{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"1.0.0","last_updated_on":"2025-04-30","out_of_network":[{"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":"721561132"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":61137.90,"providers":[{"billed_charge":76752.00,"npi":[1700910189]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":25715.40,"providers":[{"billed_charge":75454.00,"npi":[1992735088]}]},{"allowed_amount":1265.22,"providers":[{"billed_charge":2441.00,"npi":[1992735088]}]},{"allowed_amount":112.32,"providers":[{"billed_charge":208.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":589152.00,"providers":[{"billed_charge":981920.00,"npi":[1760480503]}]},{"allowed_amount":10810.80,"providers":[{"billed_charge":18018.00,"npi":[1760480503]}]},{"allowed_amount":12468.60,"providers":[{"billed_charge":20781.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"860098923"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":16.80,"providers":[{"billed_charge":56.00,"npi":[1902897820]}]},{"allowed_amount":44.42,"providers":[{"billed_charge":189.00,"npi":[1902897820]}]}]},{"tin":{"type":"ein","value":"833547294"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2174.56,"providers":[{"billed_charge":7248.54,"npi":[1609496397]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5668.38,"providers":[{"billed_charge":10497.00,"npi":[1154748416]}]},{"allowed_amount":72.90,"providers":[{"billed_charge":218.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":1681.25,"providers":[{"billed_charge":3508.40,"npi":[1700910189]}]},{"allowed_amount":6.48,"providers":[{"billed_charge":12.00,"npi":[1700910189]}]},{"allowed_amount":145.80,"providers":[{"billed_charge":270.00,"npi":[1700910189]}]},{"allowed_amount":38994.18,"providers":[{"billed_charge":85534.90,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7432.94,"providers":[{"billed_charge":14910.00,"npi":[1982733655]}]},{"allowed_amount":11.34,"providers":[{"billed_charge":21.00,"npi":[1982733655]}]},{"allowed_amount":1304.22,"providers":[{"billed_charge":3840.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":47.95,"providers":[{"billed_charge":8001.70,"npi":[]}]},{"allowed_amount":0.69,"providers":[{"billed_charge":133.80,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":7317.02,"providers":[{"billed_charge":24505.62,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":232.74,"providers":[{"billed_charge":435.00,"npi":[1992131734]}]}]}]},{"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":"860422559"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5610.00,"providers":[{"billed_charge":9350.00,"npi":[1760480503]}]},{"allowed_amount":9191.00,"providers":[{"billed_charge":15220.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"851516898"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10435.64,"providers":[{"billed_charge":29109.00,"npi":[1518539048]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4278.40,"providers":[{"billed_charge":9334.00,"npi":[1700910189]}]},{"allowed_amount":9941.36,"providers":[{"billed_charge":20522.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":6530.76,"providers":[{"billed_charge":17643.00,"npi":[1982733655]}]},{"allowed_amount":19298.86,"providers":[{"billed_charge":43944.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1101.54,"providers":[{"billed_charge":14352.70,"npi":[]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15382.12,"providers":[{"billed_charge":29130.00,"npi":[1992131734]}]}]}]},{"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":"862195601"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1753.02,"providers":[{"billed_charge":5827.71,"npi":[1881352037]}]}]},{"tin":{"type":"ein","value":"821703810"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":219.36,"providers":[{"billed_charge":776.48,"npi":[1356818496]}]}]}]},{"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":"833547294"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":486.75,"providers":[{"billed_charge":1622.56,"npi":[1609496397]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":708.48,"providers":[{"billed_charge":1312.00,"npi":[1982733655]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1077.84,"providers":[{"billed_charge":2780.00,"npi":[1992735088]}]},{"allowed_amount":37.02,"providers":[{"billed_charge":68.56,"npi":[1992735088]}]},{"allowed_amount":1685.76,"providers":[{"billed_charge":5256.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1138.80,"providers":[{"billed_charge":1898.00,"npi":[1760480503]}]},{"allowed_amount":1617.60,"providers":[{"billed_charge":2696.00,"npi":[1760480503]}]},{"allowed_amount":3258.31,"providers":[{"billed_charge":5430.51,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1077.30,"providers":[{"billed_charge":2850.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"860212139"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45.09,"providers":[{"billed_charge":45.09,"npi":[1083643738]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":61.99,"providers":[{"billed_charge":308.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":35.10,"providers":[{"billed_charge":65.00,"npi":[1992131734]}]}]},{"tin":{"type":"ein","value":"821703810"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3273.47,"providers":[{"billed_charge":13539.66,"npi":[1356818496]}]}]},{"tin":{"type":"ein","value":"621867232"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":24843.65,"providers":[{"billed_charge":38221.00,"npi":[1093791170]}]},{"allowed_amount":814.45,"providers":[{"billed_charge":1253.00,"npi":[1093791170]}]}]},{"tin":{"type":"ein","value":"860181654"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":99.21,"providers":[{"billed_charge":4297.48,"npi":[1114744752]}]}]},{"tin":{"type":"ein","value":"752694137"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":673.43,"providers":[{"billed_charge":2336.00,"npi":[1104856095]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1323.54,"providers":[{"billed_charge":3591.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"862195601"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1959.72,"providers":[{"billed_charge":26306.69,"npi":[1881352037]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":30.24,"providers":[{"billed_charge":56.00,"npi":[1700910189]}]},{"allowed_amount":4258.44,"providers":[{"billed_charge":12152.00,"npi":[1700910189]}]},{"allowed_amount":1431.54,"providers":[{"billed_charge":3164.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":114.42,"providers":[{"billed_charge":211.92,"npi":[1982733655]}]},{"allowed_amount":2432.95,"providers":[{"billed_charge":6175.00,"npi":[1982733655]}]},{"allowed_amount":4889.95,"providers":[{"billed_charge":10335.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"621811285"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":14783.60,"providers":[{"billed_charge":22744.00,"npi":[1326022765]}]},{"allowed_amount":98718.75,"providers":[{"billed_charge":151875.00,"npi":[1326022765]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2158.66,"providers":[{"billed_charge":78478.42,"npi":[]}]},{"allowed_amount":410.22,"providers":[{"billed_charge":4909.59,"npi":[]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"860181654"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24.37,"providers":[{"billed_charge":6180.00,"npi":[1427875061]}]}]},{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1090.74,"providers":[{"billed_charge":2019.88,"npi":[1992735088]}]},{"allowed_amount":53093.03,"providers":[{"billed_charge":129448.48,"npi":[1992735088]}]},{"allowed_amount":55248.06,"providers":[{"billed_charge":173085.88,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":30395.40,"providers":[{"billed_charge":50659.00,"npi":[1760480503]}]},{"allowed_amount":41017.90,"providers":[{"billed_charge":69746.00,"npi":[1760480503]}]},{"allowed_amount":44745.60,"providers":[{"billed_charge":74576.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"860098923"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":896.33,"providers":[{"billed_charge":3067.00,"npi":[1902897820]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":34837.12,"providers":[{"billed_charge":95033.00,"npi":[1154748416]}]},{"allowed_amount":6874.74,"providers":[{"billed_charge":12731.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":103769.56,"providers":[{"billed_charge":328970.84,"npi":[1700910189]}]},{"allowed_amount":63924.84,"providers":[{"billed_charge":147960.04,"npi":[1700910189]}]},{"allowed_amount":1049.22,"providers":[{"billed_charge":1943.00,"npi":[1700910189]}]},{"allowed_amount":162.54,"providers":[{"billed_charge":301.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":30537.34,"providers":[{"billed_charge":78902.80,"npi":[1689121188]}]},{"allowed_amount":5874.66,"providers":[{"billed_charge":40422.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":78895.79,"providers":[{"billed_charge":169600.00,"npi":[1982733655]}]},{"allowed_amount":1881.90,"providers":[{"billed_charge":3485.00,"npi":[1265065445]}]},{"allowed_amount":49185.64,"providers":[{"billed_charge":117368.00,"npi":[1982733655]}]},{"allowed_amount":2277.68,"providers":[{"billed_charge":4217.92,"npi":[1982733655]}]},{"allowed_amount":1050.84,"providers":[{"billed_charge":1946.00,"npi":[1609408665]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4083.67,"providers":[{"billed_charge":89933.26,"npi":[]}]},{"allowed_amount":671.95,"providers":[{"billed_charge":9377.43,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2760.06,"providers":[{"billed_charge":14060.00,"npi":[1154392231]}]},{"allowed_amount":70.77,"providers":[{"billed_charge":34801.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26137.62,"providers":[{"billed_charge":60481.00,"npi":[1992131734]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":411.00,"providers":[{"billed_charge":685.00,"npi":[1760480503]}]},{"allowed_amount":563.50,"providers":[{"billed_charge":850.00,"npi":[1760480503]}]},{"allowed_amount":507.00,"providers":[{"billed_charge":845.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1229.58,"providers":[{"billed_charge":3537.00,"npi":[1982733655]}]},{"allowed_amount":419.04,"providers":[{"billed_charge":972.00,"npi":[1982733655]}]},{"allowed_amount":9.22,"providers":[{"billed_charge":17.08,"npi":[1982733655]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8106.20,"providers":[{"billed_charge":13789.00,"npi":[1760480503]}]},{"allowed_amount":4933.20,"providers":[{"billed_charge":8222.00,"npi":[1760480503]}]},{"allowed_amount":5105.40,"providers":[{"billed_charge":8509.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":174.96,"providers":[{"billed_charge":324.00,"npi":[1992735088]}]},{"allowed_amount":11820.18,"providers":[{"billed_charge":27561.00,"npi":[1992735088]}]},{"allowed_amount":7773.84,"providers":[{"billed_charge":20795.