{
    "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": "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": "813734117"
                    },
                    "service_code": ["56", "21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10672.00,
                            "providers": [{
                                    "billed_charge": 10672.00,
                                    "npi": [1447701230]
                                }
                            ]
                        }, {
                            "allowed_amount": 6960.00,
                            "providers": [{
                                    "billed_charge": 6960.00,
                                    "npi": [1447701230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PHARMACY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "250",
            "description": "PHARMACY - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 255.21,
                            "providers": [{
                                    "billed_charge": 814.20,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351142669"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8.90,
                            "providers": [{
                                    "billed_charge": 20.30,
                                    "npi": [1174571129]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350892672"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 35.87,
                            "providers": [{
                                    "billed_charge": 119.55,
                                    "npi": [1063457380]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352087092"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 307.50,
                            "providers": [{
                                    "billed_charge": 843.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }, {
                            "allowed_amount": 2146.71,
                            "providers": [{
                                    "billed_charge": 11018.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5177.06,
                            "providers": [{
                                    "billed_charge": 9908.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LABORATORY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "300",
            "description": "LABORATORY - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351967665"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 25.22,
                            "providers": [{
                                    "billed_charge": 42.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352019022"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 155.40,
                            "providers": [{
                                    "billed_charge": 1930.00,
                                    "npi": [1386749893]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 810.69,
                            "providers": [{
                                    "billed_charge": 1130.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356001583"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 18.68,
                            "providers": [{
                                    "billed_charge": 70.60,
                                    "npi": [1356428429]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3.00,
                            "providers": [{
                                    "billed_charge": 8.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }, {
                            "allowed_amount": 442.85,
                            "providers": [{
                                    "billed_charge": 567.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "610444707"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 650.79,
                            "providers": [{
                                    "billed_charge": 2815.30,
                                    "npi": [1689282147]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350892672"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1010.69,
                            "providers": [{
                                    "billed_charge": 1715.28,
                                    "npi": [1063457380]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351151208"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 106.28,
                            "providers": [{
                                    "billed_charge": 1120.35,
                                    "npi": [1699757401]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/CHEMISTRY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "301",
            "description": "LABORATORY - CHEMISTRY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351967665"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1030.04,
                            "providers": [{
                                    "billed_charge": 8497.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }, {
                            "allowed_amount": 370.80,
                            "providers": [{
                                    "billed_charge": 10542.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472105584"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 381.18,
                            "providers": [{
                                    "billed_charge": 2766.12,
                                    "npi": [1740686443]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "922355855"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 623.72,
                            "providers": [{
                                    "billed_charge": 2211.00,
                                    "npi": [1144914532]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2575.74,
                            "providers": [{
                                    "billed_charge": 24257.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356001583"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 84.34,
                            "providers": [{
                                    "billed_charge": 1959.30,
                                    "npi": [1356428429]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13491.04,
                            "providers": [{
                                    "billed_charge": 31722.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351142669"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1851.58,
                            "providers": [{
                                    "billed_charge": 5428.00,
                                    "npi": [1174571129]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "362513909"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 564.59,
                            "providers": [{
                                    "billed_charge": 6248.00,
                                    "npi": [1003864810]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/IMMUNOLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "302",
            "description": "LABORATORY - IMMUNOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 120.97,
                            "providers": [{
                                    "billed_charge": 2427.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/HEMATOLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "305",
            "description": "LABORATORY - HEMATOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351967665"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 56.03,
                            "providers": [{
                                    "billed_charge": 405.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }, {
                            "allowed_amount": 32.87,
                            "providers": [{
                                    "billed_charge": 1362.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 165.94,
                            "providers": [{
                                    "billed_charge": 1455.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2588.19,
                            "providers": [{
                                    "billed_charge": 5783.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351142669"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 320.95,
                            "providers": [{
                                    "billed_charge": 733.00,
                                    "npi": [1174571129]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352087092"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 385.10,
                            "providers": [{
                                    "billed_charge": 1648.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1562.44,
                            "providers": [{
                                    "billed_charge": 4064.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350869066"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1200.68,
                            "providers": [{
                                    "billed_charge": 15147.00,
                                    "npi": [1851833230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "350869066"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2642.05,
                            "providers": [{
                                    "billed_charge": 4640.00,
