge":6288.04,"npi":[1285327452]}]},{"allowed_amount":1595.23,"providers":[{"billed_charge":2636.92,"npi":[1043028939]}]},{"allowed_amount":1717.94,"providers":[{"billed_charge":2839.76,"npi":[1043931793]}]},{"allowed_amount":1328.21,"providers":[{"billed_charge":2636.92,"npi":[1396191136]}]},{"allowed_amount":2830.88,"providers":[{"billed_charge":5273.84,"npi":[1033659677]}]},{"allowed_amount":1963.36,"providers":[{"billed_charge":3245.44,"npi":[1407629264]}]},{"allowed_amount":8517.83,"providers":[{"billed_charge":11967.56,"npi":[1578026027]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":368.13,"providers":[{"billed_charge":853.20,"npi":[1457801797]}]},{"allowed_amount":122.71,"providers":[{"billed_charge":284.40,"npi":[1205884640,1063296333]}]},{"allowed_amount":2454.20,"providers":[{"billed_charge":5688.00,"npi":[1033696273]}]},{"allowed_amount":859.05,"providers":[{"billed_charge":1990.80,"npi":[1033960265]}]},{"allowed_amount":3926.72,"providers":[{"billed_charge":9100.80,"npi":[1275105983]}]},{"allowed_amount":1225.45,"providers":[{"billed_charge":2844.00,"npi":[1447012158]}]},{"allowed_amount":613.55,"providers":[{"billed_charge":1422.00,"npi":[1083433981]}]},{"allowed_amount":2086.07,"providers":[{"billed_charge":4834.80,"npi":[1245291301]}]},{"allowed_amount":3681.30,"providers":[{"billed_charge":8532.00,"npi":[1023996600]}]},{"allowed_amount":2208.86,"providers":[{"billed_charge":5119.20,"npi":[1861925331]}]},{"allowed_amount":1716.29,"providers":[{"billed_charge":3981.60,"npi":[1417707662]}]},{"allowed_amount":3558.59,"providers":[{"billed_charge":8247.60,"npi":[1457801797]}]}]},{"tin":{"type":"ein","value":"262358356"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3331.80,"providers":[{"billed_charge":9216.00,"npi":[1609979426]}]},{"allowed_amount":3731.18,"providers":[{"billed_charge":8192.00,"npi":[1285724757]}]}]},{"tin":{"type":"ein","value":"832504107"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":4031.60,"providers":[{"billed_charge":4900.00,"npi":[1427144005]}]}]},{"tin":{"type":"ein","value":"710787860"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.10,"providers":[{"billed_charge":329.76,"npi":[1306394465]}]}]},{"tin":{"type":"ein","value":"452901217"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":122.71,"providers":[{"billed_charge":162.50,"npi":[1063396737]}]},{"allowed_amount":8466.99,"providers":[{"billed_charge":11212.50,"npi":[1063396737]}]}]},{"tin":{"type":"ein","value":"932686392"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1595.23,"providers":[{"billed_charge":3697.20,"npi":[1003015348]}]},{"allowed_amount":122.71,"providers":[{"billed_charge":284.40,"npi":[1003015348]}]},{"allowed_amount":736.26,"providers":[{"billed_charge":1706.40,"npi":[1588321376]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13279.57,"providers":[{"billed_charge":15459.36,"npi":[1073099198]}]}]},{"tin":{"type":"ein","value":"993161677"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10302.69,"providers":[{"billed_charge":18900.00,"npi":[1598417511]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1942.38,"providers":[{"billed_charge":3474.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":243.77,"providers":[{"billed_charge":270.60,"npi":[1912663758]}]},{"allowed_amount":1840.65,"providers":[{"billed_charge":2029.50,"npi":[1912663758]}]}]},{"tin":{"type":"ein","value":"237128104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2309.92,"providers":[{"billed_charge":3824.00,"npi":[1720617616]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":433.20,"providers":[{"billed_charge":1254.00,"npi":[1811536931]}]}]},{"tin":{"type":"ein","value":"731547175"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":6195.20,"providers":[{"billed_charge":6528.00,"npi":[1528052107]}]}]},{"tin":{"type":"ein","value":"710561765"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":118.46,"providers":[{"billed_charge":232.00,"npi":[1699123562]}]},{"allowed_amount":355.38,"providers":[{"billed_charge":696.00,"npi":[1699123562]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":122.71,"providers":[{"billed_charge":250.00,"npi":[1487299525,1487422572]}]},{"allowed_amount":13007.26,"providers":[{"billed_charge":26500.00,"npi":[1154194579]}]},{"allowed_amount":5153.82,"providers":[{"billed_charge":10500.00,"npi":[1417238981]}]},{"allowed_amount":736.26,"providers":[{"billed_charge":1500.00,"npi":[1487299525]}]},{"allowed_amount":10430.35,"providers":[{"billed_charge":21250.00,"npi":[1487299525]}]},{"allowed_amount":1104.39,"providers":[{"billed_charge":2250.00,"npi":[1154194579]}]},{"allowed_amount":12881.25,"providers":[{"billed_charge":26250.00,"npi":[1487422572]}]},{"allowed_amount":245.42,"providers":[{"billed_charge":500.00,"npi":[1154194579,1417238981]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2208.78,"providers":[{"billed_charge":2610.00,"npi":[1730479668]}]}]},{"tin":{"type":"ein","value":"333151160"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2249.29,"providers":[{"billed_charge":6847.56,"npi":[1346339066]}]},{"allowed_amount":832.95,"providers":[{"billed_charge":2679.48,"npi":[1346339066]}]}]},{"tin":{"type":"ein","value":"862804596"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1088.80,"providers":[{"billed_charge":2250.00,"npi":[1265587869]}]}]},{"tin":{"type":"ein","value":"931397886"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2057.70,"providers":[{"billed_charge":2097.98,"npi":[1417600099]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":860.02,"providers":[{"billed_charge":1350.96,"npi":[1891544888]}]},{"allowed_amount":866.22,"providers":[{"billed_charge":1013.22,"npi":[1477321917]}]}]},{"tin":{"type":"ein","value":"710408284"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":286.80,"providers":[{"billed_charge":298.00,"npi":[1477585982]}]},{"allowed_amount":144.37,"providers":[{"billed_charge":149.00,"npi":[1558469163]}]},{"allowed_amount":431.17,"providers":[{"billed_charge":704.83,"npi":[1629163274]}]},{"allowed_amount":253.25,"providers":[{"billed_charge":298.00,"npi":[1275596678]}]},{"allowed_amount":866.22,"providers":[{"billed_charge":894.00,"npi":[1477585982]}]},{"allowed_amount":433.11,"providers":[{"billed_charge":704.83,"npi":[1629163274]}]},{"allowed_amount":828.79,"providers":[{"billed_charge":894.00,"npi":[1275596678]}]},{"allowed_amount":108.88,"providers":[{"billed_charge":149.00,"npi":[1275596678]}]},{"allowed_amount":577.48,"providers":[{"billed_charge":596.00,"npi":[1558469163]}]}]},{"tin":{"type":"ein","value":"710836622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":721.85,"providers":[{"billed_charge":725.00,"npi":[1710340088]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99215","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"813521979"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6613.65,"providers":[{"billed_charge":16875.00,"npi":[1750328233]}]}]},{"tin":{"type":"ein","value":"851281892"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":522.96,"providers":[{"billed_charge":714.93,"npi":[1164054649]}]}]},{"tin":{"type":"ein","value":"872968297"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1239.28,"providers":[{"billed_charge":2200.00,"npi":[1447481072]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99223","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2062.68,"providers":[{"billed_charge":3300.00,"npi":[1831206341]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99231","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"352564331"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1319.69,"providers":[{"billed_charge":3480.00,"npi":[1164568598]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["02","21"],"billing_class":"professional","payments":[{"allowed_amount":39.38,"providers":[{"billed_charge":75.00,"npi":[1992371330,1164104543]}]},{"allowed_amount":157.52,"providers":[{"billed_charge":300.00,"npi":[1164104543]}]},{"allowed_amount":551.32,"providers":[{"billed_charge":1050.00,"npi":[1992371330]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99232","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":5979.05,"providers":[{"billed_charge":10934.00,"npi":[1265657274]}]}]},{"tin":{"type":"ein","value":"710813923"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":7306.10,"providers":[{"billed_charge":12089.00,"npi":[1790756195]}]}]},{"tin":{"type":"ein","value":"880857678"},"service_code":["61"],"billing_class":"professional","payments":[{"allowed_amount":277.64,"providers":[{"billed_charge":700.00,"npi":[1154959310]}]}]},{"tin":{"type":"ein","value":"752888880"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1926.21,"providers":[{"billed_charge":3870.00,"npi":[1033797451]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":8460.63,"providers":[{"billed_charge":13080.00,"npi":[1831206341]}]},{"allowed_amount":543.55,"providers":[{"billed_charge":840.00,"npi":[1376664342]}]}]},{"tin":{"type":"ein","value":"621681750"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":911.43,"providers":[{"billed_charge":2457.00,"npi":[1477267193]}]}]},{"tin":{"type":"ein","value":"273705652"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1044.05,"providers":[{"billed_charge":2546.00,"npi":[1881279222]}]}]},{"tin":{"type":"ein","value":"861923754"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":67.32,"providers":[{"billed_charge":520.00,"npi":[1235486440]}]}]},{"tin":{"type":"ein","value":"710408284"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":931.80,"providers":[{"billed_charge":2346.00,"npi":[1629163274]}]}]},{"tin":{"type":"ein","value":"611922162"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2182.63,"providers":[{"billed_charge":14618.70,"npi":[1972457737]}]},{"allowed_amount":648.89,"providers":[{"billed_charge":4346.10,"npi":[1245912898]}]},{"allowed_amount":766.87,"providers":[{"billed_charge":5136.30,"npi":[1477267193,1841861317]}]}]},{"tin":{"type":"ein","value":"932089284"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":388.25,"providers":[{"billed_charge":720.00,"npi":[1124687157]}]}]},{"tin":{"type":"ein","value":"208297311"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1315