{
    "reporting_entity_name": "Centene Management Company LLC",
    "reporting_entity_type": "Third Party Administrator",
    "version": "2.0.0",
    "last_updated_on": "2026-07-29",
    "out_of_network": [{
            "name": "ROOM-BOARD/PVT",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "110",
            "description": "ROOM AND BOARD - PRIVATE -GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 17720.64,
                            "providers": [{
                                    "billed_charge": 9492.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 74256.79,
                            "providers": [{
                                    "billed_charge": 15433.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 165763.31,
                            "providers": [{
                                    "billed_charge": 28900.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3303056.54,
                            "providers": [{
                                    "billed_charge": 964359.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MED-SUR-GY/PVT",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "111",
            "description": "ROOM AND BOARD - PRIVATE -MEDICAL/SURGICAL/GYN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1586623.83,
                            "providers": [{
                                    "billed_charge": 502746.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ROOM-BOARD/SEMI",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "120",
            "description": "ROOM AND BOARD - SEMI PRIVATE TWO BED -GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 40852.97,
                            "providers": [{
                                    "billed_charge": 12988.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PSTAY/2 BED",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "124",
            "description": "ROOM AND BOARD - SEMI PRIVATE TWO BED -PSYCHIATRIC",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "850961512"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 69700.00,
                            "providers": [{
                                    "billed_charge": 102500.00,
                                    "npi": [1356950398]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "INTENSIVE CARE OR ICU",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "200",
            "description": "INTENSIVE CARE - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 316747.38,
                            "providers": [{
                                    "billed_charge": 149850.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 627564.24,
                            "providers": [{
                                    "billed_charge": 759330.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "POST ICU",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "206",
            "description": "INTENSIVE CARE - POST ICU",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 66688.98,
                            "providers": [{
                                    "billed_charge": 68425.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "POST CCU",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "214",
            "description": "CORONARY CARE - POST-CCU",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 98903.66,
                            "providers": [{
                                    "billed_charge": 75174.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1132869.24,
                            "providers": [{
                                    "billed_charge": 590303.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["21"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 209253.62,
                            "providers": [{
                                    "billed_charge": 312661.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PHARMACY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "250",
            "description": "PHARMACY - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 550.03,
                            "providers": [{
                                    "billed_charge": 1833.47,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 113.06,
                            "providers": [{
                                    "billed_charge": 376.83,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2958.20,
                            "providers": [{
                                    "billed_charge": 9860.37,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 9283.89,
                            "providers": [{
                                    "billed_charge": 31761.68,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3831.38,
                            "providers": [{
                                    "billed_charge": 12771.20,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3371.17,
                            "providers": [{
                                    "billed_charge": 11372.28,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 249.06,
                            "providers": [{
                                    "billed_charge": 830.25,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3351.48,
                            "providers": [{
                                    "billed_charge": 11171.30,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 883.38,
                            "providers": [{
                                    "billed_charge": 2944.56,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8697.85,
                            "providers": [{
                                    "billed_charge": 28992.71,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6060.65,
                            "providers": [{
                                    "billed_charge": 20336.50,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 661.45,
                            "providers": [{
                                    "billed_charge": 2204.81,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 551.49,
                            "providers": [{
                                    "billed_charge": 1838.17,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1330.41,
                            "providers": [{
                                    "billed_charge": 12284.21,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720535375"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 87.14,
                            "providers": [{
                                    "billed_charge": 290.46,
                                    "npi": [1275536799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 52.33,
                            "providers": [{
                                    "billed_charge": 174.43,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 26447.73,
                            "providers": [{
                                    "billed_charge": 88223.98,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2803.82,
                            "providers": [{
                                    "billed_charge": 9345.85,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DRUGS/INCIDNT RAD",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "255",
            "description": "PHARMACY - DRUGS INCIDENT TO RADIOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3591.01,
                            "providers": [{
                                    "billed_charge": 12111.12,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2801.60,
                            "providers": [{
                                    "billed_charge": 9338.61,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4665.30,
                            "providers": [{
                                    "billed_charge": 15550.93,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3637.57,
                            "providers": [{
                                    "billed_charge": 12125.03,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3707.99,
                            "providers": [{
                                    "billed_charge": 12359.98,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 3568.32,
                            "providers": [{
                                    "billed_charge": 11894.40,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7413.48,
                            "providers": [{
                                    "billed_charge": 68856.40,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 24748.85,
                            "providers": [{
                                    "billed_charge": 82495.13,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3253.00,
                            "providers": [{
                                    "billed_charge": 10843.26,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "IV SOLUTIONS",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "258",
            "description": "PHARMACY - IV SOLUTIONS",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 153.00,
                            "providers": [{
                                    "billed_charge": 510.00,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 454.03,
                            "providers": [{
                                    "billed_charge": 1513.44,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DRUGS/OTHER",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "259",
            "description": "PHARMACY - OTHER PHARMACY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1304.74,
                            "providers": [{
                                    "billed_charge": 4349.10,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 315.99,
                            "providers": [{
                                    "billed_charge": 1053.30,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1132.11,
                            "providers": [{
                                    "billed_charge": 3773.70,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 1296.54,
                            "providers": [{
                                    "billed_charge": 4321.81,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "720652905"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 191.66,
                            "providers": [{
                                    "billed_charge": 246.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }, {
                            "allowed_amount": 861.28,
                            "providers": [{
                                    "billed_charge": 1200.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204670876"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3887.94,
                            "providers": [{
                                    "billed_charge": 4866.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6574.49,
                            "providers": [{
                                    "billed_charge": 13440.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2914.52,
                            "providers": [{
                                    "billed_charge": 3248.00,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720880258"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2590.07,
                            "providers": [{
                                    "billed_charge": 4720.25,
                                    "npi": [1518924109]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 11844.52,
                            "providers": [{
                                    "billed_charge": 48125.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 31480.67,
                            "providers": [{
                                    "billed_charge": 96721.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 28958.95,
                            "providers": [{
                                    "billed_charge": 147506.50,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 415.42,
                            "providers": [{
                                    "billed_charge": 1623.07,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 50264.52,
                            "providers": [{
                                    "billed_charge": 52791.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9207.54,
                            "providers": [{
                                    "billed_charge": 16443.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 391.12,
                            "providers": [{
                                    "billed_charge": 729.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }, {
                            "allowed_amount": 44015.70,
                            "providers": [{
                                    "billed_charge": 89502.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3935.79,
                            "providers": [{
                                    "billed_charge": 6587.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 299.26,
                            "providers": [{
                                    "billed_charge": 2896.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 161095.78,
                            "providers": [{
                                    "billed_charge": 338697.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7725.89,
                            "providers": [{
                                    "billed_charge": 22762.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 177933.27,
                            "providers": [{
                                    "billed_charge": 279056.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10318.98,
                            "providers": [{
                                    "billed_charge": 15089.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "IV THERAPY/OTHER",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "269",
            "description": "IV THERAPY - OTHER IV THERAPY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 71.21,
                            "providers": [{
                                    "billed_charge": 307.61,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MED-SUR SUPPLIES",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "270",
            "description": "MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 56.41,
                            "providers": [{
                                    "billed_charge": 188.05,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1045.89,
                            "providers": [{
                                    "billed_charge": 3486.28,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 381.90,
                            "providers": [{
                                    "billed_charge": 1273.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 304.80,
                            "providers": [{
                                    "billed_charge": 1016.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "STERILE SUPPLY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "272",
            "description": "MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2313.14,
                            "providers": [{
                                    "billed_charge": 7710.48,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 587.30,
                            "providers": [{
                                    "billed_charge": 1957.69,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1164.25,
                            "providers": [{
                                    "billed_charge": 11726.28,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1853.42,
                            "providers": [{
                                    "billed_charge": 6178.03,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SUPPLY/IMPLANTS",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "278",
            "description": "MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANTS",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1190.38,
                            "providers": [{
                                    "billed_charge": 3967.90,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LABORATORY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "300",
            "description": "LABORATORY - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "204670876"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 17.38,
                            "providers": [{
                                    "billed_charge": 56.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }, {
                            "allowed_amount": 6345.25,
                            "providers": [{
                                    "billed_charge": 8426.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 161.75,
                            "providers": [{
                                    "billed_charge": 1306.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462605366"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3086.30,
                            "providers": [{
                                    "billed_charge": 5000.00,
                                    "npi": [1306281126]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5646.81,
                            "providers": [{
                                    "billed_charge": 8490.00,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3593.60,
                            "providers": [{
                                    "billed_charge": 13001.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 3746.78,
                            "providers": [{
                                    "billed_charge": 18214.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 65.71,
                            "providers": [{
                                    "billed_charge": 912.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 23.37,
                            "providers": [{
                                    "billed_charge": 1333.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }, {
                            "allowed_amount": 28783.33,
                            "providers": [{
                                    "billed_charge": 187571.44,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720880258"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5088.52,
                            "providers": [{
                                    "billed_charge": 11525.75,
                                    "npi": [1518924109]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 34161.97,
                            "providers": [{
                                    "billed_charge": 66707.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9141.23,
                            "providers": [{
                                    "billed_charge": 123275.22,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 66754.78,
                            "providers": [{
                                    "billed_charge": 117555.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 633.84,
                            "providers": [{
                                    "billed_charge": 2956.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2449.08,
                            "providers": [{
                                    "billed_charge": 28096.44,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7467.84,
                            "providers": [{
                                    "billed_charge": 26040.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }, {
                            "allowed_amount": 15.40,
                            "providers": [{
                                    "billed_charge": 573.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "19"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 560.15,
                            "providers": [{
                                    "billed_charge": 1203.24,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 1825.93,
                            "providers": [{
                                    "billed_charge": 3688.02,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "464958152"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1051.93,
                            "providers": [{
                                    "billed_charge": 2072.00,
                                    "npi": [1669882940]
                                }
                            ]
                        }, {
                            "allowed_amount": 23.37,
                            "providers": [{
                                    "billed_charge": 221.00,
                                    "npi": [1669882940]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 48225.12,
                            "providers": [{
                                    "billed_charge": 126997.85,
                                    "npi": [1710097936]
                                }
                            ]
                        }, {
                            "allowed_amount": 23.71,
                            "providers": [{
                                    "billed_charge": 1113.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3598.99,
                            "providers": [{
                                    "billed_charge": 7557.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6971.72,
                            "providers": [{
                                    "billed_charge": 8663.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1192.41,
                            "providers": [{
                                    "billed_charge": 3472.00,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3347.61,
                            "providers": [{
                                    "billed_charge": 33575.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720535375"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3764.89,
                            "providers": [{
                                    "billed_charge": 9763.00,
                                    "npi": [1275536799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1934.05,
                            "providers": [{
                                    "billed_charge": 6754.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "800945173"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3341.41,
                            "providers": [{
                                    "billed_charge": 7375.00,
                                    "npi": [1215939210]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 193278.31,
                            "providers": [{
                                    "billed_charge": 460138.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 160.41,
                            "providers": [{
                                    "billed_charge": 1465.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 51066.65,
                            "providers": [{
                                    "billed_charge": 77197.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }, {
                            "allowed_amount": 152.59,
                            "providers": [{
                                    "billed_charge": 824.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/CHEMISTRY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "301",
            "description": "LABORATORY - CHEMISTRY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 21.12,
                            "providers": [{
                                    "billed_charge": 498.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }, {
                            "allowed_amount": 5028.17,
                            "providers": [{
                                    "billed_charge": 9168.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204670876"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 665.36,
                            "providers": [{
                                    "billed_charge": 859.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }, {
                            "allowed_amount": 27.61,
                            "providers": [{
                                    "billed_charge": 89.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "611267229"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 298.23,
                            "providers": [{
                                    "billed_charge": 2418.30,
                                    "npi": [1477500015]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 597.10,
                            "providers": [{
                                    "billed_charge": 686.00,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 333.70,
                            "providers": [{
                                    "billed_charge": 5561.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 17017.83,
                            "providers": [{
                                    "billed_charge": 69226.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 13223.45,
                            "providers": [{
                                    "billed_charge": 47373.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720880258"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1294.49,
                            "providers": [{
                                    "billed_charge": 2210.50,
                                    "npi": [1518924109]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9468.94,
                            "providers": [{
                                    "billed_charge": 16236.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 209.52,
                            "providers": [{
                                    "billed_charge": 1011.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 12939.79,
                            "providers": [{
                                    "billed_charge": 15879.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423635"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 151.43,
                            "providers": [{
                                    "billed_charge": 1362.00,
                                    "npi": [1598766495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13475.87,
                            "providers": [{
                                    "billed_charge": 33681.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }, {
                            "allowed_amount": 76.99,
                            "providers": [{
                                    "billed_charge": 957.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 54711.78,
                            "providers": [{
                                    "billed_charge": 533801.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 8.46,
                            "providers": [{
                                    "billed_charge": 1246.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 15124.95,
                            "providers": [{
                                    "billed_charge": 38778.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "800945173"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 97.26,
                            "providers": [{
                                    "billed_charge": 154.00,
                                    "npi": [1215939210]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 50213.68,
                            "providers": [{
                                    "billed_charge": 71083.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 75.38,
                            "providers": [{
                                    "billed_charge": 694.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9020.57,
                            "providers": [{
                                    "billed_charge": 11859.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }, {
                            "allowed_amount": 52.72,
                            "providers": [{
                                    "billed_charge": 265.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408970"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 388.49,
                            "providers": [{
                                    "billed_charge": 11779.00,
                                    "npi": [1295723229]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3724.84,
                            "providers": [{
                                    "billed_charge": 27844.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 21.07,
                            "providers": [{
                                    "billed_charge": 533.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }, {
                            "allowed_amount": 12261.06,
                            "providers": [{
                                    "billed_charge": 48302.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "842046902"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1985.87,
                            "providers": [{
                                    "billed_charge": 4700.00,
                                    "npi": [1902465065]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 45.70,
                            "providers": [{
                                    "billed_charge": 979.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }, {
                            "allowed_amount": 1447.21,
                            "providers": [{
                                    "billed_charge": 5403.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726010747"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 264.75,
                            "providers": [{
                                    "billed_charge": 308.00,
                                    "npi": [1588654966]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "19"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 251.07,
                            "providers": [{
                                    "billed_charge": 5216.40,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 7154.82,
                            "providers": [{
                                    "billed_charge": 77631.01,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 44317.49,
                            "providers": [{
                                    "billed_charge": 63037.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1187.79,
                            "providers": [{
                                    "billed_charge": 1337.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4335.77,
                            "providers": [{
                                    "billed_charge": 14654.00,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720535375"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 365.18,
                            "providers": [{
                                    "billed_charge": 683.00,
                                    "npi": [1275536799]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/IMMUNOLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "302",
            "description": "LABORATORY - IMMUNOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 150.65,
                            "providers": [{
                                    "billed_charge": 509.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 404.05,
                            "providers": [{
                                    "billed_charge": 984.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 48.21,
                            "providers": [{
                                    "billed_charge": 610.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 218.97,
                            "providers": [{
                                    "billed_charge": 1602.70,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 531.60,
                            "providers": [{
                                    "billed_charge": 3293.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1230.83,
                            "providers": [{
                                    "billed_charge": 12991.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 139.08,
                            "providers": [{
                                    "billed_charge": 574.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 2144.49,
                            "providers": [{
                                    "billed_charge": 21142.23,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 32.00,
                            "providers": [{
                                    "billed_charge": 32.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/HEMATOLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "305",