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":11903.76,"providers":[{"billed_charge":32670.00,"npi":[1154748416]}]},{"allowed_amount":522.72,"providers":[{"billed_charge":968.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":141.48,"providers":[{"billed_charge":262.00,"npi":[1700910189]}]},{"allowed_amount":8694.04,"providers":[{"billed_charge":19000.00,"npi":[1700910189]}]},{"allowed_amount":17832.95,"providers":[{"billed_charge":46055.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":11190.42,"providers":[{"billed_charge":25505.00,"npi":[1689121188]}]},{"allowed_amount":1426.68,"providers":[{"billed_charge":10292.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":19173.77,"providers":[{"billed_charge":42240.00,"npi":[1982733655]}]},{"allowed_amount":362.48,"providers":[{"billed_charge":671.28,"npi":[1982733655]}]},{"allowed_amount":15303.12,"providers":[{"billed_charge":34828.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":854.36,"providers":[{"billed_charge":21500.50,"npi":[]}]},{"allowed_amount":50.06,"providers":[{"billed_charge":633.92,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":187.00,"providers":[{"billed_charge":620.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4486.32,"providers":[{"billed_charge":9814.00,"npi":[1992131734]}]}]}]},{"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":"860181654"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":138.54,"providers":[{"billed_charge":1759.00,"npi":[1427875061]}]}]},{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5698.41,"providers":[{"billed_charge":14750.00,"npi":[1992735088]}]},{"allowed_amount":7172.24,"providers":[{"billed_charge":18952.92,"npi":[1992735088]}]},{"allowed_amount":17.43,"providers":[{"billed_charge":32.28,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12609.00,"providers":[{"billed_charge":21015.00,"npi":[1760480503]}]},{"allowed_amount":13077.00,"providers":[{"billed_charge":21795.00,"npi":[1760480503]}]},{"allowed_amount":2792.90,"providers":[{"billed_charge":6698.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"833547294"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":208.36,"providers":[{"billed_charge":1111.08,"npi":[1609496397]}]}]},{"tin":{"type":"ein","value":"851516898"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3383.71,"providers":[{"billed_charge":5505.00,"npi":[1518539048]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":769.50,"providers":[{"billed_charge":1425.00,"npi":[1154748416]}]},{"allowed_amount":18225.83,"providers":[{"billed_charge":40254.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":21159.38,"providers":[{"billed_charge":42742.04,"npi":[1700910189]}]},{"allowed_amount":5716.73,"providers":[{"billed_charge":10586.54,"npi":[1700910189]}]},{"allowed_amount":6542.84,"providers":[{"billed_charge":14173.72,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8594.30,"providers":[{"billed_charge":18499.00,"npi":[1689121188]}]},{"allowed_amount":565.38,"providers":[{"billed_charge":3756.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":837.86,"providers":[{"billed_charge":1551.64,"npi":[1982733655]}]},{"allowed_amount":12411.90,"providers":[{"billed_charge":30744.00,"npi":[1982733655]}]},{"allowed_amount":10694.68,"providers":[{"billed_charge":24430.52,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":35.30,"providers":[{"billed_charge":981.00,"npi":[]}]},{"allowed_amount":3394.03,"providers":[{"billed_charge":12318.97,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1979.30,"providers":[{"billed_charge":3091.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3222.72,"providers":[{"billed_charge":6054.00,"npi":[1992131734]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1522.80,"providers":[{"billed_charge":2538.00,"npi":[1760480503]}]},{"allowed_amount":522.00,"providers":[{"billed_charge":870.00,"npi":[1760480503]}]},{"allowed_amount":6234.60,"providers":[{"billed_charge":10391.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7.02,"providers":[{"billed_charge":13.00,"npi":[1992735088]}]},{"allowed_amount":440.22,"providers":[{"billed_charge":1595.00,"npi":[1992735088]}]},{"allowed_amount":741.42,"providers":[{"billed_charge":1692.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8805.24,"providers":[{"billed_charge":23828.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":1602.72,"providers":[{"billed_charge":4882.00,"npi":[1700910189]}]},{"allowed_amount":1981.26,"providers":[{"billed_charge":4945.00,"npi":[1700910189]}]},{"allowed_amount":1349.46,"providers":[{"billed_charge":2499.00,"npi":[1700910189]}]},{"allowed_amount":253.26,"providers":[{"billed_charge":469.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4985.28,"providers":[{"billed_charge":11890.00,"npi":[1689121188]}]},{"allowed_amount":388.26,"providers":[{"billed_charge":1085.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":923.94,"providers":[{"billed_charge":2211.00,"npi":[1982733655]}]},{"allowed_amount":327.64,"providers":[{"billed_charge":606.72,"npi":[1982733655]}]},{"allowed_amount":3002.40,"providers":[{"billed_charge":7704.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":83.27,"providers":[{"billed_charge":2740.79,"npi":[]}]},{"allowed_amount":9.99,"providers":[{"billed_charge":402.00,"npi":[]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":257.58,"providers":[{"billed_charge":636.00,"npi":[1992131734]}]}]}]},{"name":"LAB/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"309","description":"LABORATORY - OTHER LABORATORY","allowed_amounts":[{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1551.64,"providers":[{"billed_charge":3990.00,"npi":[1700910189]}]},{"allowed_amount":6760.26,"providers":[{"billed_charge":13190.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":201.96,"providers":[{"billed_charge":374.00,"npi":[1982733655]}]},{"allowed_amount":14207.42,"providers":[{"billed_charge":26033.00,"npi":[1982733655]}]},{"allowed_amount":1697.24,"providers":[{"billed_charge":4120.00,"npi":[1982733655]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":660.00,"providers":[{"billed_charge":1100.00,"npi":[1760480503]}]},{"allowed_amount":6822.00,"providers":[{"billed_charge":11370.00,"npi":[1760480503]}]},{"allowed_amount":186.00,"providers":[{"billed_charge":310.00,"npi":[1760480503]}]}]}]},{"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":"721561134"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1425.60,"providers":[{"billed_charge":2640.00,"npi":[1982733655]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":22218.00,"providers":[{"billed_charge":37030.00,"npi":[1760480503]}]},{"allowed_amount":4917.00,"providers":[{"billed_charge":8195.00,"npi":[1760480503]}]},{"allowed_amount":13831.20,"providers":[{"billed_charge":23052.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19010.70,"providers":[{"billed_charge":54966.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":1844.10,"providers":[{"billed_charge":5269.00,"npi":[1700910189]}]},{"allowed_amount":5512.14,"providers":[{"billed_charge":10750.00,"npi":[1700910189]}]},{"allowed_amount":1891.08,"providers":[{"billed_charge":3502.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":388.80,"providers":[{"billed_charge":4420.00,"npi":[1689121188]}]},{"allowed_amount":7958.52,"providers":[{"billed_charge":18298.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2529.36,"providers":[{"billed_charge":7337.00,"npi":[1982733655]}]},{"allowed_amount":6501.06,"providers":[{"billed_charge":15209.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3628.81,"providers":[{"billed_charge":32797.25,"npi":[]}]},{"allowed_amount":1667.73,"providers":[{"billed_charge":7692.76,"npi":[]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2455.20,"providers":[{"billed_charge":4092.00,"npi":[1760480503]}]},{"allowed_amount":6270.00,"providers":[{"billed_charge":10450.00,"npi":[1760480503]}]},{"allowed_amount":1313.30,"providers":[{"billed_charge":2114.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"352263845"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2201.04,"providers":[{"billed_charge":5597.00,"npi":[1992735088]}]},{"allowed_amount":6184.71,"providers":[{"billed_charge":11861.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18166.14,"providers":[{"billed_charge":38422.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":2298.03,"providers":[{"billed_charge":7138.00,"npi":[1700910189]}]},{"allowed_amount":7517.89,"providers":[{"billed_charge":14496.00,"npi":[1700910189]}]},{"allowed_amount":797.58,"providers":[{"billed_charge":1477.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14085.18,"providers":[{"billed_charge":28671.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3061.80,"providers":[{"billed_charge":6764.00,"npi":[1982733655]}]},{"allowed_amount":9100.90,"providers":[{"billed_charge":17463.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":129.03,"providers":[{"billed_charge":488.00,"npi":[]}]},{"allowed_amount":1609.45,"providers":[{"billed_charge":7374.37,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1044.99,"providers":[{"billed_charge":1177.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1762.86,"providers":[{"billed_charge":3382.00,"npi":[1992131734]}]}]}]},{"name":"CHEMOTHER/INJ","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"331","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--INJECTED","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3055.80,"providers":[{"billed_charge":5093.00,"npi":[1760480503]}]}]}]},{"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":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25581.22,"providers":[{"billed_charge":60629.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":14121.54,"providers":[{"billed_charge":48328.00,"npi":[1700910189]}]},{"allowed_amount":9490.19,"providers":[{"billed_charge":19315.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14532.31,"providers":[{"billed_charge":38902.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":18973.55,"providers":[{"billed_charge":46893.00,"npi":[1982733655]}]},{"allowed_amount":12123.00,"providers":[{"billed_charge":46195.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1973.94,"providers":[{"billed_charge":55701.80,"npi":[]}]}]}]},{"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":"352263845"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":17654.78,"providers":[{"billed_charge":37693.00,"npi":[1992735088]}]},{"allowed_amount":11756.88,"providers":[{"billed_charge":38679.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":113762.44,"providers":[{"billed_charge":280503.00,"npi":[1154748416]}]},{"allowed_amount":2398.68,"providers":[{"billed_charge":4442.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":69016.67,"providers":[{"billed_charge":142906.00,"npi":[1700910189]}]},{"allowed_amount":32302.04,"providers":[{"billed_charge":73843.