.22,"providers":[{"billed_charge":4012.00,"npi":[1720749740]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99233","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"710290019"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":270.44,"providers":[{"billed_charge":400.00,"npi":[1114207677]}]}]},{"tin":{"type":"ein","value":"710813923"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":12415.63,"providers":[{"billed_charge":18620.00,"npi":[1790756195]}]}]},{"tin":{"type":"ein","value":"821171262"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1294.92,"providers":[{"billed_charge":1375.00,"npi":[1114995198]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":8711.28,"providers":[{"billed_charge":11100.00,"npi":[1831206341]}]}]},{"tin":{"type":"ein","value":"825023163"},"service_code":["02","21"],"billing_class":"professional","payments":[{"allowed_amount":200.12,"providers":[{"billed_charge":2742.00,"npi":[1225685142]}]},{"allowed_amount":2601.56,"providers":[{"billed_charge":35646.00,"npi":[1326588526]}]},{"allowed_amount":4202.52,"providers":[{"billed_charge":57582.00,"npi":[1326588526]}]}]},{"tin":{"type":"ein","value":"453592104"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":588.60,"providers":[{"billed_charge":690.00,"npi":[1467970954]}]}]},{"tin":{"type":"ein","value":"333761273"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2957.92,"providers":[{"billed_charge":4620.00,"npi":[1235524869]}]}]},{"tin":{"type":"ein","value":"933452980"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1128.01,"providers":[{"billed_charge":2907.06,"npi":[1720670474]}]}]},{"tin":{"type":"ein","value":"208297311"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1177.20,"providers":[{"billed_charge":3200.00,"npi":[1720749740]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99238","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS","allowed_amounts":[{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":815.00,"providers":[{"billed_charge":950.00,"npi":[1265657274]}]}]},{"tin":{"type":"ein","value":"752888880"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":219.77,"providers":[{"billed_charge":400.00,"npi":[1033797451]}]}]},{"tin":{"type":"ein","value":"710408284"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":163.00,"providers":[{"billed_charge":349.00,"npi":[1629163274]}]}]},{"tin":{"type":"ein","value":"611922162"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":146.74,"providers":[{"billed_charge":811.50,"npi":[1346771011]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99239","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1276.91,"providers":[{"billed_charge":1650.00,"npi":[1831206341]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99283","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"710787860"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":128.56,"providers":[{"billed_charge":610.78,"npi":[1336870641]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99284","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"760729179"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3756.69,"providers":[{"billed_charge":9207.00,"npi":[1407380082]},{"billed_charge":9873.00,"npi":[1801268479]}]},{"allowed_amount":834.82,"providers":[{"billed_charge":2046.00,"npi":[1316694466]}]},{"allowed_amount":10017.84,"providers":[{"billed_charge":26328.00,"npi":[1881878064]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5843.74,"providers":[{"billed_charge":15022.00,"npi":[1821785593]},{"billed_charge":18883.00,"npi":[1922627249]}]},{"allowed_amount":417.41,"providers":[{"billed_charge":1152.00,"npi":[1982135000]},{"billed_charge":1119.00,"npi":[1285273326]}]},{"allowed_amount":2087.05,"providers":[{"billed_charge":5695.00,"npi":[1720575822]}]},{"allowed_amount":834.82,"providers":[{"billed_charge":2740.00,"npi":[1023873171]}]},{"allowed_amount":10017.84,"providers":[{"billed_charge":32880.00,"npi":[1609165760]}]},{"allowed_amount":5426.33,"providers":[{"billed_charge":14118.00,"npi":[1942977756]}]},{"allowed_amount":17948.63,"providers":[{"billed_charge":42355.00,"npi":[1629425061]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99285","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"760729179"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2429.48,"providers":[{"billed_charge":5940.00,"npi":[1538746441]}]},{"allowed_amount":5466.33,"providers":[{"billed_charge":14526.00,"npi":[1023579166]}]},{"allowed_amount":10932.66,"providers":[{"billed_charge":26730.00,"npi":[1043954084]}]},{"allowed_amount":7288.44,"providers":[{"billed_charge":19110.00,"npi":[1215679162]}]},{"allowed_amount":13969.51,"providers":[{"billed_charge":34155.00,"npi":[1184203648]}]},{"allowed_amount":1822.11,"providers":[{"billed_charge":4842.00,"npi":[1881878064]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3036.85,"providers":[{"billed_charge":8410.00,"npi":[1679153944]}]},{"allowed_amount":607.37,"providers":[{"billed_charge":1682.00,"npi":[1942913066]},{"billed_charge":1582.00,"npi":[1275095457]}]},{"allowed_amount":17613.73,"providers":[{"billed_charge":59276.00,"npi":[1922627249]}]},{"allowed_amount":1214.74,"providers":[{"billed_charge":3164.00,"npi":[1972308906]}]},{"allowed_amount":7288.44,"providers":[{"billed_charge":20188.00,"npi":[1982135000]}]},{"allowed_amount":4858.96,"providers":[{"billed_charge":13456.00,"npi":[1801250865]}]},{"allowed_amount":6681.07,"providers":[{"billed_charge":18502.00,"npi":[1508362591]}]},{"allowed_amount":16398.99,"providers":[{"billed_charge":55188.00,"npi":[1609165760]}]}]}]},{"name":"CRITICAL