                                    "npi": [1851833230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "350869066"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9791.15,
                            "providers": [{
                                    "billed_charge": 15368.00,
                                    "npi": [1851833230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352087092"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1487.58,
                            "providers": [{
                                    "billed_charge": 9555.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }, {
                            "allowed_amount": 737.01,
                            "providers": [{
                                    "billed_charge": 4720.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "621695507"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 212.42,
                            "providers": [{
                                    "billed_charge": 828.00,
                                    "npi": [1942526447]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2576.76,
                            "providers": [{
                                    "billed_charge": 5372.19,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["11", "17", "81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 4.67,
                            "providers": [{
                                    "billed_charge": 22.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 8.41,
                            "providers": [{
                                    "billed_charge": 40.73,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 293.34,
                            "providers": [{
                                    "billed_charge": 2666.38,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352087092"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1560.15,
                            "providers": [{
                                    "billed_charge": 8456.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351967665"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4975.76,
                            "providers": [{
                                    "billed_charge": 30016.00,
                                    "npi": [1205844495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472105584"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 20664.74,
                            "providers": [{
                                    "billed_charge": 21363.32,
                                    "npi": [1740686443]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "922355855"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 845.23,
                            "providers": [{
                                    "billed_charge": 2832.00,
                                    "npi": [1144914532]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 26302.44,
                            "providers": [{
                                    "billed_charge": 157555.00,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 22392.92,
                            "providers": [{
                                    "billed_charge": 43235.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351142669"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3488.85,
                            "providers": [{
                                    "billed_charge": 5024.00,
                                    "npi": [1174571129]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350892672"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9586.95,
                            "providers": [{
                                    "billed_charge": 28836.87,
                                    "npi": [1063457380]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350869066"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 224937.24,
                            "providers": [{
                                    "billed_charge": 955318.00,
                                    "npi": [1851833230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PSYCH CLINIC",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "513",
            "description": "CLINIC - PSYCHIATRIC CLINIC",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "350869066"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2782.93,
                            "providers": [{
                                    "billed_charge": 92738.00,
                                    "npi": [1003866740]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351967665"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 218.39,
                            "providers": [{
                                    "billed_charge": 5418.78,
                                    "npi": [1205844495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472105584"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 183.63,
                            "providers": [{
                                    "billed_charge": 612.09,
                                    "npi": [1740686443]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352087092"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 73307.33,
                            "providers": [{
                                    "billed_charge": 312676.82,
                                    "npi": [1457366189]
                                }
                            ]
                        }, {
                            "allowed_amount": 7406.50,
                            "providers": [{
                                    "billed_charge": 21798.42,
                                    "npi": [1457366189]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350868157"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 457.46,
                            "providers": [{
                                    "billed_charge": 1357.00,
                                    "npi": [1841245594]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351142669"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 36.97,
                            "providers": [{
                                    "billed_charge": 90.45,
                                    "npi": [1174571129]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350892672"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 511.85,
                            "providers": [{
                                    "billed_charge": 2365.68,
                                    "npi": [1063457380]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350869066"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 54.03,
                            "providers": [{
                                    "billed_charge": 18589.18,
                                    "npi": [1851833230]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MRI JOINT UPR EXTREM W/O DYE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "73221",
            "description": "MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351158723"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 202.17,
                            "providers": [{
                                    "billed_charge": 1382.00,
                                    "npi": [1285809103]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MRI JNT OF LWR EXTRE W/O DYE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "73721",
            "description": "MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351158723"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 547.82,
                            "providers": [{
                                    "billed_charge": 3013.00,
                                    "npi": [1811978497]
                                }
                            ]
                        }, {
                            "allowed_amount": 854.04,
                            "providers": [{
                                    "billed_charge": 4872.00,
                                    "npi": [1285809103]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "274591786"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 334.80,
                            "providers": [{
                                    "billed_charge": 3102.00,
                                    "npi": [1659725323]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "356005697"
                    },
                    "service_code": ["49"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 478.21,
                            "providers": [{
                                    "billed_charge": 3162.00,
                                    "npi": [1396500922]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "274591786"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 340.83,
                            "providers": [{
                                    "billed_charge": 1491.00,
                                    "npi": [1366647034]
                                }
                            ]
                        }, {
                            "allowed_amount": 4820.31,
                            "providers": [{
                                    "billed_charge": 21087.00,
                                    "npi": [1659725323]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "274591786"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 868.45,