            "description": "LABORATORY - HEMATOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7.77,
                            "providers": [{
                                    "billed_charge": 156.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }, {
                            "allowed_amount": 921.64,
                            "providers": [{
                                    "billed_charge": 2749.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "842046902"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 154.62,
                            "providers": [{
                                    "billed_charge": 300.00,
                                    "npi": [1902465065]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 431.13,
                            "providers": [{
                                    "billed_charge": 3483.15,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "19"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 83.94,
                            "providers": [{
                                    "billed_charge": 1505.25,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 944.27,
                            "providers": [{
                                    "billed_charge": 13666.25,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5052.12,
                            "providers": [{
                                    "billed_charge": 13636.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 636.78,
                            "providers": [{
                                    "billed_charge": 4633.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 954.68,
                            "providers": [{
                                    "billed_charge": 4932.00,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2585.17,
                            "providers": [{
                                    "billed_charge": 12911.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 2567.75,
                            "providers": [{
                                    "billed_charge": 13508.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 72.90,
                            "providers": [{
                                    "billed_charge": 1287.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6761.70,
                            "providers": [{
                                    "billed_charge": 94169.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2086.62,
                            "providers": [{
                                    "billed_charge": 4855.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1740.75,
                            "providers": [{
                                    "billed_charge": 13740.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1242.33,
                            "providers": [{
                                    "billed_charge": 1431.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 140.38,
                            "providers": [{
                                    "billed_charge": 422.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }, {
                            "allowed_amount": 3414.12,
                            "providers": [{
                                    "billed_charge": 5797.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2486.35,
                            "providers": [{
                                    "billed_charge": 3844.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "23", "19"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 256.73,
                            "providers": [{
                                    "billed_charge": 1858.55,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 473.38,
                            "providers": [{
                                    "billed_charge": 1309.40,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 601.90,
                            "providers": [{
                                    "billed_charge": 3231.40,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1050.24,
                            "providers": [{
                                    "billed_charge": 3053.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1307.92,
                            "providers": [{
                                    "billed_charge": 5158.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3593.98,
                            "providers": [{
                                    "billed_charge": 10286.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6102.82,
                            "providers": [{
                                    "billed_charge": 23924.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 9343.18,
                            "providers": [{
                                    "billed_charge": 43203.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 132.30,
                            "providers": [{
                                    "billed_charge": 1755.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 28662.40,
                            "providers": [{
                                    "billed_charge": 104409.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 1405.80,
                            "providers": [{
                                    "billed_charge": 12180.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 594.00,
                            "providers": [{
                                    "billed_charge": 2202.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7445.79,
                            "providers": [{
                                    "billed_charge": 13061.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 900.00,
                            "providers": [{
                                    "billed_charge": 4016.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "LAB/UROLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "307",
            "description": "LABORATORY - UROLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2689.74,
                            "providers": [{
                                    "billed_charge": 3777.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "19"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4.05,
                            "providers": [{
                                    "billed_charge": 253.35,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 79.77,
                            "providers": [{
                                    "billed_charge": 2331.45,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 366.05,
                            "providers": [{
                                    "billed_charge": 1286.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4819.59,
                            "providers": [{
                                    "billed_charge": 7997.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1773.88,
                            "providers": [{
                                    "billed_charge": 10038.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 1339.48,
                            "providers": [{
                                    "billed_charge": 4801.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 26.63,
                            "providers": [{
                                    "billed_charge": 656.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2902.20,
                            "providers": [{
                                    "billed_charge": 36590.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 501.76,
                            "providers": [{
                                    "billed_charge": 754.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 73.75,
                            "providers": [{
                                    "billed_charge": 700.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PATHOLOGY LAB",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "310",
            "description": "LABORATORY PATHOLOGICAL - GENERAL CLASSIFIATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1799.24,
                            "providers": [{
                                    "billed_charge": 6028.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PATHOL/HYSTOL",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "312",
            "description": "LABORATORY PATHOLOGICAL - HISTOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 949.39,
                            "providers": [{
                                    "billed_charge": 3037.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DX X-RAY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "320",
            "description": "RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10446.34,
                            "providers": [{
                                    "billed_charge": 14376.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }, {
                            "allowed_amount": 96.12,
                            "providers": [{
                                    "billed_charge": 390.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 19080.09,
                            "providers": [{
                                    "billed_charge": 21649.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 340.03,
                            "providers": [{
                                    "billed_charge": 1172.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 289.40,
                            "providers": [{
                                    "billed_charge": 1643.47,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9418.28,
                            "providers": [{
                                    "billed_charge": 15797.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 680.53,
                            "providers": [{
                                    "billed_charge": 2304.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7328.67,
                            "providers": [{
                                    "billed_charge": 9685.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 539.00,
                            "providers": [{
                                    "billed_charge": 539.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7201.58,
                            "providers": [{
                                    "billed_charge": 19100.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 5271.89,
                            "providers": [{
                                    "billed_charge": 13684.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 24232.39,
                            "providers": [{
                                    "billed_charge": 147336.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 481.05,
                            "providers": [{
                                    "billed_charge": 8194.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 176.13,
                            "providers": [{
                                    "billed_charge": 677.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 52712.34,
                            "providers": [{
                                    "billed_charge": 72452.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 96.03,
                            "providers": [{
                                    "billed_charge": 852.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }, {
                            "allowed_amount": 8034.20,
                            "providers": [{
                                    "billed_charge": 15954.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 30288.81,
                            "providers": [{
                                    "billed_charge": 37759.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5304.25,
                            "providers": [{
                                    "billed_charge": 13446.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13554.00,
                            "providers": [{
                                    "billed_charge": 13554.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 155.42,
                            "providers": [{
                                    "billed_charge": 372.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6283.36,
                            "providers": [{
                                    "billed_charge": 10944.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 561.32,
                            "providers": [{
                                    "billed_charge": 1384.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8237.77,
                            "providers": [{
                                    "billed_charge": 13828.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2111.94,
                            "providers": [{
                                    "billed_charge": 9324.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 3050.58,
                            "providers": [{
                                    "billed_charge": 13468.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 49315.80,
                            "providers": [{
                                    "billed_charge": 77385.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 159.37,
                            "providers": [{
                                    "billed_charge": 766.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 139.77,
                            "providers": [{
                                    "billed_charge": 799.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 40166.06,
                            "providers": [{
                                    "billed_charge": 65442.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 80.01,
                            "providers": [{
                                    "billed_charge": 208.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5298.28,
                            "providers": [{
                                    "billed_charge": 16386.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 16887.05,
                            "providers": [{
                                    "billed_charge": 21847.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 14064.18,
                            "providers": [{
                                    "billed_charge": 20236.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 38934.42,
                            "providers": [{
                                    "billed_charge": 43782.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 33922.66,
                            "providers": [{
                                    "billed_charge": 47494.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1040.60,
                            "providers": [{
                                    "billed_charge": 4448.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 143339.45,
                            "providers": [{
                                    "billed_charge": 328179.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 176.13,
                            "providers": [{
                                    "billed_charge": 812.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 29519.18,
                            "providers": [{
                                    "billed_charge": 119401.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CT SCAN/HEAD",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "351",
            "description": "CT SCAN - HEAD SCAN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10421.40,
                            "providers": [{
                                    "billed_charge": 16513.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 35314.00,
                            "providers": [{
                                    "billed_charge": 48397.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 14002.69,
                            "providers": [{
                                    "billed_charge": 34813.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3772.99,
                            "providers": [{
                                    "billed_charge": 9828.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 94396.32,
                            "providers": [{