CARE, FIRST HOUR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99291","description":"CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJURED PATIENT; FIRST ","allowed_amounts":[{"tin":{"type":"ein","value":"261318597"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1410.25,"providers":[{"billed_charge":2315.00,"npi":[1780160275]}]}]}]},{"name":"HOME VISIT EST PATIENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99349","description":"HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF","allowed_amounts":[{"tin":{"type":"ein","value":"923706167"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":109.96,"providers":[{"billed_charge":250.00,"npi":[1962167874]}]}]}]},{"name":"PROLNG OFF/OP E/M EA 15 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99417","description":"PROLONGED OFFICE/OUTPATIENT E/M SVC EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"851281892"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":118.66,"providers":[{"billed_charge":140.00,"npi":[1164054649]}]}]}]},{"name":"CHRON CARE MGMT SRVC 20 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99490","description":"CHRONIC CARE MANAGEMENT SERVICES, AT LEAST 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":86.24,"providers":[{"billed_charge":176.78,"npi":[1699731091]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"716002614"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1612.80,"providers":[{"billed_charge":1612.80,"npi":[1871693721]}]}]},{"tin":{"type":"ein","value":"716010719"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3683.75,"providers":[{"billed_charge":3683.75,"npi":[1144352998]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34523.55,"providers":[{"billed_charge":45609.20,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2977.20,"providers":[{"billed_charge":2977.20,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"710555170"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13415.21,"providers":[{"billed_charge":14335.65,"npi":[1235129685]}]}]},{"tin":{"type":"ein","value":"716012481"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5051.52,"providers":[{"billed_charge":5445.00,"npi":[1457481053]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":99250.96,"providers":[{"billed_charge":100587.25,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"883095152"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4862.00,"providers":[{"billed_charge":4862.00,"npi":[1164139036]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":605270.95,"providers":[{"billed_charge":777332.60,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"716010996"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":50.00,"providers":[{"billed_charge":50.00,"npi":[1174558530]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":82697.80,"providers":[{"billed_charge":82982.80,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"710699155"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8530.99,"providers":[{"billed_charge":13820.00,"npi":[1285672659]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5449.70,"providers":[{"billed_charge":5449.70,"npi":[1346278348]}]}]},{"tin":{"type":"ein","value":"204139343"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":987.70,"providers":[{"billed_charge":987.70,"npi":[1841242435]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":129654.79,"providers":[{"billed_charge":137637.50,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"716009773"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29320.40,"providers":[{"billed_charge":31518.30,"npi":[1992708804]}]}]},{"tin":{"type":"ein","value":"412078862"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8694.70,"providers":[{"billed_charge":9230.00,"npi":[1912012337]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":157681.59,"providers":[{"billed_charge":170672.56,"npi":[1396736559]}]}]},{"tin":{"type":"ein","value":"716000642"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2317.20,"providers":[{"billed_charge":2317.20,"npi":[1871611459]}]}]},{"tin":{"type":"ein","value":"756000508"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":160.00,"providers":[{"billed_charge":160.00,"npi":[1861530990]}]}]},{"tin":{"type":"ein","value":"626000361"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":94.51,"providers":[{"billed_charge":260.00,"npi":[1942381819]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13579.00,"providers":[{"billed_charge":104765.50,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"710583459"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