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":78130.64,"providers":[{"billed_charge":176168.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":28219.51,"providers":[{"billed_charge":58331.00,"npi":[1982733655]}]},{"allowed_amount":2231.82,"providers":[{"billed_charge":4133.00,"npi":[1982733655]}]},{"allowed_amount":81247.86,"providers":[{"billed_charge":187375.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5857.40,"providers":[{"billed_charge":127845.70,"npi":[]}]},{"allowed_amount":110.85,"providers":[{"billed_charge":7599.96,"npi":[]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2732.64,"providers":[{"billed_charge":7206.00,"npi":[1154392231]}]},{"allowed_amount":498.52,"providers":[{"billed_charge":3385.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10022.94,"providers":[{"billed_charge":18561.00,"npi":[1992131734]}]}]}]},{"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":"860422559"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":9747.00,"providers":[{"billed_charge":16245.00,"npi":[1760480503]}]},{"allowed_amount":80589.50,"providers":[{"billed_charge":134315.84,"npi":[1760480503]}]}]}]},{"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":"860422559"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2217.60,"providers":[{"billed_charge":3696.00,"npi":[1760480503]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5180.98,"providers":[{"billed_charge":76330.62,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":91.77,"providers":[{"billed_charge":1471.63,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":354.20,"providers":[{"billed_charge":5349.79,"npi":[1234567893]}]},{"allowed_amount":39.73,"providers":[{"billed_charge":105.32,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":46.80,"providers":[{"billed_charge":840.00,"npi":[1003395484]}]}]}]},{"name":"ANESTHESIA","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"370","description":"ANESTHESIA - GENERAL CLASSIFICATIION","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4563.00,"providers":[{"billed_charge":7605.00,"npi":[1760480503]}]},{"allowed_amount":29790.00,"providers":[{"billed_charge":49650.00,"npi":[1760480503]}]},{"allowed_amount":38493.00,"providers":[{"billed_charge":64155.00,"npi":[1760480503]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3474.60,"providers":[{"billed_charge":5791.00,"npi":[1760480503]}]},{"allowed_amount":5426.40,"providers":[{"billed_charge":9044.00,"npi":[1760480503]}]},{"allowed_amount":4974.00,"providers":[{"billed_charge":8290.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10977.15,"providers":[{"billed_charge":24430.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2927.76,"providers":[{"billed_charge":7712.00,"npi":[1700910189]}]},{"allowed_amount":866.70,"providers":[{"billed_charge":2971.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1491.24,"providers":[{"billed_charge":9601.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":715.23,"providers":[{"billed_charge":2649.00,"npi":[1982733655]}]},{"allowed_amount":1756.62,"providers":[{"billed_charge":3253.00,"npi":[1982733655]}]}]}]},{"name":"INHALATION SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"412","description":"RESPIRATORY SERVICES - INHALATION SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":381.24,"providers":[{"billed_charge":1412.00,"npi":[1154748416]}]}]}]},{"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":"860422559"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6411.00,"providers":[{"billed_charge":10685.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"860181654"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":496.71,"providers":[{"billed_charge":3979.84,"npi":[1427875061]}]}]}]},{"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":"352263845"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":108186.22,"providers":[{"billed_charge":226826.00,"npi":[1992735088]}]},{"allowed_amount":18193.80,"providers":[{"billed_charge":73606.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":86013.60,"providers":[{"billed_charge":143356.00,"npi":[1760480503]}]},{"allowed_amount":408007.20,"providers":[{"billed_charge":682239.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":393308.86,"providers":[{"billed_charge":781128.00,"npi":[1689121188]}]},{"allowed_amount":8672.40,"providers":[{"billed_charge":40436.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":90960.25,"providers":[{"billed_charge":198898.00,"npi":[1154392231]}]},{"allowed_amount":1492.00,"providers":[{"billed_charge":12484.00,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90075.49,"providers":[{"billed_charge":171838.00,"npi":[1992131734]}]}]},{"tin":{"type":"ein","value":"821703810"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13801.65,"providers":[{"billed_charge":52037.18,"npi":[1356818496]}]}]},{"tin":{"type":"ein","value":"621867232"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4997.85,"providers":[{"billed_charge":7689.00,"npi":[1093791170]}]}]},{"tin":{"type":"ein","value":"860181654"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10009.86,"providers":[{"billed_charge":53336.68,"npi":[1114744752]}]},{"allowed_amount":1225.40,"providers":[{"billed_charge":7020.00,"npi":[1427875061]}]}]},{"tin":{"type":"ein","value":"860098923"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8065.37,"providers":[{"billed_charge":9736.00,"npi":[1902897820]}]},{"allowed_amount":1976.58,"providers":[{"billed_charge":8411.00,"npi":[1902897820]}]}]},{"tin":{"type":"ein","value":"833547294"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":43359.29,"providers":[{"billed_charge":156915.72,"npi":[1609496397]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":505695.97,"providers":[{"billed_charge":1066700.00,"npi":[1154748416]}]},{"allowed_amount":5002.02,"providers":[{"billed_charge":9263.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"851516898"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":56097.07,"providers":[{"billed_charge":154050.00,"npi":[1518539048]}]}]},{"tin":{"type":"ein","value":"862195601"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23405.45,"providers":[{"billed_charge":85119.47,"npi":[1881352037]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":165116.03,"providers":[{"billed_charge":328191.00,"npi":[1700910189]}]},{"allowed_amount":58011.12,"providers":[{"billed_charge":191182.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":38075.94,"providers":[{"billed_charge":78505.00,"npi":[1982733655]}]},{"allowed_amount":25126.74,"providers":[{"billed_charge":46921.00,"npi":[1265065445]}]},{"allowed_amount":172597.42,"providers":[{"billed_charge":322487.00,"npi":[1982733655]}]},{"allowed_amount":31166.28,"providers":[{"billed_charge":57252.00,"npi":[1609408665]}]}]},{"tin":{"type":"ein","value":"621811285"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17806.10,"providers":[{"billed_charge":27394.00,"npi":[1326022765]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":73464.77,"providers":[{"billed_charge":558413.57,"npi":[]}]}]}]},{"name":"URGENT CARE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"456","description":"EMERGENCY ROOM - URGENT CARE","allowed_amounts":[{"tin":{"type":"ein","value":"721561132"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":22169.49,"providers":[{"billed_charge":41054.62,"npi":[1700910189]}]}]}]},{"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":"860422559"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":1149.60,"providers":[{"billed_charge":1916.00,"npi":[1760480503]}]},{"allowed_amount":110.40,"providers":[{"billed_charge":184.00,"npi":[1760480503]}]}]}]},{"name":"ECHOCARDIOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"483","description":"CARDIOLOGY - ECHOCARDIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"860422559"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":2535.00,"providers":[{"billed_charge":4225.00,"npi":[1760480503]}]},{"allowed_amount":6924.10,"providers":[{"billed_charge":10836.00,"npi":[1760480503]}]}]}]},{"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":"352263845"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":11973.80,"providers":[{"billed_charge":39182.00,"npi":[1992735088]}]},{"allowed_amount":75157.66,"providers":[{"billed_charge":179266.00,"npi":[1992735088]}]},{"allowed_amount":178.20,"providers":[{"billed_charge":330.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1070704.80,"providers":[{"billed_charge":1784510.00,"npi":[1760480503]}]},{"allowed_amount":8760.00,"providers":[{"billed_charge":14600.00,"npi":[1760480503]}]},{"allowed_amount":20917.20,"providers":[{"billed_charge":34862.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"621861138"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":335.40,"providers":[{"billed_charge":516.00,"npi":[1326022732]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23804.20,"providers":[{"billed_charge":63061.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"951643360"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":139.88,"providers":[{"billed_charge":466.25,"npi":[1992752315]}]}]},{"tin":{"type":"ein","value":"860800150"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":78.15,"providers":[{"billed_charge":7297.90,"npi":[1154392231]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1703.26,"providers":[{"billed_charge":3873.00,"npi":[1992131734]}]}]},{"tin":{"type":"ein","value":"821703810"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":878.44,"providers":[{"billed_charge":2927.10,"npi":[1356818496]}]}]},{"tin":{"type":"ein","value":"621867232"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1088.10,"providers":[{"billed_charge":1674.00,"npi":[1093791170]}]},{"allowed_amount":365.30,"providers":[{"billed_charge":562.00,"npi":[1093791170]}]}]},{"tin":{"type":"ein","value":"860181654"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6.07,"providers":[{"billed_charge":5260.70,"npi":[1427875061]}]},{"allowed_amount":5.07,"providers":[{"billed_charge":12350.25,"npi":[1427875061]}]},{"allowed_amount":5.18,"providers":[{"billed_charge":3547.75,"npi":[1114744752]}]}]},{"tin":{"type":"ein","value":"833547294"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":196.16,"providers":[{"billed_charge":653.84,"npi":[1609496397]}]}]},{"tin":{"type":"ein","value":"851516898"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6.80,"providers":[{"billed_charge":13193.92,"npi":[1518539048]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":47320.42,"providers":[{"billed_charge":120630.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["22","23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":17599.76,"providers":[{"billed_charge":41230.00,"npi":[1700910189]}]},{"allowed_amount":127612.28,"providers":[{"billed_charge":304760.00,"npi":[1700910189]}]},{"allowed_amount":1034.10,"providers":[{"billed_charge":1915.00,"npi":[1700910189]}]},{"allowed_amount":342.90,"providers":[{"billed_charge":635.