                                    "billed_charge": 274597.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 158.05,
                            "providers": [{
                                    "billed_charge": 2765.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1931.09,
                            "providers": [{
                                    "billed_charge": 7442.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 95777.10,
                            "providers": [{
                                    "billed_charge": 244219.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10164.81,
                            "providers": [{
                                    "billed_charge": 15121.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 16919.30,
                            "providers": [{
                                    "billed_charge": 29800.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 11758.42,
                            "providers": [{
                                    "billed_charge": 14199.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 17650.16,
                            "providers": [{
                                    "billed_charge": 35021.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 54855.72,
                            "providers": [{
                                    "billed_charge": 79102.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 32045.90,
                            "providers": [{
                                    "billed_charge": 124249.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 40004.43,
                            "providers": [{
                                    "billed_charge": 143338.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 200885.14,
                            "providers": [{
                                    "billed_charge": 997158.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 504.30,
                            "providers": [{
                                    "billed_charge": 9293.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 76711.82,
                            "providers": [{
                                    "billed_charge": 244072.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13305.74,
                            "providers": [{
                                    "billed_charge": 44477.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 19497.04,
                            "providers": [{
                                    "billed_charge": 25890.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }, {
                            "allowed_amount": 397.85,
                            "providers": [{
                                    "billed_charge": 3151.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OR SERVICES",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "360",
            "description": "OPERATING ROOM SERVICES - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 11830.78,
                            "providers": [{
                                    "billed_charge": 21228.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 76615.24,
                            "providers": [{
                                    "billed_charge": 102150.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7677.95,
                            "providers": [{
                                    "billed_charge": 57749.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 70683.88,
                            "providers": [{
                                    "billed_charge": 337916.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OR/MINOR",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "361",
            "description": "OPERATING ROOM SERVICES - MINOR SURGERY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 12883.44,
                            "providers": [{
                                    "billed_charge": 24286.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "721111417"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 18.68,
                            "providers": [{
                                    "billed_charge": 44.00,
                                    "npi": [1407433592]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 294.83,
                            "providers": [{
                                    "billed_charge": 3201.29,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ANESTHESIA",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "370",
            "description": "ANESTHESIA - GENERAL CLASSIFICATIION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1817.40,
                            "providers": [{
                                    "billed_charge": 29107.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8219.10,
                            "providers": [{
                                    "billed_charge": 26809.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "BLOOD/STOR-PROC",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "390",
            "description": "BLOOD STORAGE AND PROCESSING - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 780.80,
                            "providers": [{
                                    "billed_charge": 2064.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 480.00,
                            "providers": [{
                                    "billed_charge": 1600.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "BLOOD/ADMIN",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "391",
            "description": "BLOOD STORAGE AND PROCESSING - BLOOD ADMINISTRATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 721.63,
                            "providers": [{
                                    "billed_charge": 3145.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ULTRASOUND",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "402",
            "description": "OTHER IMAGING SERVICES - ULTRASOUND",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 14236.96,
                            "providers": [{
                                    "billed_charge": 19729.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 93.39,
                            "providers": [{
                                    "billed_charge": 244.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 3367.14,
                            "providers": [{
                                    "billed_charge": 3522.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 434.60,
                            "providers": [{
                                    "billed_charge": 1564.81,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 735.49,
                            "providers": [{
                                    "billed_charge": 3615.29,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5231.31,
                            "providers": [{
                                    "billed_charge": 12323.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }, {
                            "allowed_amount": 192.24,
                            "providers": [{
                                    "billed_charge": 1101.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1050.42,
                            "providers": [{
                                    "billed_charge": 1955.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9700.53,
                            "providers": [{
                                    "billed_charge": 41952.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 97.65,
                            "providers": [{
                                    "billed_charge": 1061.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 19139.82,
                            "providers": [{
                                    "billed_charge": 50950.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 236.52,
                            "providers": [{
                                    "billed_charge": 528.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SCRN MAMMOGRAPHY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "403",
            "description": "OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1132.48,
                            "providers": [{
                                    "billed_charge": 2313.04,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "RESPIRATORY SVC",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "410",
            "description": "RESPIRATORY SERVICES - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1806.26,
                            "providers": [{
                                    "billed_charge": 2544.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 208.12,
                            "providers": [{
                                    "billed_charge": 438.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 961.20,
                            "providers": [{
                                    "billed_charge": 7767.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7327.77,
                            "providers": [{
                                    "billed_charge": 14587.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 490.83,
                            "providers": [{
                                    "billed_charge": 864.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PHYSICAL THERP",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "420",
            "description": "PHYSICAL THERAPY - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2703.47,
                            "providers": [{
                                    "billed_charge": 7301.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 71.74,
                            "providers": [{
                                    "billed_charge": 737.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 482.73,
                            "providers": [{
                                    "billed_charge": 2136.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 531.21,
                            "providers": [{
                                    "billed_charge": 1541.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PHYS THERP/EVAL",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "424",
            "description": "PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1406.26,
                            "providers": [{
                                    "billed_charge": 2766.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 94.91,
                            "providers": [{
                                    "billed_charge": 589.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 1316.66,
                            "providers": [{
                                    "billed_charge": 3535.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 283.78,
                            "providers": [{
                                    "billed_charge": 1480.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OCCUP THERP/EVAL",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "434",
            "description": "OCCUPATIONAL THERAPY - EVALUATION OR RE-EVALUATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1971.72,
                            "providers": [{
                                    "billed_charge": 3960.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SPEECH PATH/EVAL",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "444",
            "description": "SPEECH-LANGUAGE PATHOLOGY - EVALUATION OR RE-EVALUATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 834.86,
                            "providers": [{
                                    "billed_charge": 2129.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 48951.52,
                            "providers": [{
                                    "billed_charge": 60286.00,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204670876"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 12038.55,
                            "providers": [{
                                    "billed_charge": 15611.00,
                                    "npi": [1396761805]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "611267229"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 807.57,
                            "providers": [{
                                    "billed_charge": 1380.90,
                                    "npi": [1477500015]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462605366"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3429.73,
                            "providers": [{
                                    "billed_charge": 4239.00,
                                    "npi": [1306281126]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13203.00,
                            "providers": [{
                                    "billed_charge": 13203.00,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 147807.11,
                            "providers": [{
                                    "billed_charge": 375431.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 150386.30,
                            "providers": [{
                                    "billed_charge": 376481.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720880258"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 14782.43,
                            "providers": [{
                                    "billed_charge": 27700.00,
                                    "npi": [1518924109]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 256416.83,
                            "providers": [{
                                    "billed_charge": 333019.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 537626.47,
                            "providers": [{
                                    "billed_charge": 642964.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 455447.11,
                            "providers": [{
                                    "billed_charge": 577262.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "760591590"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4321.98,
                            "providers": [{
                                    "billed_charge": 25748.00,
                                    "npi": [1679557888]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 904021.62,
                            "providers": [{
                                    "billed_charge": 1598603.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 30891.10,
                            "providers": [{
                                    "billed_charge": 129057.00,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1645285.71,
                            "providers": [{
                                    "billed_charge": 3137266.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "800945173"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 12032.22,
                            "providers": [{
                                    "billed_charge": 18231.00,
                                    "npi": [1215939210]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 172931.25,
                            "providers": [{
                                    "billed_charge": 411645.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408970"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4839.21,
                            "providers": [{
                                    "billed_charge": 9482.00,
                                    "npi": [1295723229]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 59904.92,
                            "providers": [{
                                    "billed_charge": 89233.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 237898.22,
                            "providers": [{
                                    "billed_charge": 288940.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4459.92,
                            "providers": [{
                                    "billed_charge": 25698.64,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5180.90,
                            "providers": [{
                                    "billed_charge": 19742.81,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726010747"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5671.00,
                            "providers": [{
                                    "billed_charge": 7398.00,