31079.86,"providers":[{"billed_charge":55577.50,"npi":[1992701981]}]}]},{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":36971.45,"providers":[{"billed_charge":39864.00,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"716010871"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1007.60,"providers":[{"billed_charge":1007.60,"npi":[1881319507]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":129851.00,"providers":[{"billed_charge":139949.70,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"237428478"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":22073.49,"providers":[{"billed_charge":28772.00,"npi":[1831272145]}]}]},{"tin":{"type":"ein","value":"710659515"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":14717.70,"providers":[{"billed_charge":14717.70,"npi":[1053361295]}]}]},{"tin":{"type":"ein","value":"204285867"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33675.00,"providers":[{"billed_charge":33675.00,"npi":[1023055118]}]}]},{"tin":{"type":"ein","value":"251915451"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8048.65,"providers":[{"billed_charge":14443.00,"npi":[1861422560]}]}]}]},{"name":"AMB SVC ALS NON ER TRSPRT L1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0426","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NONEMERGENCY TRANSPORT, LEVEL 1 (ALS 1)","allowed_amounts":[{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9272.25,"providers":[{"billed_charge":10800.00,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5151.25,"providers":[{"billed_charge":8400.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"204285867"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3480.00,"providers":[{"billed_charge":3480.00,"npi":[1023055118]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3090.75,"providers":[{"billed_charge":4635.00,"npi":[1396736559]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"716002614"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":24000.00,"providers":[{"billed_charge":24000.00,"npi":[1871693721]}]}]},{"tin":{"type":"ein","value":"716000642"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20806.70,"providers":[{"billed_charge":20806.70,"npi":[1871611459]}]}]},{"tin":{"type":"ein","value":"716010719"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25800.00,"providers":[{"billed_charge":25800.00,"npi":[1144352998]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2400.00,"providers":[{"billed_charge":2400.00,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23831.20,"providers":[{"billed_charge":26425.00,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"710555170"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2831.24,"providers":[{"billed_charge":2950.00,"npi":[1235129685]}]}]},{"tin":{"type":"ein","value":"626000361"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":398.85,"providers":[{"billed_charge":1260.00,"npi":[1942381819]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3222.08,"providers":[{"billed_charge":44863.12,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"716012481"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13049.92,"providers":[{"billed_charge":13600.00,"npi":[1457481053]}]}]},{"tin":{"type":"ein","value":"710583459"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37518.52,"providers":[{"billed_charge":57500.00,"npi":[1992701981]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":102768.12,"providers":[{"billed_charge":107100.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":944487.96,"providers":[{"billed_charge":1166765.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":112800.00,"providers":[{"billed_charge":112800.00,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":58110.28,"providers":[{"billed_charge":58110.28,"npi":[1346278348]}]}]},{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":65249.60,"providers":[{"billed_charge":91793.20,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"716010871"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12000.00,"providers":[{"billed_charge":12000.00,"npi":[1881319507]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":115818.04,"providers":[{"billed_charge":120700.00,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":147434.17,"providers":[{"billed_charge":170000.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"237428478"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11200.00,"providers":[{"billed_charge":11200.00,"npi":[1831272145]}]}]},{"tin":{"type":"ein","value":"204285867"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5950.00,"providers":[{"billed_charge":5950.00,"npi":[1023055118]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":156599.04,"providers":[{"billed_charge":163008.00,"npi":[1396736559]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0428","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NONEMERGENCY TRANSPORT, (BLS)","allowed_amounts":[{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1717.10,"providers":[{"billed_charge":2415.60,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30049.25,"providers":[{"billed_charge":31500.