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"862195601"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":18.49,"providers":[{"billed_charge":6192.92,"npi":[1881352037]}]}]},{"tin":{"type":"ein","value":"474131755"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":517.40,"providers":[{"billed_charge":796.00,"npi":[1538535158]}]},{"allowed_amount":163.80,"providers":[{"billed_charge":252.00,"npi":[1538535158]}]}]},{"tin":{"type":"ein","value":"621811285"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9983.35,"providers":[{"billed_charge":15359.00,"npi":[1326022765]}]},{"allowed_amount":675.35,"providers":[{"billed_charge":1039.00,"npi":[1326022765]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":7943.21,"providers":[{"billed_charge":22398.00,"npi":[1982733655]}]},{"allowed_amount":482.76,"providers":[{"billed_charge":894.00,"npi":[1609408665]}]},{"allowed_amount":1333.80,"providers":[{"billed_charge":2470.00,"npi":[1982733655]}]},{"allowed_amount":477.90,"providers":[{"billed_charge":885.00,"npi":[1265065445]}]},{"allowed_amount":25784.14,"providers":[{"billed_charge":90500.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":843.93,"providers":[{"billed_charge":14333.44,"npi":[]}]},{"allowed_amount":47.15,"providers":[{"billed_charge":280.00,"npi":[]}]}]}]},{"name":"HOSPICE/RTN HOME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"651","description":"HOSPICE SERVICES - ROUTINE HOME CARE","allowed_amounts":[{"tin":{"type":"ein","value":"272510318"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":2400.00,"providers":[{"billed_charge":2400.00,"npi":[1578874053]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4836.00,"providers":[{"billed_charge":8060.00,"npi":[1760480503]}]},{"allowed_amount":44502.00,"providers":[{"billed_charge":74170.00,"npi":[1760480503]}]},{"allowed_amount":8640.00,"providers":[{"billed_charge":14400.00,"npi":[1760480503]}]}]}]},{"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":"845116186"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":18.17,"providers":[{"billed_charge":153.00,"npi":[1356503478]}]},{"allowed_amount":476.70,"providers":[{"billed_charge":681.00,"npi":[1356503478]}]}]}]},{"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":"352263845"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3993.84,"providers":[{"billed_charge":10320.00,"npi":[1992735088]}]},{"allowed_amount":1486.08,"providers":[{"billed_charge":6880.00,"npi":[1992735088]}]}]},{"tin":{"type":"ein","value":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3381.60,"providers":[{"billed_charge":5636.00,"npi":[1760480503]}]},{"allowed_amount":4382.80,"providers":[{"billed_charge":7161.00,"npi":[1760480503]}]},{"allowed_amount":2745.00,"providers":[{"billed_charge":4575.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"471587223"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":406.08,"providers":[{"billed_charge":752.00,"npi":[1154748416]}]},{"allowed_amount":8933.76,"providers":[{"billed_charge":21056.00,"npi":[1154748416]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23","20","21"],"billing_class":"institutional","payments":[{"allowed_amount":56.16,"providers":[{"billed_charge":104.00,"npi":[1700910189]}]},{"allowed_amount":3089.12,"providers":[{"billed_charge":8944.00,"npi":[1700910189]}]},{"allowed_amount":10759.12,"providers":[{"billed_charge":22016.00,"npi":[1700910189]}]}]},{"tin":{"type":"ein","value":"383990879"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":11776.32,"providers":[{"billed_charge":27824.00,"npi":[1689121188]}]},{"allowed_amount":406.08,"providers":[{"billed_charge":752.00,"npi":[1689121188]}]}]},{"tin":{"type":"ein","value":"721561134"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1885.68,"providers":[{"billed_charge":4074.00,"npi":[1982733655]}]},{"allowed_amount":6521.31,"providers":[{"billed_charge":16878.00,"npi":[1982733655]}]}]},{"tin":{"type":"ein","value":"571165217"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":36.32,"providers":[{"billed_charge":250.00,"npi":[]}]},{"allowed_amount":1151.74,"providers":[{"billed_charge":21608.50,"npi":[]}]}]},{"tin":{"type":"ein","value":"463533638"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":864.27,"providers":[{"billed_charge":3492.00,"npi":[1992131734]}]}]}]},{"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":"860422559"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":8847.60,"providers":[{"billed_charge":14746.00,"npi":[1760480503]}]},{"allowed_amount":3542.40,"providers":[{"billed_charge":5904.00,"npi":[1760480503]}]},{"allowed_amount":12500.40,"providers":[{"billed_charge":20834.00,"npi":[1760480503]}]}]},{"tin":{"type":"ein","value":"721561132"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4561.92,"providers":[{"billed_charge":8448.00,"npi":[1700910189]}]}]}]},{"name":"ECHO GUIDE FOR BIOPSY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76942","description":"ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), I","allowed_amounts":[{"tin":{"type":"ein","value":"870699281"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":375.58,"providers":[{"billed_charge":678.00,"npi":[1245229087]}]}]}]},{"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":"264000683"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1316.09,"providers":[{"billed_charge":7859.00,"npi":[1972091742]}]}]},{"tin":{"type":"ein","value":"200382536"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1968.31,"providers":[{"billed_charge":9516.00,"npi":[1154558039]}]}]},{"tin":{"type":"ein","value":"845116186"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":385.14,"providers":[{"billed_charge":1488.00,"npi":[1417186081]}]}]}]},{"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":"264000683"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3214.82,"providers":[{"billed_charge":20300.00,"npi":[1972091742]}]}]},{"tin":{"type":"ein","value":"200382536"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4821.66,"providers":[{"billed_charge":23010.00,"npi":[1154558039]}]}]},{"tin":{"type":"ein","value":"845116186"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":370.08,"providers":[{"billed_charge":2208.00,"npi":[1417186081]}]}]}]},{"name":"DXA BONE DENSITY, AXIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77080","description":"DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIP","allowed_amounts":[{"tin":{"type":"ein","value":"200382536"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":113.30,"providers":[{"billed_charge":525.00,"npi":[1154558039]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":602.64,"providers":[{"billed_charge":4302.63,"npi":[1740262880]}]}]}]},{"name":"GENERAL HEALTH PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80050","description":"GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2355.20,"providers":[{"billed_charge":13364.05,"npi":[1740262880]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31213.24,"providers":[{"billed_charge":197626.44,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":194.10,"providers":[{"billed_charge":1521.68,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1587.60,"providers":[{"billed_charge":10142.38,"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31662.41,"providers":[{"billed_charge":319663.35,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1674.01,"providers":[{"billed_charge":16751.10,"npi":[1234567893]}]}]}]},{"name":"RENAL FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80069","description":"RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":86.45,"providers":[{"billed_charge":628.35,"npi":[1740262880]}]}]}]},{"name":"ACUTE HEPATITIS PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80074","description":"ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6685.28,"providers":[{"billed_charge":87534.98,"npi":[1740262880]}]}]}]},{"name":"HEPATIC FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80076","description":"HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":244.14,"providers":[{"billed_charge":1807.63,"npi":[1740262880]}]}]}]},{"name":"DRUG TEST PRSMV INSTRMNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80306","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; READ BY","allowed_amounts":[{"tin":{"type":"ein","value":"454995568"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":256.22,"providers":[{"billed_charge":460.00,"npi":[1891971628]}]}]}]},{"name":"DRUG TEST PRSMV CHEM ANLYZR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80307","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2956.64,"providers":[{"billed_charge":7804.65,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2695.76,"providers":[{"billed_charge":7536.80,"npi":[1538144910]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1156.68,"providers":[{"billed_charge":17986.65,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":41.31,"providers":[{"billed_charge":642.65,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS NONAUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81002","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"203134104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.48,"providers":[{"billed_charge":17.40,"npi":[1639243058]}]}]},{"tin":{"type":"ein","value":"812124295"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.55,"providers":[{"billed_charge":75.00,"npi":[1932557675]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":232.20,"providers":[{"billed_charge":4392.54,"npi":[1740262880]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":134.40,"providers":[{"billed_charge":600.00,"npi":[1003395484]}]}]}]},{"name":"ANES LWR INTST SCR COLSC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"812","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; SCRE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":57.40,"providers":[{"billed_charge":950.00,"npi":[1234567893]}]}]}]},{"name":"FETAL CHRMOML ANEUPLOIDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81420","description":"FETAL CHROMOSOMAL ANEUPLOIDY (EG, TRISOMY 21, MONOSOMY X) GENOMIC SEQUENCE ANALYSIS PANEL, CIRCULATI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6453.20,"providers":[{"billed_charge":11539.48,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF SERUM ALBUMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82040","description":"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":384.91,"providers":[{"billed_charge":640.70,"npi":[1740262880]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2397.60,"providers":[{"billed_charge":39421.53,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":71.04,"providers":[{"billed_charge":1200.55,"npi":[1234567893]}]}]}]},{"name":"ALPHA-FETOPROTEIN, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82105","description":"ALPHA-FETOPROTEIN (AFP); SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":131.56,"providers":[{"billed_charge":1599.15,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":159.04,"providers":[{"billed_charge":1912.25,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF APOLIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82172","description":"APOLIPOPROTEIN, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":273.01,"providers":[{"billed_charge":792.70,"npi":[1740262880]}]}]}]},{"name":"BILIRUBIN, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82247","description":"BILIRUBIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":384.41,"providers":[{"billed_charge":566.41,"npi":[1740262880]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":107.90,"providers":[{"billed_charge":266.81,"npi":[1740262880]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29411.75,"providers":[{"billed_charge":487145.68,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":181.44,"providers":[{"billed_charge":2339.42,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1331.25,"providers":[{"billed_charge":22011.22,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82310","description":"CALCIUM; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":367.14,"providers":[{"billed_charge":735.25,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82330","description":"CALCIUM; IONIZED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.27,"providers":[{"billed_charge":74.24,"npi":[1740262880]}]}]}]},{"name":"ASSAY, BLOOD CARBON DIOXIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82374","description":"CARBON DIOXIDE (BICARBONATE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40.26,"providers":[{"billed_charge":43.60,"npi":[1740262880]}]}]}]},{"name":"CARCINOEMBRYONIC ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82378","description":"CARCINOEMBRYONIC ANTIGEN (CEA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":232.64,"providers":[{"billed_charge":2183.62,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF CERULOPLASMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82390","description":"CERULOPLASMIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.23,"providers":[{"billed_charge":88.20,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF BLOOD CHLORIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82435","description":"CHLORIDE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":299.38,"providers":[{"billed_charge":355.06,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF COPPER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82525","description":"COPPER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":152.13,"providers":[{"billed_charge":1303.60,"npi":[1740262880]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2023.38,"providers":[{"billed_charge":19116.98,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF CK (CPK)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82550","description":"CREATINE KINASE (CK), (CPK); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.80,"providers":[{"billed_charge":792.99,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82565","description":"CREATININE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":412.59,"providers":[{"billed_charge":796.91,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82570","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2098.80,"providers":[{"billed_charge":33484.87,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":55.44,"providers":[{"billed_charge":911.57,"npi":[1234567893]}]}]}]},{"name":"VITAMIN B-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82607","description":"CYANOCOBALAMIN (VITAMIN B-12);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8304.45,"providers":[{"billed_charge":77585.86,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":34.65,"providers":[{"billed_charge":335.58,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":334.95,"providers":[{"billed_charge":3196.50,"npi":[1234567893]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82626","description":"DEHYDROEPIANDROSTERONE (DHEA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":96.85,"providers":[{"billed_charge":1211.04,"npi":[1740262880]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82627","description":"DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3646.56,"providers":[{"billed_charge":38887.08,"npi":[1740262880]}]}]}]},{"name":"DIHYDROTESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82642","description":"DIHYDROTESTOSTERONE (DHT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":22.43,"providers":[{"billed_charge":189.00,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF ESTRADIOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82670","description":"ESTRADIOL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10833.46,"providers":[{"billed_charge":92689.62,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":146.00,"providers":[{"billed_charge":1563.68,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":214.10,"providers":[{"billed_charge":1733.80,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF ESTROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82672","description":"ESTROGENS; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1113.54,"providers":[{"billed_charge":11180.12,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF ESTRONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82679","description":"ESTRONE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":994.76,"providers":[{"billed_charge":10579.93,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5032.08,"providers":[{"billed_charge":42376.75,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.44,"providers":[{"billed_charge":94.89,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":135.72,"providers":[{"billed_charge":1090.36,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF FOLIC ACID SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82746","description":"FOLIC ACID; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5702.62,"providers":[{"billed_charge":53280.46,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":146.51,"providers":[{"billed_charge":1396.36,"npi":[1234567893]}]}]}]},{"name":"ASSAY IGA/IGD/IGG/IGM EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82784","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":344.86,"providers":[{"billed_charge":6863.47,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":199.60,"providers":[{"billed_charge":2740.92,"npi":[1538144910]}]}]}]},{"name":"ASSAY OF IGE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82785","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":214.54,"providers":[{"billed_charge":2029.93,"npi":[1740262880]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82947","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":216.24,"providers":[{"billed_charge":450.47,"npi":[1740262880]}]}]}]},{"name":"GLUCOSE TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82950","description":"GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":367.64,"providers":[{"billed_charge":3078.50,"npi":[1740262880]}]}]}]},{"name":"GLUCOSE TOLERANCE TEST (GTT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82951","description":"GLUCOSE; TOLERANCE TEST (GTT), 3 SPECIMENS (INCLUDES GLUCOSE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":46.90,"providers":[{"billed_charge":540.83,"npi":[1740262880]}]}]}]},{"name":"GTT-ADDED SAMPLES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82952","description":"GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.00,"providers":[{"billed_charge":165.14,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF GGT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82977","description":"GLUTAMYLTRANSFERASE, GAMMA (GGT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":391.92,"providers":[{"billed_charge":2755.00,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (FSH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83001","description":"GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4371.68,"providers":[{"billed_charge":37685.05,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (LH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83002","description":"GONADOTROPIN; LUTEINIZING HORMONE (LH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3519.12,"providers":[{"billed_charge":29854.15,"npi":[1740262880]}]}]}]},{"name":"H PYLORI (C-13), BREATH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83013","description":"HELICOBACTER PYLORI; BREATH TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (EG, C-13)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1806.35,"providers":[{"billed_charge":11909.06,"npi":[1740262880]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21062.64,"providers":[{"billed_charge":223130.93,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":126.48,"providers":[{"billed_charge":1296.21,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":17.96,"providers":[{"billed_charge":48.00,"npi":[1234567893]}]},{"allowed_amount":1049.04,"providers":[{"billed_charge":11171.04,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF HOMOCYSTINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83090","description":"HOMOCYSTEINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":866.31,"providers":[{"billed_charge":12813.01,"npi":[1740262880]}]}]}]},{"name":"IMMUNOASSAY QUANT NOS NONAB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83520","description":"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":128.94,"providers":[{"billed_charge":2219.16,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF INSULIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83525","description":"INSULIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1033.03,"providers":[{"billed_charge":14199.87,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.76,"providers":[{"billed_charge":99.75,"npi":[1538144910]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2338.81,"providers":[{"billed_charge":17261.24,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.97,"providers":[{"billed_charge":501.68,"npi":[1234567893]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83550","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2646.50,"providers":[{"billed_charge":19586.80,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":53.60,"providers":[{"billed_charge":399.57,"npi":[1234567893]}]}]}]},{"name":"LACTATE (LD) (LDH) ENZYME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83615","description":"LACTATE DEHYDROGENASE (LD), (LDH);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":297.07,"providers":[{"billed_charge":1977.31,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF LIPASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83690","description":"LIPASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":232.32,"providers":[{"billed_charge":2712.99,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF LIPOPROTEIN(A)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83695","description":"LIPOPROTEIN (A)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":59.52,"providers":[{"billed_charge":976.50,"npi":[1740262880]}]}]}]},{"name":"LIPOPROTEIN BLD QUAN PART","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83704","description":"LIPOPROTEIN, BLOOD; QUANTITATION OF LIPOPROTEIN PARTICLE NUMBER(S) (EG, BY NUCLEAR MAGNETIC RESONANC","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":483.60,"providers":[{"billed_charge":1793.53,"npi":[1538144910]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":884.08,"providers":[{"billed_charge":8495.44,"npi":[1740262880]}]}]}]},{"name":"MASS SPECTROMETRY QUAL/QUAN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83789","description":"MASS SPECTROMETRY AND TANDEM MASS SPECTROMETRY (EG, MS, MS/MS, MALDI, MS-TOF, QTOF), NON-DRUG ANALYT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27.68,"providers":[{"billed_charge":156.90,"npi":[1740262880]}]}]}]},{"name":"ORGANIC ACID SINGLE QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83921","description":"ORGANIC ACID, SINGLE, QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":214.54,"providers":[{"billed_charge":4449.10,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PARATHORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83970","description":"PARATHORMONE (PARATHYROID HORMONE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1581.50,"providers":[{"billed_charge":10135.33,"npi":[1740262880]}]}]}]},{"name":"ASSAY ALKALINE PHOSPHATASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84075","description":"PHOSPHATASE, ALKALINE;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":392.85,"providers":[{"billed_charge":667.63,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84100","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":247.92,"providers":[{"billed_charge":1963.58,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF SERUM POTASSIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84132","description":"POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.53,"providers":[{"billed_charge":291.70,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PROGESTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84144","description":"PROGESTERONE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5468.58,"providers":[{"billed_charge":50414.33,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1871.10,"providers":[{"billed_charge":18073.15,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PSA, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84153","description":"PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4551.07,"providers":[{"billed_charge":38011.28,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":28.18,"providers":[{"billed_charge":239.40,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PSA, FREE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84154","description":"PROSTATE SPECIFIC ANTIGEN (PSA); FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":704.50,"providers":[{"billed_charge":5025.63,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PROTEIN SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84155","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":304.59,"providers":[{"billed_charge":710.23,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF PROTEIN, URINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84156","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.36,"providers":[{"billed_charge":2217.66,"npi":[1740262880]}]}]}]},{"name":"PROTEIN E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84165","description":"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":65.84,"providers":[{"billed_charge":528.75,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF VITAMIN B-6","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84207","description":"PYRIDOXAL PHOSPHATE (VITAMIN B-6)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":43.06,"providers":[{"billed_charge":402.18,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF SEX HORMONE GLOBUL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84270","description":"SEX HORMONE BINDING GLOBULIN (SHBG)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1311.50,"providers":[{"billed_charge":12344.37,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF SERUM SODIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84295","description":"SODIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":311.93,"providers":[{"billed_charge":412.36,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF SOMATOMEDIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84305","description":"SOMATOMEDIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":407.25,"providers":[{"billed_charge":7749.43,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF FREE TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84402","description":"TESTOSTERONE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9384.31,"providers":[{"billed_charge":89940.27,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":39.02,"providers":[{"billed_charge":421.85,"npi":[1538144910]}]}]}]},{"name":"ASSAY OF TOTAL TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84403","description":"TESTOSTERONE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14281.20,"providers":[{"billed_charge":132598.59,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":158.24,"providers":[{"billed_charge":1624.96,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":316.48,"providers":[{"billed_charge":2691.71,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF VITAMIN B-1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84425","description":"THIAMINE (VITAMIN B-1)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":211.51,"providers":[{"billed_charge":1719.90,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF TOTAL THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84436","description":"THYROXINE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":757.44,"providers":[{"billed_charge":6919.26,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8257.45,"providers":[{"billed_charge":130004.63,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":76.01,"providers":[{"billed_charge":1482.54,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":324.77,"providers":[{"billed_charge":4878.34,"npi":[1234567893]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84443","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":36795.33,"providers":[{"billed_charge":348111.40,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":249.80,"providers":[{"billed_charge":2408.03,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1724.58,"providers":[{"billed_charge":16283.39,"npi":[1234567893]}]}]}]},{"name":"TRANSFERASE (AST) (SGOT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84450","description":"TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":457.75,"providers":[{"billed_charge":1133.38,"npi":[1740262880]}]}]}]},{"name":"ALANINE AMINO (ALT) (SGPT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84460","description":"TRANSFERASE; ALANINE AMINO (ALT) (SGPT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":193.53,"providers":[{"billed_charge":1006.99,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF TRANSFERRIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84466","description":"TRANSFERRIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":303.49,"providers":[{"billed_charge":3092.66,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF THYROID (T3 OR T4)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84479","description":"THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":347.20,"providers":[{"billed_charge":3214.10,"npi":[1740262880]}]}]}]},{"name":"ASSAY, TRIIODOTHYRONINE (T3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84480","description":"TRIIODOTHYRONINE T3; TOTAL (TT-3)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":347.84,"providers":[{"billed_charge":3903.55,"npi":[1740262880]}]}]}]},{"name":"FREE ASSAY (FT-3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84481","description":"TRIIODOTHYRONINE T3; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7137.40,"providers":[{"billed_charge":119902.81,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":77.88,"providers":[{"billed_charge":1401.86,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":254.00,"providers":[{"billed_charge":4006.70,"npi":[1234567893]}]}]}]},{"name":"T3 REVERSE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84482","description":"TRIIODOTHYRONINE T3; REVERSE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":616.08,"providers":[{"billed_charge":11947.84,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF UREA NITROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84520","description":"UREA NITROGEN; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":299.29,"providers":[{"billed_charge":534.28,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84550","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":529.40,"providers":[{"billed_charge":4968.13,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF VITAMIN A","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84590","description":"VITAMIN A","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":35.56,"providers":[{"billed_charge":505.49,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF ZINC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84630","description":"ZINC","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":200.79,"providers":[{"billed_charge":2383.69,"npi":[1740262880]}]}]}]},{"name":"ASSAY OF C-PEPTIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84681","description":"C-PEPTIDE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":92.46,"providers":[{"billed_charge":743.98,"npi":[1740262880]}]}]}]},{"name":"CHORIONIC GONADOTROPIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84702","description":"GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1258.92,"providers":[{"billed_charge":10442.54,"npi":[1740262880]}]}]}]},{"name":"HEMATOCRIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85014","description":"BLOOD COUNT; HEMATOCRIT (HCT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":48.87,"providers":[{"billed_charge":517.45,"npi":[1740262880]}]}]}]},{"name":"HEMOGLOBIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85018","description":"BLOOD COUNT; HEMOGLOBIN (HGB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":39.82,"providers":[{"billed_charge":378.22,"npi":[1740262880]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18135.11,"providers":[{"billed_charge":144397.10,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":178.80,"providers":[{"billed_charge":1200.10,"npi":[1538144910]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":929.88,"providers":[{"billed_charge":7447.98,"npi":[1234567893]}]}]}]},{"name":"COMPLETE CBC, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85027","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1013.52,"providers":[{"billed_charge":7920.21,"npi":[1740262880]}]}]}]},{"name":"PROTHROMBIN TIME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85610","description":"PROTHROMBIN TIME;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":364.18,"providers":[{"billed_charge":5083.03,"npi":[1740262880]}]}]}]},{"name":"RBC SED RATE, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85652","description":"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":426.42,"providers":[{"billed_charge":7810.55,"npi":[1740262880]}]}]}]},{"name":"THROMBOPLASTIN TIME, PARTIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85730","description":"THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":299.00,"providers":[{"billed_charge":4170.99,"npi":[1740262880]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86038","description":"ANTINUCLEAR ANTIBODIES (ANA);","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1093.86,"providers":[{"billed_charge":11607.97,"npi":[1740262880]}]}]}]},{"name":"C-REACTIVE PROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86140","description":"C-REACTIVE PROTEIN;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":704.88,"providers":[{"billed_charge":12282.01,"npi":[1740262880]}]}]}]},{"name":"C-REACTIVE PROTEIN, HS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86141","description":"C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1428.48,"providers":[{"billed_charge":11683.84,"npi":[1740262880]}]}]}]},{"name":"CCP ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86200","description":"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":89.28,"providers":[{"billed_charge":945.37,"npi":[1740262880]}]}]}]},{"name":"DNA ANTIBODY NATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86225","description":"DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":294.84,"providers":[{"billed_charge":3031.41,"npi":[1740262880]}]}]}]},{"name":"EMA EACH IG CLASS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86231","description":"ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":64.70,"providers":[{"billed_charge":1230.70,"npi":[1538144910]}]}]}]},{"name":"NUCLEAR ANTIGEN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86235","description":"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1538.57,"providers":[{"billed_charge":20234.43,"npi":[1740262880]}]}]}]},{"name":"IMMUNOASSAY, TUMOR, CA 15-3","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86300","description":"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":111.65,"providers":[{"billed_charge":1059.45,"npi":[1740262880]}]}]}]},{"name":"IMMUNOASSAY, TUMOR, CA 125","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86304","description":"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":175.45,"providers":[{"billed_charge":2215.50,"npi":[1740262880]}]}]}]},{"name":"IMMUNOASSAY INFECTIOUS AGENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86317","description":"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":149.34,"providers":[{"billed_charge":910.41,"npi":[1740262880]}]}]}]},{"name":"TISS TRNSGLTMNASE EA IG CLAS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86364","description":"TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.17,"providers":[{"billed_charge":118.39,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"133757370"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":129.57,"providers":[{"billed_charge":2446.42,"npi":[1538144910]}]}]}]},{"name":"MICROSOMAL ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86376","description":"MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1993.64,"providers":[{"billed_charge":23109.05,"npi":[1740262880]}]}]}]},{"name":"RHEUMATOID FACTOR, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86431","description":"RHEUMATOID FACTOR; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":208.80,"providers":[{"billed_charge":2270.53,"npi":[1740262880]}]}]}]},{"name":"TB TEST CELL IMMUN MEASURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86480","description":"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1852.11,"providers":[{"billed_charge":8923.10,"npi":[1740262880]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1962.00,"providers":[{"billed_charge":20297.72,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.35,"providers":[{"billed_charge":185.74,"npi":[1234567893]}]}]}]},{"name":"COCCIDIOIDES ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86635","description":"ANTIBODY; COCCIDIOIDES","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1388.82,"providers":[{"billed_charge":16331.24,"npi":[1740262880]}]}]}]},{"name":"EPSTEIN-BARR NUCLEAR ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86664","description":"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":58.60,"providers":[{"billed_charge":620.12,"npi":[1740262880]}]}]}]},{"name":"EPSTEIN-BARR CAPSID VCA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86665","description":"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":264.10,"providers":[{"billed_charge":2591.67,"npi":[1740262880]}]}]}]},{"name":"HERPES SIMPLEX TYPE 1 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86695","description":"ANTIBODY; HERPES SIMPLEX, TYPE 1","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1344.63,"providers":[{"billed_charge":12157.47,"npi":[1740262880]}]}]}]},{"name":"HERPES SIMPLEX TYPE 2 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86696","description":"ANTIBODY; HERPES SIMPLEX, TYPE 2","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2209.67,"providers":[{"billed_charge":19988.67,"npi":[1740262880]}]}]}]},{"name":"HEP B CORE ANTIBODY, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86704","description":"HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":534.77,"providers":[{"billed_charge":6147.58,"npi":[1740262880]}]}]}]},{"name":"HEP B SURFACE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86706","description":"HEPATITIS B SURFACE ANTIBODY (HBSAB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":460.88,"providers":[{"billed_charge":5202.02,"npi":[1740262880]}]}]}]},{"name":"HEPATITIS A ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86708","description":"HEPATITIS A ANTIBODY (HAAB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":45.15,"providers":[{"billed_charge":336.80,"npi":[1740262880]}]}]}]},{"name":"MUMPS ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86735","description":"ANTIBODY; MUMPS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40.00,"providers":[{"billed_charge":423.21,"npi":[1740262880]}]}]}]},{"name":"RUBELLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86762","description":"ANTIBODY; RUBELLA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1621.41,"providers":[{"billed_charge":10884.24,"npi":[1740262880]}]}]}]},{"name":"RUBEOLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86765","description":"ANTIBODY; RUBEOLA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":39.52,"providers":[{"billed_charge":395.74,"npi":[1740262880]}]}]}]},{"name":"TREPONEMA PALLIDUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86780","description":"ANTIBODY; TREPONEMA PALLIDUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.85,"providers":[{"billed_charge":1993.85,"npi":[1740262880]}]}]}]},{"name":"VARICELLA-ZOSTER ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86787","description":"ANTIBODY; VARICELLA-ZOSTER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":187.72,"providers":[{"billed_charge":2453.85,"npi":[1740262880]}]}]}]},{"name":"THYROGLOBULIN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86800","description":"THYROGLOBULIN ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":809.60,"providers":[{"billed_charge":9607.18,"npi":[1740262880]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3960.28,"providers":[{"billed_charge":38003.08,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.94,"providers":[{"billed_charge":90.08,"npi":[1234567893]}]}]}]},{"name":"RBC ANTIBODY SCREEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86850","description":"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":972.78,"providers":[{"billed_charge":8987.88,"npi":[1740262880]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86900","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":426.36,"providers":[{"billed_charge":4260.98,"npi":[1740262880]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC RH(D)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86901","description":"BLOOD TYPING, SEROLOGIC; RH (D)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":421.80,"providers":[{"billed_charge":4175.24,"npi":[1740262880]}]}]}]},{"name":"CULTURE OTHR SPECIMN AEROBIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87070","description":"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":132.00,"providers":[{"billed_charge":1730.38,"npi":[1740262880]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":420.92,"providers":[{"billed_charge":1503.67,"npi":[1740262880]}]}]}]},{"name":"CULTURE SCREEN ONLY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87081","description":"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":579.13,"providers":[{"billed_charge":5466.07,"npi":[1740262880]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4401.09,"providers":[{"billed_charge":39049.39,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":241.41,"providers":[{"billed_charge":2034.94,"npi":[1234567893]}]}]}]},{"name":"URINE BACTERIA CULTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87088","description":"CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1130.22,"providers":[{"billed_charge":5462.12,"npi":[1740262880]}]}]}]},{"name":"DNA/RNA AMPLIFIED PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87150","description":"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, AMPLIFIED PROBE TECHNIQUE, PER C","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":699.14,"providers":[{"billed_charge":3395.66,"npi":[1740262880]}]}]}]},{"name":"MICROBE SUSCEPTIBLE MIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87186","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONC","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1105.57,"providers":[{"billed_charge":13822.50,"npi":[1740262880]}]}]}]},{"name":"HPYLORI