                            "providers": [{
                                    "billed_charge": 4719.00,
                                    "npi": [1659725323]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "356005697"
                    },
                    "service_code": ["49"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1836.17,
                            "providers": [{
                                    "billed_charge": 9442.65,
                                    "npi": [1396500922]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "274591786"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 5957.82,
                            "providers": [{
                                    "billed_charge": 31284.00,
                                    "npi": [1659725323]
                                }
                            ]
                        }, {
                            "allowed_amount": 421.26,
                            "providers": [{
                                    "billed_charge": 2212.00,
                                    "npi": [1366647034]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352091937"
                    },
                    "service_code": ["22", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 55.94,
                            "providers": [{
                                    "billed_charge": 330.00,
                                    "npi": [1457841157]
                                }
                            ]
                        }, {
                            "allowed_amount": 419.55,
                            "providers": [{
                                    "billed_charge": 2475.00,
                                    "npi": [1457841157]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 23.68,
                            "providers": [{
                                    "billed_charge": 50.76,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 4463.56,
                            "providers": [{
                                    "billed_charge": 9567.36,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 231.86,
                            "providers": [{
                                    "billed_charge": 2609.53,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 4500.00,
                            "providers": [{
                                    "billed_charge": 9640.80,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 213.79,
                            "providers": [{
                                    "billed_charge": 2519.75,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "RENAL FUNCTION PANEL",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "80069",
            "description": "RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 36.45,
                            "providers": [{
                                    "billed_charge": 78.12,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 461.13,
                            "providers": [{
                                    "billed_charge": 988.38,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3356.64,
                            "providers": [{
                                    "billed_charge": 7192.80,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 356.09,
                            "providers": [{
                                    "billed_charge": 3487.20,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 384.25,
                            "providers": [{
                                    "billed_charge": 823.62,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 759.96,
                            "providers": [{
                                    "billed_charge": 1628.64,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 78.52,
                            "providers": [{
                                    "billed_charge": 849.18,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF FERRITIN",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "82728",
            "description": "FERRITIN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 610.56,
                            "providers": [{
                                    "billed_charge": 1308.48,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 370.44,
                            "providers": [{
                                    "billed_charge": 793.80,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1916.19,
                            "providers": [{
                                    "billed_charge": 4107.33,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 153.95,
                            "providers": [{
                                    "billed_charge": 1925.05,
                                    "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 226.50,
                            "providers": [{
                                    "billed_charge": 485.25,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 293.76,
                            "providers": [{
                                    "billed_charge": 629.28,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF PROGESTERONE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "84144",
            "description": "PROGESTERONE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 175.20,
                            "providers": [{
                                    "billed_charge": 375.48,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 44.24,
                            "providers": [{
                                    "billed_charge": 501.70,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 289.04,
                            "providers": [{
                                    "billed_charge": 619.44,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 341.01,
                            "providers": [{
                                    "billed_charge": 730.62,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3034.08,
                            "providers": [{
                                    "billed_charge": 6501.60,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 343.87,
                            "providers": [{
                                    "billed_charge": 3602.24,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "COMPLETE CBC W/AUTO DIFF WBC",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "85025",
            "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2502.40,
                            "providers": [{
                                    "billed_charge": 5361.30,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 169.80,
                            "providers": [{
                                    "billed_charge": 1703.64,
                                    "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 226.50,
                            "providers": [{
                                    "billed_charge": 485.25,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 79.75,
                            "providers": [{
                                    "billed_charge": 170.94,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 56.55,
                            "providers": [{
                                    "billed_charge": 121.20,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 531.10,
                            "providers": [{
                                    "billed_charge": 1137.87,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "621695507"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 70.20,
                            "providers": [{
                                    "billed_charge": 440.00,
                                    "npi": [1093753303]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "621695507"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1053.00,
                            "providers": [{
                                    "billed_charge": 6318.00,
                                    "npi": [1093753303]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 861.45,
                            "providers": [{
                                    "billed_charge": 9126.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "621695507"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1474.20,
                            "providers": [{
                                    "billed_charge": 12034.22,
                                    "npi": [1093753303]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "270851352"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 21.09,
                            "providers": [{
                                    "billed_charge": 123.00,
                                    "npi": [1801541719]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "621695507"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1291.07,
                            "providers": [{
                                    "billed_charge": 9118.00,
                                    "npi": [1093753303]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 149.00,
                            "providers": [{
                                    "billed_charge": 317.88,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 440.09,
                            "providers": [{