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":60098.50,"providers":[{"billed_charge":107740.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37776.20,"providers":[{"billed_charge":59972.00,"npi":[1396736559]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0429","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8242.08,"providers":[{"billed_charge":11594.88,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17156.16,"providers":[{"billed_charge":21000.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2625.00,"providers":[{"billed_charge":2625.00,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2035.02,"providers":[{"billed_charge":33647.34,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":35715.68,"providers":[{"billed_charge":36400.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":203304.64,"providers":[{"billed_charge":280920.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30400.00,"providers":[{"billed_charge":30400.00,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9952.80,"providers":[{"billed_charge":9952.80,"npi":[1346278348]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":166215.28,"providers":[{"billed_charge":174482.00,"npi":[1396736559]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0434","description":"SPECIALTY CARE TRANSPORT (SCT)","allowed_amounts":[{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5000.00,"providers":[{"billed_charge":5000.00,"npi":[1477652501]}]}]}]},{"name":"AMB RSPN&TREATMENT NO TRNSPT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0998","description":"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37840.00,"providers":[{"billed_charge":94600.00,"npi":[1477652501]}]}]}]},{"name":"SPLY ALW NONIMPL CGM 1 MO SP=1 UOS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4239","description":"SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":5465.60,"providers":[{"billed_charge":16075.20,"npi":[1234567893]}]}]}]},{"name":"ELECTRODES  PER PAIR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4556","description":"ELECTRODES (E.G., APNEA MONITOR), PER PAIR","allowed_amounts":[{"tin":{"type":"ein","value":"593497691"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":15213.76,"providers":[{"billed_charge":33608.50,"npi":[1124044623]}]}]}]},{"name":"ELEC STIM SPPLS 2 LD PER MTH","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4595","description":"ELECTRICAL STIMULATOR SUPPLIES, 2 LEAD, PER MONTH, (E.G., TENS, NMES)","allowed_amounts":[{"tin":{"type":"ein","value":"593497691"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":76.75,"providers":[{"billed_charge":138.00,"npi":[1124044623]}]}]}]},{"name":"NEG PRSS WND TX PUMP STATN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E2402","description":"NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":11721.72,"providers":[{"billed_charge":29989.30,"npi":[1234567893]}]}]}]},{"name":"PROSTATE CANCER SCREENING","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0103","description":"PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2837.16,"providers":[{"billed_charge":26997.73,"npi":[1265418669]}]}]}]},{"name":"SCR CERV/VAG THIN LAY PHYS I","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0124","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":628.68,"providers":[{"billed_charge":1937.31,"npi":[1265418669]}]}]}]},{"name":"SCR CERV/VAG AUTO&MNL RSCR P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0145","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6237.60,"providers":[{"billed_charge":32790.64,"npi":[1265418669]}]}]}]},{"name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (","allowed_amounts":[{"tin":{"type":"ein","value":"933452980"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":314.86,"providers":[{"billed_charge":843.08,"npi":[1720670474]}]}]}]},{"name":"COLOREC CA SCR; FOB TST IMMU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0328","description":"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS DETERMINATIONS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":78.96,"providers":[{"billed_charge":698.25,"npi":[1265418669]}]}]}]},{"name":"HEP C ABO SC IND HI RSK&OTH","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0472","description":"HEPATITIS C ANTIBODY SCREENING FOR INDIVIDUAL AT HIGH RISK AND OTHER COVERED INDICATION(S)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5851.94,"providers":[{"billed_charge":19035.90,"npi":[1265418669]}]}]}]},{"name":"HIV ANTIGEN/ANTIBODY, COMBIN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0475","description":"HIV ANTIGEN/ANTIBODY, COMBINATION ASSAY, SCREENING","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3728.56,"providers":[{"billed_charge":36270.56,"npi":[1265418669]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 1-7","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"853913921"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3318.76,"providers":[{"billed_charge":10150.00,"npi":[1538755376]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1358.88,"providers":[{"billed_charge":2991.39,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31585.44,"providers":[{"billed_charge":79488.