                                    "npi": [1588654966]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 23907.41,
                            "providers": [{
                                    "billed_charge": 55109.24,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 55073.93,
                            "providers": [{
                                    "billed_charge": 57202.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 117640.55,
                            "providers": [{
                                    "billed_charge": 252915.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 36155.53,
                            "providers": [{
                                    "billed_charge": 53142.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 30388.88,
                            "providers": [{
                                    "billed_charge": 59628.00,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720535375"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9073.87,
                            "providers": [{
                                    "billed_charge": 15120.00,
                                    "npi": [1275536799]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PULMONARY FUNC",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "460",
            "description": "PULMONARY FUNCTION - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 231.90,
                            "providers": [{
                                    "billed_charge": 1276.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 323.36,
                            "providers": [{
                                    "billed_charge": 952.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ECHOCARDIOLOGY",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "483",
            "description": "CARDIOLOGY - ECHOCARDIOLOGY",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1386.70,
                            "providers": [{
                                    "billed_charge": 2141.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9706.90,
                            "providers": [{
                                    "billed_charge": 31270.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 995.81,
                            "providers": [{
                                    "billed_charge": 3761.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 10551.31,
                            "providers": [{
                                    "billed_charge": 15771.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "AMBUL SURG",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "490",
            "description": "AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 11362.78,
                            "providers": [{
                                    "billed_charge": 15824.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "RURAL/CLINIC",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "521",
            "description": "FREE-STANDING CLINIC - RURAL HEALTH-CLINIC",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "141958494"
                    },
                    "service_code": ["50"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 57966.03,
                            "providers": [{
                                    "billed_charge": 92236.34,
                                    "npi": [1659082105]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "AMBULANCE",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "540",
            "description": "AMBULANCE - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6283.99,
                            "providers": [{
                                    "billed_charge": 20728.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MRI-BRAIN",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "611",
            "description": "MRI - BRAIN (INCLUDING BRAINSTEM)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9447.84,
                            "providers": [{
                                    "billed_charge": 23823.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "MRI-SPINE",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "612",
            "description": "MRI - SPINAL CORD (INCLUDING SPINE)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6231.09,
                            "providers": [{
                                    "billed_charge": 16539.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9115.89,
                            "providers": [{
                                    "billed_charge": 27453.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "720652905"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 694.09,
                            "providers": [{
                                    "billed_charge": 2313.48,
                                    "npi": [1912943184]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204670876"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 517.40,
                            "providers": [{
                                    "billed_charge": 1384.46,
                                    "npi": [1396761805]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "314379491"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10.76,
                            "providers": [{
                                    "billed_charge": 35.85,
                                    "npi": [1942256888]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "462743282"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 836.15,
                            "providers": [{
                                    "billed_charge": 2103.51,
                                    "npi": [1326485749]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7390.62,
                            "providers": [{
                                    "billed_charge": 26195.12,
                                    "npi": [1548796378]
                                }
                            ]
                        }, {
                            "allowed_amount": 4956.87,
                            "providers": [{
                                    "billed_charge": 20423.38,
                                    "npi": [1629076468]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720880258"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 169.30,
                            "providers": [{
                                    "billed_charge": 564.31,
                                    "npi": [1518924109]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6816.39,
                            "providers": [{
                                    "billed_charge": 21406.75,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 212.31,
                            "providers": [{
                                    "billed_charge": 883.20,
                                    "npi": [1053360651]
                                }
                            ]
                        }, {
                            "allowed_amount": 23600.05,
                            "providers": [{
                                    "billed_charge": 74164.39,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423635"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 67.86,
                            "providers": [{
                                    "billed_charge": 302.91,
                                    "npi": [1598766495]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7908.32,
                            "providers": [{
                                    "billed_charge": 26168.97,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 16305.70,
                            "providers": [{
                                    "billed_charge": 161629.07,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 1570.10,
                            "providers": [{
                                    "billed_charge": 17765.22,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "451834769"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3071.16,
                            "providers": [{
                                    "billed_charge": 10237.40,
                                    "npi": [1144227539]
                                }
                            ]
                        }, {
                            "allowed_amount": 191.25,
                            "providers": [{
                                    "billed_charge": 5390.62,
                                    "npi": [1144227539]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 32023.28,
                            "providers": [{
                                    "billed_charge": 104584.19,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 777.50,
                            "providers": [{
                                    "billed_charge": 6767.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "800945173"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 53.01,
                            "providers": [{
                                    "billed_charge": 176.71,
                                    "npi": [1215939210]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2005.87,
                            "providers": [{
                                    "billed_charge": 5326.32,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 719.22,
                            "providers": [{
                                    "billed_charge": 6143.47,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 29998.12,
                            "providers": [{
                                    "billed_charge": 142605.52,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9453.39,
                            "providers": [{
                                    "billed_charge": 31512.10,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "863658746"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2083.08,
                            "providers": [{
                                    "billed_charge": 6809.71,
                                    "npi": [1649849910]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 915.11,
                            "providers": [{
                                    "billed_charge": 3044.37,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720551963"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6.58,
                            "providers": [{
                                    "billed_charge": 2144.01,
                                    "npi": [1972549855]
                                }
                            ]
                        }, {
                            "allowed_amount": 54845.87,
                            "providers": [{
                                    "billed_charge": 185044.25,
                                    "npi": [1972549855]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726010747"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 9293.10,
                            "providers": [{
                                    "billed_charge": 30977.00,
                                    "npi": [1588654966]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3239.81,
                            "providers": [{
                                    "billed_charge": 10933.15,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1696.89,
                            "providers": [{
                                    "billed_charge": 5426.51,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408984"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 370.16,
                            "providers": [{
                                    "billed_charge": 1233.84,
                                    "npi": [1639160799]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720535375"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1290.53,
                            "providers": [{
                                    "billed_charge": 4301.76,
                                    "npi": [1275536799]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "RECOVERY ROOM",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "710",
            "description": "RECOVERY ROOM - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1896.60,
                            "providers": [{
                                    "billed_charge": 18506.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6114.60,
                            "providers": [{
                                    "billed_charge": 20382.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "X-RAY EXAM CHEST 1 VIEW",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "71045",
            "description": "RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "741740101"
                    },
                    "service_code": ["22", "23", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 6.48,
                            "providers": [{
                                    "billed_charge": 202.00,
                                    "npi": [1245213164]
                                }
                            ]
                        }, {
                            "allowed_amount": 25.92,
                            "providers": [{
                                    "billed_charge": 808.00,
                                    "npi": [1245213164]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "EKG/ECG",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "730",
            "description": "EKG/ECG - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "463123178"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 386.08,
                            "providers": [{
                                    "billed_charge": 1192.00,
                                    "npi": [1093140600]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720411322"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6255.36,
                            "providers": [{
                                    "billed_charge": 18624.00,
                                    "npi": [1629076468]
                                }
                            ]
                        }, {
                            "allowed_amount": 3127.68,
                            "providers": [{
                                    "billed_charge": 9312.00,
                                    "npi": [1548796378]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6112.20,
                            "providers": [{
                                    "billed_charge": 15660.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }, {
                            "allowed_amount": 53.41,
                            "providers": [{
                                    "billed_charge": 261.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5297.24,
                            "providers": [{
                                    "billed_charge": 8684.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "994947730"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 214.21,
                            "providers": [{
                                    "billed_charge": 1007.00,
                                    "npi": [1427878909]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10848.00,
                            "providers": [{
                                    "billed_charge": 10848.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014606"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 305.61,
                            "providers": [{
                                    "billed_charge": 354.00,
                                    "npi": [1295716637]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 11409.44,
                            "providers": [{
                                    "billed_charge": 15680.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720408982"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 3147.20,
                            "providers": [{
                                    "billed_charge": 8224.00,
                                    "npi": [1417950106]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "880907240"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 193.04,
                            "providers": [{
                                    "billed_charge": 238.00,
                                    "npi": [1184373268]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 26321.52,
                            "providers": [{
                                    "billed_charge": 91336.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 50629.39,
                            "providers": [{
                                    "billed_charge": 58646.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 6687.80,
                            "providers": [{
                                    "billed_charge": 9452.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "GASTR-INTS SVS",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "750",
            "description": "GASTRO-INTESTINAL SERVICES - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2350.64,
                            "providers": [{
                                    "billed_charge": 5289.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "TREATMENT ROOM",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "761",
            "description": "TREATMENT OR OBSERVATION ROOM - TREATMENT ROOM",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8066.81,
                            "providers": [{
                                    "billed_charge": 22342.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }, {
                            "allowed_amount": 732.58,
                            "providers": [{
                                    "billed_charge": 5200.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OBSERVATION ROOM",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "762",
            "description": "TREATMENT OR OBSERVATION ROOM - OBSERVATION ROOM",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "261576974"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2379.00,
                            "providers": [{
                                    "billed_charge": 7930.00,
                                    "npi": [1083903744]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "201729674"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4100.10,
                            "providers": [{
                                    "billed_charge": 13667.00,
                                    "npi": [1053360651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 4126.80,
                            "providers": [{
                                    "billed_charge": 13756.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 28600.50,
                            "providers": [{
                                    "billed_charge": 290612.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["22", "23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 82620.00,
                            "providers": [{
                                    "billed_charge": 275400.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }, {
                            "allowed_amount": 2404.72,
                            "providers": [{
                                    "billed_charge": 5261.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726014895"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 2085.00,
                            "providers": [{
                                    "billed_charge": 6950.00,
                                    "npi": [1578568481]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "831173631"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 8059.50,
                            "providers": [{
                                    "billed_charge": 26865.00,
                                    "npi": [1427536325]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "741740101"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 236.50,
                            "providers": [{
                                    "billed_charge": 2343.00,
                                    "npi": [1679872568]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204722218"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 329.40,
                            "providers": [{
                                    "billed_charge": 900.00,
                                    "npi": [1265751259]
                                }
                            ]
                        }, {
                            "allowed_amount": 631.35,
                            "providers": [{
                                    "billed_charge": 1725.00,
                                    "npi": [1871598474]
                                }
                            ]
                        }, {
                            "allowed_amount": 1684.98,
                            "providers": [{
                                    "billed_charge": 4725.00,
                                    "npi": [1609195312]
                                }
                            ]
                        }, {
                            "allowed_amount": 161.22,
                            "providers": [{
                                    "billed_charge": 450.00,
                                    "npi": [1861724080]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "741740101"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 278.60,
                            "providers": [{
                                    "billed_charge": 3476.00,
                                    "npi": [1679872568]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "204722218"
                    },
                    "service_code": ["22"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 416.64,
                            "providers": [{
                                    "billed_charge": 1368.00,
                                    "npi": [1265751259]
                                }
                            ]
                        }, {
                            "allowed_amount": 203.88,
                            "providers": [{
                                    "billed_charge": 684.00,
                                    "npi": [1861724080]
                                }
                            ]
                        }, {
                            "allowed_amount": 833.28,
                            "providers": [{
                                    "billed_charge": 2736.00,
                                    "npi": [1871598474]
                                }
                            ]
                        }, {
                            "allowed_amount": 2132.46,
                            "providers": [{
                                    "billed_charge": 7182.00,
                                    "npi": [1609195312]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "VACCINE ADMIN",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "771",
            "description": "PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 231.12,
                            "providers": [{
                                    "billed_charge": 1649.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 543.84,
                            "providers": [{
                                    "billed_charge": 836.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 258.35,
                            "providers": [{
                                    "billed_charge": 3026.40,
                                    "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 192.21,
                            "providers": [{
                                    "billed_charge": 2303.08,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DRUG TEST PRSMV CHEM ANLYZR",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "80307",
            "description": "DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 6100.50,
                            "providers": [{
                                    "billed_charge": 54807.48,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "URINALYSIS AUTO W/SCOPE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "81001",
            "description": "URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 40.28,
                            "providers": [{
                                    "billed_charge": 481.84,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "NFCT DS BV&VAGINITIS DNA ALG",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "81514",
            "description": "NFCT DS BCT VAGINOSIS&VAGINITIS DNA VAG FLU ALG",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 614.88,
                            "providers": [{
                                    "billed_charge": 7000.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "VITAMIN D 25 HYDROXY",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "82306",
            "description": "VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 418.81,
                            "providers": [{
                                    "billed_charge": 4891.40,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "VITAMIN B-12",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "82607",
            "description": "CYANOCOBALAMIN (VITAMIN B-12);",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 110.88,
                            "providers": [{
                                    "billed_charge": 1327.04,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF FOLIC ACID SERUM",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "82746",
            "description": "FOLIC ACID; SERUM",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 73.65,
                            "providers": [{
                                    "billed_charge": 882.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF GGT",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "82977",
            "description": "GLUTAMYLTRANSFERASE, GAMMA (GGT)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 28.80,
                            "providers": [{
                                    "billed_charge": 345.60,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 165.24,
                            "providers": [{
                                    "billed_charge": 1980.84,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF MAGNESIUM",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "83735",
            "description": "MAGNESIUM",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2.24,
                            "providers": [{
                                    "billed_charge": 26.80,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY OF FREE THYROXINE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "84439",
            "description": "THYROXINE; FREE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 36.12,
                            "providers": [{
                                    "billed_charge": 432.96,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "ASSAY THYROID STIM HORMONE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "84443",
            "description": "THYROID STIMULATING HORMONE (TSH)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 91.71,
                            "providers": [{
                                    "billed_charge": 1092.00,
                                    "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 169.90,
                            "providers": [{
                                    "billed_charge": 2025.12,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SYPHILIS TEST NON-TREP QUAL",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "86592",
            "description": "SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 81.51,
                            "providers": [{
                                    "billed_charge": 973.56,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEP B CORE ANTIBODY, TOTAL",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "86704",
            "description": "HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 180.90,
                            "providers": [{
                                    "billed_charge": 2169.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEP B SURFACE ANTIBODY",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "86706",
            "description": "HEPATITIS B SURFACE ANTIBODY (HBSAB)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 161.55,
                            "providers": [{
                                    "billed_charge": 1933.20,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEPATITIS A ANTIBODY",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "86708",
            "description": "HEPATITIS A ANTIBODY (HAAB)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 186.30,
                            "providers": [{
                                    "billed_charge": 2230.20,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEPATITIS C AB TEST",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "86803",
            "description": "HEPATITIS C ANTIBODY;",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 214.65,
                            "providers": [{
                                    "billed_charge": 2568.60,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HEPATITIS B SURFACE AG IA",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87340",
            "description": "INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 148.35,
                            "providers": [{
                                    "billed_charge": 1776.76,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HIV-1 AG W/HIV-1 & HIV-2 AB",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87389",
            "description": "INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 471.92,
                            "providers": [{
                                    "billed_charge": 5561.92,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CORONAVIRUS AG IA",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87426",
            "description": "IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 40.63,
                            "providers": [{
                                    "billed_charge": 109.00,
                                    "npi": [1780891523]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CHYLMD TRACH, DNA, AMP PROBE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87491",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1195.44,
                            "providers": [{
                                    "billed_charge": 11850.39,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "HSV, DNA, AMP PROBE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87529",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHN",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 316.44,
                            "providers": [{
                                    "billed_charge": 3510.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "M. GENITALIUM AMP PROBE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87563",
            "description": "IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 398.48,
                            "providers": [{
                                    "billed_charge": 4395.27,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "N.GONORRHOEAE, DNA, AMP PROB",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87591",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1195.44,
                            "providers": [{
                                    "billed_charge": 11850.39,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 23.44,
                            "providers": [{
                                    "billed_charge": 340.00,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "STAPH A, DNA, AMP PROBE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87640",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 128.92,
                            "providers": [{
                                    "billed_charge": 1405.27,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "STREP B, DNA, AMP PROBE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87653",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 199.24,
                            "providers": [{
                                    "billed_charge": 2185.27,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "TRICHOMONAS VAGINALIS AMPLIF",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87661",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 773.52,