                                    "billed_charge": 4448.20,
                                    "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": "351604525"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 145.62,
                            "providers": [{
                                    "billed_charge": 900.00,
                                    "npi": [1093057911]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["22", "24", "81", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2666.05,
                            "providers": [{
                                    "billed_charge": 33275.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 1009.05,
                            "providers": [{
                                    "billed_charge": 2760.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 2612.19,
                            "providers": [{
                                    "billed_charge": 9648.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 60.80,
                            "providers": [{
                                    "billed_charge": 610.70,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "823508457"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4200.00,
                            "providers": [{
                                    "billed_charge": 59500.00,
                                    "npi": [1437658572]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "833632697"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2280.00,
                            "providers": [{
                                    "billed_charge": 6000.00,
                                    "npi": [1154979615]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "208989098"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 169.02,
                            "providers": [{
                                    "billed_charge": 390.00,
                                    "npi": [1780883538]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 616.74,
                            "providers": [{
                                    "billed_charge": 1400.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "460722516"
                    },
                    "service_code": ["11", "02"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 13913.34,
                            "providers": [{
                                    "billed_charge": 20611.00,
                                    "npi": [1629085717]
                                }
                            ]
                        }, {
                            "allowed_amount": 134.32,
                            "providers": [{
                                    "billed_charge": 294.50,
                                    "npi": [1629085717]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "842463346"
                    },
                    "service_code": ["11", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 201.48,
                            "providers": [{
                                    "billed_charge": 320.00,
                                    "npi": [1578551495]
                                }
                            ]
                        }, {
                            "allowed_amount": 614.00,
                            "providers": [{
                                    "billed_charge": 800.00,
                                    "npi": [1578551495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "873075048"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1719.34,
                            "providers": [{
                                    "billed_charge": 2100.00,
                                    "npi": [1063309599]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "208989098"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 84.54,
                            "providers": [{
                                    "billed_charge": 187.50,
                                    "npi": [1780883538]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831247457"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 360.00,
                            "providers": [{
                                    "billed_charge": 360.00,
                                    "npi": [1467959775]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351678281"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1624.54,
                            "providers": [{
                                    "billed_charge": 1650.00,
                                    "npi": [1235862871]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880660774"
                    },
                    "service_code": ["10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 453.35,
                            "providers": [{
                                    "billed_charge": 600.00,
                                    "npi": [1386305332]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "820783414"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 122.80,
                            "providers": [{
                                    "billed_charge": 175.00,
                                    "npi": [1023428208]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "932834934"
                    },
                    "service_code": ["11", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1610.70,
                            "providers": [{
                                    "billed_charge": 3200.00,
                                    "npi": [1356934582]
                                }
                            ]
                        }, {
                            "allowed_amount": 1104.07,
                            "providers": [{
                                    "billed_charge": 1800.00,
                                    "npi": [1356934582]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "356202739"
                    },
                    "service_code": ["11", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 34.12,
                            "providers": [{
                                    "billed_charge": 79.00,
                                    "npi": [1528117769]
                                }
                            ]
                        }, {
                            "allowed_amount": 185.24,
                            "providers": [{
                                    "billed_charge": 462.00,
                                    "npi": [1528117769]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "460722516"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1808.45,
                            "providers": [{
                                    "billed_charge": 3114.12,
                                    "npi": [1629085717]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "823508457"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3000.00,
                            "providers": [{
                                    "billed_charge": 36250.00,
                                    "npi": [1437658572]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "833632697"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10725.00,
                            "providers": [{
                                    "billed_charge": 16500.00,
                                    "npi": [1154979615]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "350869066"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 573.80,
                            "providers": [{
                                    "billed_charge": 17650.00,
                                    "npi": [1003866740]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SPECIAL EYE EVALUATION",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "92060",
            "description": "SENSORIMOTOR EXAMINATION WITH MULTIPLE MEASUREMENTS OF OCULAR DEVIATION (EG, RESTRICTIVE OR PARETIC ",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "824133617"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 124.60,
                            "providers": [{
                                    "billed_charge": 136.00,
                                    "npi": [1255367686]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "873621436"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 647.79,
                            "providers": [{
                                    "billed_charge": 990.00,
                                    "npi": [1497360499]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 11527.75,
                            "providers": [{
                                    "billed_charge": 60229.00,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SPEECH SOUND LANG COMPREHEN",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "92523",
            "description": "EVALUATION OF SPEECH SOUND PRODUCTION (EG, ARTICULATION, PHONOLOGICAL PROCESS, APRAXIA, DYSARTHRIA)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 394.47,
                            "providers": [{
                                    "billed_charge": 1154.44,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351180407"
                    },
                    "service_code": ["22", "81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 14.90,