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13553.90,"providers":[{"billed_charge":52900.00,"npi":[1124687157]}]},{"allowed_amount":13228.72,"providers":[{"billed_charge":62560.00,"npi":[1427772714]}]}]},{"tin":{"type":"ein","value":"452215107"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20036.20,"providers":[{"billed_charge":58376.30,"npi":[1801226543]}]}]},{"tin":{"type":"ein","value":"262358356"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":814.73,"providers":[{"billed_charge":2793.00,"npi":[1285724757]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1220.90,"providers":[{"billed_charge":6091.45,"npi":[1234567893]}]}]}]},{"name":"VISIT CPLX INHERENT E&M ASSO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2211","description":"VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC","allowed_amounts":[{"tin":{"type":"ein","value":"932686392"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":191.34,"providers":[{"billed_charge":378.00,"npi":[1588321376]}]},{"allowed_amount":14.97,"providers":[{"billed_charge":42.00,"npi":[1245877794]}]}]},{"tin":{"type":"ein","value":"621684203"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":242.11,"providers":[{"billed_charge":396.00,"npi":[1649897687]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":212.23,"providers":[{"billed_charge":420.00,"npi":[1104169895]}]},{"allowed_amount":488.98,"providers":[{"billed_charge":966.00,"npi":[1275105983]}]},{"allowed_amount":382.32,"providers":[{"billed_charge":756.00,"npi":[1417707662]}]},{"allowed_amount":616.54,"providers":[{"billed_charge":1218.00,"npi":[1023996600]}]},{"allowed_amount":21.26,"providers":[{"billed_charge":42.00,"npi":[1598440224]}]},{"allowed_amount":170.08,"providers":[{"billed_charge":336.00,"npi":[1083433981]}]},{"allowed_amount":744.11,"providers":[{"billed_charge":1470.00,"npi":[1861925331]}]},{"allowed_amount":318.17,"providers":[{"billed_charge":630.00,"npi":[1669850384]}]},{"allowed_amount":403.95,"providers":[{"billed_charge":798.00,"npi":[1033960265]}]},{"allowed_amount":127.56,"providers":[{"billed_charge":252.00,"npi":[1871032003]}]},{"allowed_amount":340.16,"providers":[{"billed_charge":672.00,"npi":[1245291301]}]},{"allowed_amount":425.20,"providers":[{"billed_charge":840.00,"npi":[1770143604]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1189.82,"providers":[{"billed_charge":2352.00,"npi":[1356179436]}]},{"allowed_amount":361.42,"providers":[{"billed_charge":714.00,"npi":[1932831880]}]},{"allowed_amount":1296.50,"providers":[{"billed_charge":2562.00,"npi":[1669868691]}]}]},{"tin":{"type":"ein","value":"261125131"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":277.76,"providers":[{"billed_charge":496.00,"npi":[1417210543]}]}]}]},{"name":"PROLNG OF/OP E&M BYND RT;EA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2212","description":"PROLONG OFC/OP E&M BYND REQ TIME; EA ADD 15 M","allowed_amounts":[{"tin":{"type":"ein","value":"872968297"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":146.63,"providers":[{"billed_charge":300.00,"npi":[1447481072]}]}]}]},{"name":"ALCOHL&/RX SRVC; INTENSV OP;","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0015","description":"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"333067540"},"service_code":["57"],"billing_class":"professional","payments":[{"allowed_amount":614190.00,"providers":[{"billed_charge":3070950.00,"npi":[1770049397]}]}]},{"tin":{"type":"ein","value":"932572939"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89700.00,"providers":[{"billed_charge":224250.00,"npi":[1790120483]}]}]},{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":26835.20,"providers":[{"billed_charge":134176.00,"npi":[1053919423]}]}]}]},{"name":"MENTAL HLTH PART HOSP TX <24","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0035","description":"MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"823552173"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5040.00,"providers":[{"billed_charge":25200.00,"npi":[1750149357]}]}]},{"tin":{"type":"ein","value":"932572939"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":142240.00,"providers":[{"billed_charge":355600.00,"npi":[1790120483]}]}]},{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":125283.20,"providers":[{"billed_charge":626416.00,"npi":[1053919423]}]}]}]},{"name":"ALCOHOL &/ DRUG SRVC BRF PER","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0050","description":"ALCOHOL AND/OR DRUG SERVICES, BRIEF INTERVENTION, PER 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"262358356"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":600.00,"npi":[1609979426]}]}]}]},{"name":"BEHAVIORL HLTH DAY TX PER HR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H2012","description":"BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR","allowed_amounts":[{"tin":{"type":"ein","value":"883178042"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10978.00,"providers":[{"billed_charge":54890.00,"npi":[1558073072]}]}]}]},{"name":"INJ TESTOSTERONE CYPION 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1071","description":"INJECTION, TESTOSTERONE CYPIONATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"810576831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":69.02,"providers":[{"billed_charge":6400.00,"npi":[1861825911]}]}]}]},{"name":"INJ DEXMETH SODM PHOSHA 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1100","description":"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"461235939"},"service_code":["72","20"],"billing_class":"professional","payments":[{"allowed_amount":1.54,"providers":[{"billed_charge":22.40,"npi":[1033659677]}]},{"allowed_amount":2.31,"providers":[{"billed_charge":33.60,"npi":[1033659677]}]},{"allowed_amount":3.76,"providers":[{"billed_charge":64.00,"npi":[1790404499]}]}]}]},{"name":"TELEHEALTH ORIG SITE FACILIT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"Q3014","description":"TELEHEALTH ORIGINATING SITE FACILITY FEE","allowed_amounts":[{"tin":{"type":"ein","value":"823218781"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":283.85,"providers":[{"billed_charge":495.00,"npi":[1154986560]}]},{"allowed_amount":45.26,"providers":[{"billed_charge":110.00,"npi":[1750793055]}]},{"allowed_amount":2790.71,"providers":[{"billed_charge":5005.00,"npi":[1629531595]}]},{"allowed_amount":856.76,"providers":[{"billed_charge":1540.00,"npi":[1932806494]}]},{"allowed_amount":1218.30,"providers":[{"billed_charge":2145.00,"npi":[1346752151]}]},{"allowed_amount":648.46,"providers":[{"billed_charge":1210.00,"npi":[1184060980]}]},{"allowed_amount":615.91,"providers":[{"billed_charge":880.00,"npi":[1124687157]}]},{"allowed_amount":1811.74,"providers":[{"billed_charge":3245.00,"npi":[1649933417]}]},{"allowed_amount":667.98,"providers":[{"billed_charge":1210.00,"npi":[1427772714]}]}]},{"tin":{"type":"ein","value":"832504107"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":36.05,"providers":[{"billed_charge":50.00,"npi":[1154570521]}]}]}]},{"name":"PART HOSITALIZATN SRVC<24 HR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S0201","description":"PARTIAL HOSPITALIZATION SERVICES, LESS THAN 24 HOURS, PER DIEM","allowed_amounts":[{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":100674.00,"providers":[{"billed_charge":503370.00,"npi":[1053919423]}]}]},{"tin":{"type":"ein","value":"461281853"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":153408.00,"providers":[{"billed_charge":767040.00,"npi":[1255407862]}]}]}]},{"name":"GLBAL FEE URGNT CARE CENTERS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9083","description":"GLOBAL FEE URGENT CARE CENTERS","allowed_amounts":[{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":4729.40,"providers":[{"billed_charge":23647.00,"npi":[1669933370]}]},{"allowed_amount":221.00,"providers":[{"billed_charge":1105.00,"npi":[1033659677]}]},{"allowed_amount":265.20,"providers":[{"billed_charge":1326.00,"npi":[1316566607]}]},{"allowed_amount":1723.80,"providers":[{"billed_charge":8619.00,"npi":[1376006585]}]},{"allowed_amount":3226.60,"providers":[{"billed_charge":16133.00,"npi":[1063870467]}]},{"allowed_amount":176.80,"providers":[{"billed_charge":884.00,"npi":[1902507494]}]},{"allowed_amount":618.80,"providers":[{"billed_charge":3094.00,"npi":[1427666346]}]},{"allowed_amount":3845.40,"providers":[{"billed_charge":19227.00,"npi":[1790404499]}]},{"allowed_amount":3094.00,"providers":[{"billed_charge":15470.00,"npi":[1174034565]}]},{"allowed_amount":1458.60,"providers":[{"billed_charge":7293.00,"npi":[1316510043]}]},{"allowed_amount":574.60,"providers":[{"billed_charge":2873.00,"npi":[1578141180]}]},{"allowed_amount":353.60,"providers":[{"billed_charge":1768.00,"npi":[1285327452]}]},{"allowed_amount":1155.43,"providers":[{"billed_charge":5777.16,"npi":[1689240913]}]}]}]},{"name":"INTNSVE OP PSYC SVC PER DIEM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9480","description":"INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM","allowed_amounts":[{"tin":{"type":"ein","value":"823552173"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10260.00,"providers":[{"billed_charge":51300.00,"npi":[1750149357]}]}]},{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":7851.86,"providers":[{"billed_charge":46123.00,"npi":[1053919423]}]}]}]},{"name":"HIT ANTIBIOTIC/ANTIFUNGAL; Q","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9500","description":"HOME INFUSION THERAPY, ANTIBIOTIC, ANTIVIRAL, OR ANTIFUNGAL THERAPY; ONCE EVERY 24 HOURS; ADMINISTRA","allowed_amounts":[{"tin":{"type":"ein","value":"871454337"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":810.00,"providers":[{"billed_charge":2700.00,"npi":[1124789573]}]}]}]},{"name":"HIT ABX ANTIVIRL/ANTIFUNGAL;","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9502","description":"HOME INFUSION THERAPY, ANTIBIOTIC, ANTIVIRAL, OR ANTIFUNGAL THERAPY; ONCE EVERY 8 HOURS, ADMINISTRAT","allowed_amounts":[{"tin":{"type":"ein","value":"871454337"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":450.00,"providers":[{"billed_charge":1500.00,"npi":[1124789573]}]}]}]}]}