                            "providers": [{
                                    "billed_charge": 7417.69,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DETECT AGENT NOS, DNA, AMP",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "87798",
            "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE TE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 234.40,
                            "providers": [{
                                    "billed_charge": 2600.00,
                                    "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": "726000821"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 491.40,
                            "providers": [{
                                    "billed_charge": 737.10,
                                    "npi": [1942221098]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 80.90,
                            "providers": [{
                                    "billed_charge": 255.00,
                                    "npi": [1982166294]
                                }
                            ]
                        }, {
                            "allowed_amount": 113.26,
                            "providers": [{
                                    "billed_charge": 357.00,
                                    "npi": [1013469022]
                                }
                            ]
                        }, {
                            "allowed_amount": 16.18,
                            "providers": [{
                                    "billed_charge": 51.00,
                                    "npi": [1043475759]
                                }
                            ]
                        }, {
                            "allowed_amount": 418.66,
                            "providers": [{
                                    "billed_charge": 1122.00,
                                    "npi": [1780891523]
                                }
                            ]
                        }, {
                            "allowed_amount": 48.54,
                            "providers": [{
                                    "billed_charge": 153.00,
                                    "npi": [1023440385, 1639552979]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 35.56,
                            "providers": [{
                                    "billed_charge": 331.44,
                                    "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": "720679679"
                    },
                    "service_code": ["81", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 62.12,
                            "providers": [{
                                    "billed_charge": 254.00,
                                    "npi": [1366647646]
                                }
                            ]
                        }, {
                            "allowed_amount": 67.74,
                            "providers": [{
                                    "billed_charge": 176.00,
                                    "npi": [1366647646]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720933293"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3335.40,
                            "providers": [{
                                    "billed_charge": 8322.15,
                                    "npi": [1699236992]
                                }
                            ]
                        }, {
                            "allowed_amount": 4122.20,
                            "providers": [{
                                    "billed_charge": 10249.24,
                                    "npi": [1972007151]
                                }
                            ]
                        }, {
                            "allowed_amount": 725.15,
                            "providers": [{
                                    "billed_charge": 1816.05,
                                    "npi": [1043579709]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "BH/INTENS OP/PSYCH",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "905",
            "description": "INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "850961512"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1800.00,
                            "providers": [{
                                    "billed_charge": 3300.00,
                                    "npi": [1356950398]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "471052932"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 5850.00,
                            "providers": [{
                                    "billed_charge": 28800.00,
                                    "npi": [1487067237]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "800966827"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1900.00,
                            "providers": [{
                                    "billed_charge": 20000.00,
                                    "npi": [1104212794]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "882656603"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 10080.00,
                            "providers": [{
                                    "billed_charge": 33600.00,
                                    "npi": [1114655834]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PSYCH DIAG EVAL W/MED SRVCS",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "90792",
            "description": "PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "711018775"
                    },
                    "service_code": ["56"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 735.00,
                            "providers": [{
                                    "billed_charge": 735.00,
                                    "npi": [1932763513]
                                }
                            ]
                        }, {
                            "allowed_amount": 1365.00,
                            "providers": [{
                                    "billed_charge": 1365.00,
                                    "npi": [1124889829]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PSYTX W PT W E/M 30 MIN",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "90833",
            "description": "PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "815146293"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 894.08,
                            "providers": [{
                                    "billed_charge": 1280.00,
                                    "npi": [1841882875]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "333583756"
                    },
                    "service_code": ["11", "02", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1112.65,
                            "providers": [{
                                    "billed_charge": 1320.00,
                                    "npi": [1689119422]
                                }
                            ]
                        }, {
                            "allowed_amount": 101.15,
                            "providers": [{
                                    "billed_charge": 120.00,
                                    "npi": [1689119422]
                                }
                            ]
                        }, {
                            "allowed_amount": 3960.00,
                            "providers": [{
                                    "billed_charge": 3960.00,
                                    "npi": [1689119422]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "474068451"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1096.02,
                            "providers": [{
                                    "billed_charge": 2979.00,
                                    "npi": [1831970185]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "462411016"
                    },
                    "service_code": ["50"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 854.62,
                            "providers": [{
                                    "billed_charge": 1454.26,
                                    "npi": [1881779320]
                                }
                            ]
                        }, {
                            "allowed_amount": 427.31,
                            "providers": [{
                                    "billed_charge": 727.13,
                                    "npi": [1689236119]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "383756689"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 420.47,
                            "providers": [{
                                    "billed_charge": 952.85,
                                    "npi": [1316475387]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "831183200"
                    },
                    "service_code": ["22"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7326.46,
                            "providers": [{
                                    "billed_charge": 13825.00,
                                    "npi": [1902381403]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OTHER DX SVS",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "920",
            "description": "OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1227.52,
                            "providers": [{
                                    "billed_charge": 1666.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "PERI VASCUL LAB",
            "billing_code_type": "RC",
            "billing_code_type_version": "2022",
            "billing_code": "921",
            "description": "OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "205432782"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 1477.54,
                            "providers": [{
                                    "billed_charge": 1813.00,
                                    "npi": [1710097936]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720423651"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 7055.34,
                            "providers": [{
                                    "billed_charge": 17372.00,
                                    "npi": [1366436123]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720502505"
                    },
                    "service_code": ["23"],
                    "billing_class": "institutional",
                    "payments": [{
                            "allowed_amount": 13559.90,
                            "providers": [{
                                    "billed_charge": 16514.00,
                                    "npi": [1811973100]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SLP STDY UNATTENDED",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "95800",
            "description": "SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; HEART RATE, OXYGEN SATURATION, RESPIRATORY ANALYSIS",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "450538779"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 898.59,
                            "providers": [{
                                    "billed_charge": 4725.00,
                                    "npi": [1295786655]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "THER/PROPH/DIAG INJ SC/IM",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "96372",
            "description": "THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 239.26,
                            "providers": [{
                                    "billed_charge": 1400.00,
                                    "npi": [1780891523]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OFFICE/OUTPATIENT VISIT NEW",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99203",
            "description": "OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3169.20,
                            "providers": [{
                                    "billed_charge": 10416.00,
                                    "npi": [1780891523]
                                }
                            ]
                        }, {
                            "allowed_amount": 1347.00,
                            "providers": [{
                                    "billed_charge": 5208.00,
                                    "npi": [1023440385]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "OFFICE/OUTPATIENT VISIT NEW",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99204",
            "description": "OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1596.96,
                            "providers": [{
                                    "billed_charge": 5344.00,
                                    "npi": [1780891523]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "720743677"
                    },
                    "service_code": ["02", "50", "10"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 26.35,
                            "providers": [{
                                    "billed_charge": 37.65,
                                    "npi": [1396326955]
                                }
                            ]
                        }, {
                            "allowed_amount": 52.70,
                            "providers": [{
                                    "billed_charge": 75.30,
                                    "npi": [1396326955]
                                }
                            ]
                        }, {
                            "allowed_amount": 263.55,
                            "providers": [{
                                    "billed_charge": 263.55,
                                    "npi": [1396326955]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1919.34,
                            "providers": [{
                                    "billed_charge": 5274.00,
                                    "npi": [1790817955]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "721111417"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 862.20,
                            "providers": [{
                                    "billed_charge": 865.00,
                                    "npi": [1407433592]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721245632"
                    },
                    "service_code": ["11"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3145.00,
                            "providers": [{
                                    "billed_charge": 3145.00,
                                    "npi": [1124580535]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SUBSEQUENT HOSPITAL CARE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99231",
            "description": "SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "752883437"
                    },
                    "service_code": ["61", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 43.42,
                            "providers": [{
                                    "billed_charge": 70.00,
                                    "npi": [1750340105]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SUBSEQUENT HOSPITAL CARE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99232",
            "description": "SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "721475018"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2475.72,
                            "providers": [{
                                    "billed_charge": 4608.00,
                                    "npi": [1366419590]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "812175816"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 939.86,
                            "providers": [{
                                    "billed_charge": 2405.00,
                                    "npi": [1477336725]
                                }
                            ]
                        }, {
                            "allowed_amount": 526.14,
                            "providers": [{
                                    "billed_charge": 1665.00,
                                    "npi": [1003273574]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721450954"
                    },
                    "service_code": ["61", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 5197.02,
                            "providers": [{