                            "providers": [{
                                    "billed_charge": 34.00,
                                    "npi": [1487658761]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DEVEL TST PHYS/QHP 1ST HR",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "96112",
            "description": "DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 134.28,
                            "providers": [{
                                    "billed_charge": 134.28,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351955872"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 502.04,
                            "providers": [{
                                    "billed_charge": 1572.00,
                                    "npi": [1669484333]
                                }
                            ]
                        }, {
                            "allowed_amount": 533.40,
                            "providers": [{
                                    "billed_charge": 1965.00,
                                    "npi": [1689340333]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351709418"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1655.35,
                            "providers": [{
                                    "billed_charge": 5492.00,
                                    "npi": [1144014218]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "871365424"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 736.23,
                            "providers": [{
                                    "billed_charge": 3255.14,
                                    "npi": [1982830584]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352163791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 535.44,
                            "providers": [{
                                    "billed_charge": 2923.92,
                                    "npi": [1437464054]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351361243"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 93.70,
                            "providers": [{
                                    "billed_charge": 372.00,
                                    "npi": [1922173970]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1304.96,
                            "providers": [{
                                    "billed_charge": 5460.00,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "270550856"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1137.81,
                            "providers": [{
                                    "billed_charge": 6213.33,
                                    "npi": [1992439707]
                                }
                            ]
                        }, {
                            "allowed_amount": 959.33,
                            "providers": [{
                                    "billed_charge": 5238.69,
                                    "npi": [1740732445]
                                }
                            ]
                        }, {
                            "allowed_amount": 423.89,
                            "providers": [{
                                    "billed_charge": 2314.77,
                                    "npi": [1912645649]
                                }
                            ]
                        }, {
                            "allowed_amount": 245.41,
                            "providers": [{
                                    "billed_charge": 1340.13,
                                    "npi": [1407604309]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "882434862"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 175.96,
                            "providers": [{
                                    "billed_charge": 343.00,
                                    "npi": [1427600519]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "871365424"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 326.69,
                            "providers": [{
                                    "billed_charge": 1625.00,
                                    "npi": [1982830584]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352163791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 150.78,
                            "providers": [{
                                    "billed_charge": 713.76,
                                    "npi": [1437464054]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351090576"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1083.99,
                            "providers": [{
                                    "billed_charge": 2461.00,
                                    "npi": [1235219015]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "471993843"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 678.54,
                            "providers": [{
                                    "billed_charge": 2808.00,
                                    "npi": [1871023978]
                                }
                            ]
                        }, {
                            "allowed_amount": 150.79,
                            "providers": [{
                                    "billed_charge": 624.00,
                                    "npi": [1275306763]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1847.30,
                            "providers": [{
                                    "billed_charge": 6860.00,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "270550856"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 201.04,
                            "providers": [{
                                    "billed_charge": 951.68,
                                    "npi": [1912645649]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "GAIT TRAINING THERAPY",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "97116",
            "description": "THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 16.73,
                            "providers": [{
                                    "billed_charge": 70.00,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "THER IVNTJ 1ST 15 MIN",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "97129",
            "description": "THERAPEUTIC INTERVENTIONS THAT FOCUS ON COGNITIVE FUNCTION (EG, ATTENTION, MEMORY, REASONING, EXECUT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 405.67,
                            "providers": [{
                                    "billed_charge": 1325.56,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "THER IVNTJ EA ADDL 15 MIN",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "97130",
            "description": "THERAPEUTIC INTERVENTIONS THAT FOCUS ON COGNITIVE FUNCTION (EG, ATTENTION, MEMORY, REASONING, EXECUT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1153.12,
                            "providers": [{
                                    "billed_charge": 3976.68,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351955872"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 203.52,
                            "providers": [{
                                    "billed_charge": 780.00,
                                    "npi": [1689340333]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351709418"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 208.53,
                            "providers": [{
                                    "billed_charge": 641.00,
                                    "npi": [1144014218]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "871365424"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 851.20,
                            "providers": [{
                                    "billed_charge": 2975.82,
                                    "npi": [1982830584]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "882434862"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 148.96,
                            "providers": [{
                                    "billed_charge": 273.00,
                                    "npi": [1427600519]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "270550856"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 85.12,
                            "providers": [{
                                    "billed_charge": 400.28,
                                    "npi": [1740732445]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "274298104"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 20493.73,
                            "providers": [{
                                    "billed_charge": 46754.25,
                                    "npi": [1699310730]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "812674567"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 750.95,
                            "providers": [{
                                    "billed_charge": 1650.00,
                                    "npi": [1881042885]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462132970"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 32708.75,
                            "providers": [{
                                    "billed_charge": 109760.00,
                                    "npi": [1700459393]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350965639"
                    },
                    "service_code": ["11", "99"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 804.96,
                            "providers": [{
                                    "billed_charge": 1560.00,
                                    "npi": [1891917449]
                                }
                            ]
                        }, {
                            "allowed_amount": 69025.32,
                            "providers": [{
                                    "billed_charge": 133770.00,
                                    "npi": [1891917449]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "202605791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 8147.89,
                            "providers": [{
                                    "billed_charge": 17050.00,
                                    "npi": [1588904445]
                                }
                            ]
                        }, {
                            "allowed_amount": 31104.41,
                            "providers": [{
                                    "billed_charge": 64950.00,
                                    "npi": [1407496540]
                                }
                            ]
                        }, {
                            "allowed_amount": 49344.87,
                            "providers": [{
                                    "billed_charge": 107450.00,
                                    "npi": [1447867924]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "870947145"
                    },
                    "service_code": ["12", "03"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 22253.08,
                            "providers": [{
                                    "billed_charge": 85850.88,
                                    "npi": [1295243608]
                                }
                            ]
                        }, {
                            "allowed_amount": 14610.60,
                            "providers": [{
                                    "billed_charge": 55875.52,
                                    "npi": [1205311404]
                                }
                            ]
                        }, {
                            "allowed_amount": 1923.60,
                            "providers": [{
                                    "billed_charge": 7244.80,
                                    "npi": [1295243608]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "473746811"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 61398.15,
                            "providers": [{
                                    "billed_charge": 146362.50,
                                    "npi": [1801470836]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ADAPT BEHAVIOR TX PHYS/QHP",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "97155",
            "description": "ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "274298104"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 144.73,
                            "providers": [{
                                    "billed_charge": 483.56,
                                    "npi": [1699310730]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350965639"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3219.84,
                            "providers": [{
                                    "billed_charge": 8640.00,
                                    "npi": [1891917449]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "202605791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1882.42,
                            "providers": [{
                                    "billed_charge": 4387.00,
                                    "npi": [1447867924]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "473746811"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 4732.36,
                            "providers": [{
                                    "billed_charge": 16995.00,
                                    "npi": [1801470836]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "873621436"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 428.00,
                            "providers": [{
                                    "billed_charge": 640.00,
                                    "npi": [1811681638]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "882434862"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 214.00,
                            "providers": [{
                                    "billed_charge": 424.00,
                                    "npi": [1427600519]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "871365424"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 187.25,
                            "providers": [{
                                    "billed_charge": 1050.00,
                                    "npi": [1982830584]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "352163791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 561.75,
                            "providers": [{
                                    "billed_charge": 2010.54,
                                    "npi": [1437464054]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "202605791"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 478.72,
                            "providers": [{
                                    "billed_charge": 1040.00,
                                    "npi": [1588247142]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "471993843"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1658.50,
                            "providers": [{
                                    "billed_charge": 6820.00,
                                    "npi": [1871023978]
                                }
                            ]
                        }, {
                            "allowed_amount": 3902.81,
                            "providers": [{
                                    "billed_charge": 16060.00,
                                    "npi": [1275306763]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 31775.78,
                            "providers": [{
                                    "billed_charge": 105392.46,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "270550856"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1498.00,
                            "providers": [{
                                    "billed_charge": 5361.44,
                                    "npi": [1740732445]
                                }
                            ]
                        }, {
                            "allowed_amount": 1016.50,
                            "providers": [{
                                    "billed_charge": 3638.12,
                                    "npi": [1992439707]
                                }
                            ]
                        }, {
                            "allowed_amount": 695.50,
                            "providers": [{
                                    "billed_charge": 2489.24,
                                    "npi": [1407604309]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SENSORY INTEGRATION",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "97533",
            "description": "SENSORY INTEGRATIVE TECHNIQUES TO ENHANCE SENSORY PROCESSING AND PROMOTE ADAPTIVE RESPONSES TO ENVIR",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "356000158"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1170.49,
                            "providers": [{
                                    "billed_charge": 2252.84,
                                    "npi": [1912166075]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "352018494"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 47.84,
                            "providers": [{
                                    "billed_charge": 102.00,
                                    "npi": [1770854119]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "204508059"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 93.27,
                            "providers": [{
                                    "billed_charge": 165.00,
                                    "npi": [1659438687]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261538329"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 186.54,
                            "providers": [{
                                    "billed_charge": 300.00,
                                    "npi": [1790462950]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "261538329"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 126.18,
                            "providers": [{
                                    "billed_charge": 189.00,
                                    "npi": [1790462950]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OFFICE/OUTPATIENT VISIT NEW",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99202",
            "description": "OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2361.00,
                            "providers": [{
                                    "billed_charge": 6326.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OFFICE/OUTPATIENT VISIT EST",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99211",