                                    "billed_charge": 8140.00,
                                    "npi": [1194887125]
                                }
                            ]
                        }, {
                            "allowed_amount": 206.54,
                            "providers": [{
                                    "billed_charge": 220.00,
                                    "npi": [1194887125]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720687735"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2626.80,
                            "providers": [{
                                    "billed_charge": 6600.00,
                                    "npi": [1396597506]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "433735670"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 11857.46,
                            "providers": [{
                                    "billed_charge": 13600.00,
                                    "npi": [1558751651]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "810608560"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3921.38,
                            "providers": [{
                                    "billed_charge": 4100.00,
                                    "npi": [1679501712]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "815146293"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 358.20,
                            "providers": [{
                                    "billed_charge": 1050.00,
                                    "npi": [1841882875]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720276883"
                    },
                    "service_code": ["61"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1718.56,
                            "providers": [{
                                    "billed_charge": 3840.00,
                                    "npi": [1679886071]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "435319285"
                    },
                    "service_code": ["51"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1265.58,
                            "providers": [{
                                    "billed_charge": 1400.00,
                                    "npi": [1275543589]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "264135949"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 550.16,
                            "providers": [{
                                    "billed_charge": 1210.40,
                                    "npi": [1346231834]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721245632"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 103.16,
                            "providers": [{
                                    "billed_charge": 133.00,
                                    "npi": [1396107975]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "SUBSEQUENT HOSPITAL CARE",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99233",
            "description": "SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "721450954"
                    },
                    "service_code": ["61", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 4675.68,
                            "providers": [{
                                    "billed_charge": 6665.00,
                                    "npi": [1194887125]
                                }
                            ]
                        }, {
                            "allowed_amount": 155.00,
                            "providers": [{
                                    "billed_charge": 155.00,
                                    "npi": [1194887125]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "871765775"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1785.59,
                            "providers": [{
                                    "billed_charge": 2975.00,
                                    "npi": [1295408698]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "822548084"
                    },
                    "service_code": ["21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3876.92,
                            "providers": [{
                                    "billed_charge": 5600.00,
                                    "npi": [1710400833]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721269878"
                    },
                    "service_code": ["22", "21"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 122.45,
                            "providers": [{
                                    "billed_charge": 420.00,
                                    "npi": [1760913487]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "NURSING FAC CARE SUBSEQ",
            "billing_code_type": "CPT",
            "billing_code_type_version": "2022",
            "billing_code": "99309",
            "description": "SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "462453627"
                    },
                    "service_code": ["31"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 242.04,
                            "providers": [{
                                    "billed_charge": 504.00,
                                    "npi": [1952031494]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "726000137"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 43514.74,
                            "providers": [{
                                    "billed_charge": 44116.80,
                                    "npi": [1760408926]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726001326"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 9091.61,
                            "providers": [{
                                    "billed_charge": 9108.93,
                                    "npi": [1396861415]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "200817213"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 85101.31,
                            "providers": [{
                                    "billed_charge": 124017.39,
                                    "npi": [1285630459]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472667968"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 26841.26,
                            "providers": [{
                                    "billed_charge": 36078.00,
                                    "npi": [1285464578]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000969"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 36390.00,
                            "providers": [{
                                    "billed_charge": 36390.00,
                                    "npi": [1982671202]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720701964"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 227060.45,
                            "providers": [{
                                    "billed_charge": 336040.22,
                                    "npi": [1316943566]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000499"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 1364.53,
                            "providers": [{
                                    "billed_charge": 1557.50,
                                    "npi": [1053373670]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721315055"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 16464.27,
                            "providers": [{
                                    "billed_charge": 16503.00,
                                    "npi": [1063533610]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "AMB SVC ALS NON ER TRSPRT L1",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "A0426",
            "description": "AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NONEMERGENCY TRANSPORT, LEVEL 1 (ALS 1)",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "472667968"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 6511.44,
                            "providers": [{
                                    "billed_charge": 11040.00,
                                    "npi": [1285464578]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "726001326"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 106900.50,
                            "providers": [{
                                    "billed_charge": 112000.00,
                                    "npi": [1396861415]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000137"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 266480.52,
                            "providers": [{
                                    "billed_charge": 267750.00,
                                    "npi": [1760408926]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472667968"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 106778.52,
                            "providers": [{
                                    "billed_charge": 111600.00,
                                    "npi": [1285464578]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "200817213"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 369069.91,
                            "providers": [{
                                    "billed_charge": 570877.99,
                                    "npi": [1285630459]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000969"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 316394.36,
                            "providers": [{
                                    "billed_charge": 357099.00,
                                    "npi": [1982671202]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720701964"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 427217.80,
                            "providers": [{
                                    "billed_charge": 664222.69,
                                    "npi": [1316943566]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000499"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 3200.00,
                            "providers": [{
                                    "billed_charge": 3200.00,
                                    "npi": [1053373670]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "200817213"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 29843.55,
                            "providers": [{
                                    "billed_charge": 55027.40,
                                    "npi": [1285630459]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472667968"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 26970.00,
                            "providers": [{
                                    "billed_charge": 26970.00,
                                    "npi": [1285464578]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720701964"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 77071.17,
                            "providers": [{
                                    "billed_charge": 138621.50,
                                    "npi": [1316943566]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "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": "726000137"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 152757.44,
                            "providers": [{
                                    "billed_charge": 153000.00,
                                    "npi": [1760408926]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "200817213"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 93736.17,
                            "providers": [{
                                    "billed_charge": 137923.80,
                                    "npi": [1285630459]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "472667968"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 26045.46,
                            "providers": [{
                                    "billed_charge": 27252.00,
                                    "npi": [1285464578]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "726000969"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 117079.40,
                            "providers": [{
                                    "billed_charge": 121705.00,
                                    "npi": [1982671202]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "720701964"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 133196.61,
                            "providers": [{
                                    "billed_charge": 200068.88,
                                    "npi": [1316943566]
                                }
                            ]
                        }
                    ]
                }, {
                    "tin": {
                        "type": "ein",
                        "value": "721315055"
                    },
                    "service_code": ["41"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 44160.00,
                            "providers": [{
                                    "billed_charge": 44160.00,
                                    "npi": [1063533610]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DR TST DEFIN DR ID M P D 1-7",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "G0480",
            "description": "DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 2140.32,
                            "providers": [{
                                    "billed_charge": 19224.24,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "DR TST DEFIN DR ID M P D 8-1",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "G0481",
            "description": "DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "999999999"
                    },
                    "service_code": ["81"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 104.60,
                            "providers": [{
                                    "billed_charge": 939.54,
                                    "npi": [1234567893]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "INJ DEXMETH SODM PHOSHA 1MG",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "J1100",
            "description": "INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "464568405"
                    },
                    "service_code": ["20"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 13.97,
                            "providers": [{
                                    "billed_charge": 58.30,
                                    "npi": [1780891523]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "TRAVL 1 WAY NEC LAB SPEC; AC",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "P9603",
            "description": "TRAVEL ALLOWANCE, ONE WAY IN CONNECTION W MEDICALLY NECESSARY LABORATORY SPECIMEN COLLECTION DRAWN F",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "810740765"
                    },
                    "service_code": ["32"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 121.04,
                            "providers": [{
                                    "billed_charge": 170.00,
                                    "npi": [1528514221]
                                }
                            ]
                        }
                    ]
                }
            ]
        }, {
            "name": "CRISIS INTRVNT MNTL HLTH SVC",
            "billing_code_type": "HCPCS",
            "billing_code_type_version": "2022",
            "billing_code": "S9485",
            "description": "CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM",
            "allowed_amounts": [{
                    "tin": {
                        "type": "ein",
                        "value": "711018775"
                    },
                    "service_code": ["56"],
                    "billing_class": "professional",
                    "payments": [{
                            "allowed_amount": 162.50,
                            "providers": [{
                                    "billed_charge": 650.00,
                                    "npi": [1497378764]
                                }
                            ]
                        }, {
                            "allowed_amount": 3250.00,
                            "providers": [{
                                    "billed_charge": 3250.00,
                                    "npi": [1932763513]
                                }
                            ]
                        }
                    ]
                }
            ]
        }
    ]
}