            "description": "OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, THAT M",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["17", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 41.20,
                            "providers": [{
                                    "billed_charge": 141.12,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 1315.00,
                            "providers": [{
                                    "billed_charge": 1351.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "999999999"
                    },
                    "service_code": ["10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 167.00,
                            "providers": [{
                                    "billed_charge": 347.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "811448348"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 450.45,
                            "providers": [{
                                    "billed_charge": 675.70,
                                    "npi": [1558734889]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351516588"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 90.09,
                            "providers": [{
                                    "billed_charge": 95.00,
                                    "npi": [1053394023]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351097350"
                    },
                    "service_code": ["02", "50"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 229.71,
                            "providers": [{
                                    "billed_charge": 390.00,
                                    "npi": [1548766181]
                                }
                            ]
                        }, {
                            "allowed_amount": 140.49,
                            "providers": [{
                                    "billed_charge": 450.00,
                                    "npi": [1548766181]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351534713"
                    },
                    "service_code": ["53"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 46.83,
                            "providers": [{
                                    "billed_charge": 137.47,
                                    "npi": [1649855388]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["22", "17", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 46.49,
                            "providers": [{
                                    "billed_charge": 348.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 1054.04,
                            "providers": [{
                                    "billed_charge": 3589.69,
                                    "npi": [1234567893]
                                }
                            ]
                        }, {
                            "allowed_amount": 303.16,
                            "providers": [{
                                    "billed_charge": 694.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351972384"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 540.00,
                            "providers": [{
                                    "billed_charge": 540.00,
                                    "npi": [1164040135]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351121699"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 119.99,
                            "providers": [{
                                    "billed_charge": 290.00,
                                    "npi": [1679451041]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351516588"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2181.61,
                            "providers": [{
                                    "billed_charge": 2380.00,
                                    "npi": [1053394023]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "350211370"
                    },
                    "service_code": ["02", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 890.45,
                            "providers": [{
                                    "billed_charge": 2802.02,
                                    "npi": [1821423393]
                                }
                            ]
                        }, {
                            "allowed_amount": 404.75,
                            "providers": [{
                                    "billed_charge": 1266.14,
                                    "npi": [1821423393]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351118234"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 216.67,
                            "providers": [{
                                    "billed_charge": 380.00,
                                    "npi": [1639849599]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HOME VISIT EST PATIENT",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99348",
            "description": "HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "205351085"
                    },
                    "service_code": ["55"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 706.21,
                            "providers": [{
                                    "billed_charge": 1837.00,
                                    "npi": [1770167280]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "205351085"
                    },
                    "service_code": ["55"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 214.54,
                            "providers": [{
                                    "billed_charge": 508.00,
                                    "npi": [1770167280]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351118234"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 72.88,
                            "providers": [{
                                    "billed_charge": 150.00,
                                    "npi": [1639849599]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "274099979"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 37199.16,
                            "providers": [{
                                    "billed_charge": 37734.00,
                                    "npi": [1578869665]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351941122"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 23814.24,
                            "providers": [{
                                    "billed_charge": 47104.70,
                                    "npi": [1174528335]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "271130459"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 263.04,
                            "providers": [{
                                    "billed_charge": 858.00,
                                    "npi": [1952683229]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351511077"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 5848.12,
                            "providers": [{
                                    "billed_charge": 5849.61,
                                    "npi": [1861499139]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "931689569"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 186.60,
                            "providers": [{
                                    "billed_charge": 193.20,
                                    "npi": [1386338382]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "272430695"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 10152.14,
                            "providers": [{
                                    "billed_charge": 10260.10,
                                    "npi": [1558681700]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356000972"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 186.60,
                            "providers": [{
                                    "billed_charge": 186.60,
                                    "npi": [1154325579]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "356001127"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 210.00,
                            "providers": [{
                                    "billed_charge": 210.00,
                                    "npi": [1871146365]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351511077"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 25118.40,
                            "providers": [{
                                    "billed_charge": 25118.40,
                                    "npi": [1861499139]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "272430695"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 6150.00,
                            "providers": [{
                                    "billed_charge": 6150.00,
                                    "npi": [1558681700]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "274099979"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 9947.52,
                            "providers": [{
                                    "billed_charge": 13428.00,
                                    "npi": [1578869665]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351941122"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 7711.76,
                            "providers": [{
                                    "billed_charge": 19622.05,
                                    "npi": [1174528335]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "351511077"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 7050.72,
                            "providers": [{
                                    "billed_charge": 7050.72,
                                    "npi": [1861499139]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "TUBING W/INTGR HEAT ELEM W/P",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A4604",
            "description": "TUBING WITH INTEGRATED HEATING ELEMENT FOR USE WITH POSITIVE AIRWAY PRESSURE DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1144.34,
                            "providers": [{
                                    "billed_charge": 4292.54,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "FULL FCE MASK POS ARWAY PRSS",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7030",
            "description": "FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 745.75,
                            "providers": [{
                                    "billed_charge": 4231.52,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "FCE MASK INTERFCE REPL FULL",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7031",
            "description": "FACE MASK INTERFACE, REPLACEMENT FOR FULL FACE MASK, EACH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1346.98,
                            "providers": [{
                                    "billed_charge": 6801.80,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CUSHN NASAL MASK INTF REPL",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7032",
            "description": "CUSHION FOR USE ON NASAL MASK INTERFACE, REPLACEMENT ONLY, EACH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1668.18,
                            "providers": [{
                                    "billed_charge": 6248.04,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PILLW NASL CANNULA TYPE INTF",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7033",
            "description": "PILLOW FOR USE ON NASAL CANNULA TYPE INTERFACE, REPLACEMENT ONLY, PAIR",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 333.00,
                            "providers": [{
                                    "billed_charge": 1403.22,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "NASL INTERFCE POS ARWAY PRSS",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7034",
            "description": "NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHOUT HE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2250.84,
                            "providers": [{
                                    "billed_charge": 9230.11,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEADGEAR USED W/POS ARWAY PR",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7035",
            "description": "HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 643.40,
                            "providers": [{
                                    "billed_charge": 3033.85,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "TUBING USED W/POS ARWAY PRES",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7037",
            "description": "TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 376.56,
                            "providers": [{
                                    "billed_charge": 1242.74,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "FLTR DISPBL W/POS ARWAY PRSS",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7038",
            "description": "FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1287.52,
                            "providers": [{
                                    "billed_charge": 3634.88,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "WATR CHAMB HUMDIFIR USED W/P",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A7046",
            "description": "WATER CHAMBER FOR HUMIDIFIER, USED WITH POSITIVE AIRWAY PRESSURE DEVICE, REPLACEMENT, EACH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 230.84,
                            "providers": [{
                                    "billed_charge": 1791.34,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SENSOR; INVSV INTRSTL GLU MO",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A9276",
            "description": "SENSOR; INVASIVE (E.G., SUBCUTANEOUS), DISPOSABLE, FOR USE WITH INTERSTITIAL CONTINUOUS GLUCOSE MONI",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 765.00,
                            "providers": [{
                                    "billed_charge": 998.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HUMDIFIR HEAT USED W/POS ARW",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "E0562",
            "description": "HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1056.93,
                            "providers": [{
                                    "billed_charge": 4449.66,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351925619"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 616.52,
                            "providers": [{
                                    "billed_charge": 1354.08,
                                    "npi": [1427870310]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CONTINUOUS POS AIRWAY PRESSU",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "E0601",
            "description": "CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3776.55,
                            "providers": [{
                                    "billed_charge": 59044.86,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "351925619"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2813.66,
                            "providers": [{
                                    "billed_charge": 4950.00,
                                    "npi": [1427870310]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "BREAST PUMP ELECTRIC ANY TYP",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "E0603",
            "description": "BREAST PUMP, ELECTRIC (AC AND/OR DC), ANY TYPE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "201830598"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3937.62,
                            "providers": [{
                                    "billed_charge": 15000.00,
                                    "npi": [1669415394]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "O2 CONC 85%/>02 CONC PRSC FL",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "E1390",
            "description": "OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCEN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1964.00,
                            "providers": [{
                                    "billed_charge": 13763.78,
                                    "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": "610445850"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 567.63,
                            "providers": [{
                                    "billed_charge": 1216.53,
                                    "npi": [1811154388]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DX DIGTL BRST TOMOSYN UNI/BI",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "G0279",
            "description": "DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 770",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "274591786"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2560.00,
                            "providers": [{
                                    "billed_charge": 6400.00,
                                    "npi": [1659725323]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MED ASST TX METHADONE;WEEKLY",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "G2067",
            "description": "MEDICATION ASSISSTED TX METHADONE; WEEKLY BUNDLE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "351140758"
                    },
                    "service_code": ["58"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 103.92,
                            "providers": [{
                                    "billed_charge": 259.80,
                                    "npi": [1598772428]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "992174368"
                    },
                    "service_code": ["57"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 950.00,
                            "providers": [{
                                    "billed_charge": 7500.00,
                                    "npi": [1083976971]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "WALKING BOOT, PNEUMATIC AND/",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "L4361",
            "description": "WALKING BOOT, PNEUMATIC AND/OR VACUUM, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, P",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["12"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1279.08,
                            "providers": [{
                                    "billed_charge": 2010.24,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "460722516"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 941.40,
                            "providers": [{
                                    "billed_charge": 2050.00,
                                    "npi": [1629085717]
                                }
                            ]
                        }
                    ]
                }
            ]
        }
    ]
}