STOOL IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87338","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HELICOBACTER PYLORI, STOOL; (EG, ENZYME","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":36.76,"providers":[{"billed_charge":966.00,"npi":[1740262880]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1849.70,"providers":[{"billed_charge":17781.66,"npi":[1740262880]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8494.20,"providers":[{"billed_charge":72744.07,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.55,"providers":[{"billed_charge":84.00,"npi":[1234567893]}]}]}]},{"name":"CANDIDA, DNA, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87480","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, DIRECT PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":199.81,"providers":[{"billed_charge":1542.45,"npi":[1740262880]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87491","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25007.51,"providers":[{"billed_charge":101620.90,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1048.72,"providers":[{"billed_charge":4256.61,"npi":[1234567893]}]}]}]},{"name":"GARDNER VAG, DNA, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87510","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, DIRECT PROBE TECHNIQ","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":199.81,"providers":[{"billed_charge":1542.45,"npi":[1740262880]}]}]}]},{"name":"HEPATITIS C REVRS TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87522","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION, INCLUDES REVER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":262.56,"providers":[{"billed_charge":4111.00,"npi":[1740262880]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1263.83,"providers":[{"billed_charge":3682.41,"npi":[1740262880]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87591","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24953.72,"providers":[{"billed_charge":101524.78,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1048.72,"providers":[{"billed_charge":4218.05,"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18425.44,"providers":[{"billed_charge":84062.55,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":490.96,"providers":[{"billed_charge":2471.17,"npi":[1234567893]}]}]}]},{"name":"Infectious Agent Antigen Detection","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87626","description":"the detection of human papillomavirus (HPV) by nucleic acid (DNA or RNA) tests, specifically reporting separately the high-risk types (16, 18, 31, 45, 51, and 52) and any high-risk pooled results.","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":300.48,"providers":[{"billed_charge":1505.80,"npi":[1740262880]}]}]}]},{"name":"TRICHOMONAS VAGIN, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87660","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, DIRECT PROBE TECHNIQ","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":476.47,"providers":[{"billed_charge":3678.15,"npi":[1740262880]}]}]}]},{"name":"TRICHOMONAS VAGINALIS AMPLIF","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87661","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5311.91,"providers":[{"billed_charge":31242.87,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":168.93,"providers":[{"billed_charge":1034.23,"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12425.49,"providers":[{"billed_charge":44575.55,"npi":[1740262880]}]}]}]},{"name":"CYTOPATH, C/V, INTERPRET","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88141","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), REQUIRING INTERPRETATION BY PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":44.37,"providers":[{"billed_charge":233.10,"npi":[1740262880]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2456.30,"providers":[{"billed_charge":9896.91,"npi":[1740262880]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5397.26,"providers":[{"billed_charge":17528.70,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"860443813"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":225.49,"providers":[{"billed_charge":471.00,"npi":[1972786382]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","22","81","21"],"billing_class":"professional","payments":[{"allowed_amount":445.91,"providers":[{"billed_charge":838.00,"npi":[1234567893]}]},{"allowed_amount":230.77,"providers":[{"billed_charge":295.24,"npi":[1234567893]}]},{"allowed_amount":1218.15,"providers":[{"billed_charge":4375.56,"npi":[1234567893]}]},{"allowed_amount":85.54,"providers":[{"billed_charge":120.48,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"452815598"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.27,"providers":[{"billed_charge":1615.00,"npi":[1740384130]}]}]}]},{"name":"IMMUNIZATION ADMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90471","description":"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJE","allowed_amounts":[{"tin":{"type":"ein","value":"860795005"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":223.47,"providers":[{"billed_charge":780.00,"npi":[1760456487]}]}]}]},{"name":"IIV3 VACC NO PRSV 0.5 ML IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90656","description":"INFLUENZA VIRUS VACCINE, TRIVALENT (IIV3), SPLIT VIRUS, PRESERVATIVE FREE, 0.5 ML DOSAGE, FOR INTRAM","allowed_amounts":[{"tin":{"type":"ein","value":"860795005"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":209.00,"providers":[{"billed_charge":660.00,"npi":[1760456487]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":163.32,"providers":[{"billed_charge":178.00,"npi":[1234567893]}]},{"allowed_amount":232.17,"providers":[{"billed_charge":600.00,"npi":[1234567893]}]}]}]},{"name":"PSYTX W PT W E/M 60 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90838","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"61040288"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":4050.00,"providers":[{"billed_charge":4050.00,"npi":[1952430647]}]}]}]},{"name":"SPEECH/HEARING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92507","description":"TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER; INDIVIDUAL","allowed_amounts":[{"tin":{"type":"ein","value":"812609370"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":52.04,"providers":[{"billed_charge":180.00,"npi":[1356878300]}]}]}]},{"name":"ELECTROCARDIOGRAM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93000","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":133.46,"providers":[{"billed_charge":1560.00,"npi":[1003395484]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"201291415"},"service_code":["11","22","19","21"],"billing_class":"professional","payments":[{"allowed_amount":19.80,"providers":[{"billed_charge":33.00,"npi":[1568480093]}]},{"allowed_amount":39.60,"providers":[{"billed_charge":66.00,"npi":[1568480093]}]},{"allowed_amount":277.20,"providers":[{"billed_charge":462.00,"npi":[1568480093]}]},{"allowed_amount":198.00,"providers":[{"billed_charge":330.00,"npi":[1568480093]}]}]}]},{"name":"RESPIRATORY FLOW VOLUME LOOP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"94375","description":"RESPIRATORY FLOW VOLUME LOOP","allowed_amounts":[{"tin":{"type":"ein","value":"873164803"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":82.75,"providers":[{"billed_charge":173.76,"npi":[1407016348]}]}]}]},{"name":"IMMUNOTHERAPY INJECTIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95117","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; 2 O","allowed_amounts":[{"tin":{"type":"ein","value":"873164803"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1043.97,"providers":[{"billed_charge":2195.18,"npi":[1407016348]}]},{"allowed_amount":1349.67,"providers":[{"billed_charge":1555.20,"npi":[1851382550]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"812124295"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10.50,"providers":[{"billed_charge":30.00,"npi":[1932557675]}]}]},{"tin":{"type":"ein","value":"860795005"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.15,"providers":[{"billed_charge":200.00,"npi":[1760456487]}]}]}]},{"name":"PT-FOCUSED HLTH RISK ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96160","description":"ADMINISTRATION OF PATIENT-FOCUSED HEALTH RISK ASSESSMENT INSTRUMENT (EG, HEALTH HAZARD APPRAISAL) WI","allowed_amounts":[{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14.91,"providers":[{"billed_charge":315.00,"npi":[1003395484]}]}]}]},{"name":"ELECTRIC CURRENT THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97033","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; IONTOPHORESIS, EACH 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":144.43,"providers":[{"billed_charge":225.00,"npi":[1972556421]}]}]}]},{"name":"ULTRASOUND THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97035","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ULTRASOUND, EACH 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":318.24,"providers":[{"billed_charge":400.00,"npi":[1972556421]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1489.18,"providers":[{"billed_charge":1750.00,"npi":[1972556421]}]}]},{"tin":{"type":"ein","value":"475433333"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":40.09,"providers":[{"billed_charge":170.11,"npi":[1629623657]}]}]},{"tin":{"type":"ein","value":"823481322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":564.08,"providers":[{"billed_charge":1800.00,"npi":[1033888466]}]},{"allowed_amount":86.02,"providers":[{"billed_charge":270.00,"npi":[1356017610]}]},{"allowed_amount":28.31,"providers":[{"billed_charge":90.00,"npi":[1871326371]}]}]},{"tin":{"type":"ein","value":"843032154"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":204.23,"providers":[{"billed_charge":607.20,"npi":[1871979195]}]},{"allowed_amount":1157.96,"providers":[{"billed_charge":3461.04,"npi":[1891732467]}]}]},{"tin":{"type":"ein","value":"824221156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1022.08,"providers":[{"billed_charge":5115.00,"npi":[1790934008]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":40.44,"providers":[{"billed_charge":167.60,"npi":[1234567893]}]},{"allowed_amount":1302.87,"providers":[{"billed_charge":5322.64,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"200619466"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1170.50,"providers":[{"billed_charge":4558.80,"npi":[1740013945]}]}]},{"tin":{"type":"ein","value":"861003167"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":428.95,"providers":[{"billed_charge":1680.00,"npi":[1922824739]}]}]}]},{"name":"NEUROMUSCULAR REEDUCATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97112","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALA","allowed_amounts":[{"tin":{"type":"ein","value":"823481322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":222.40,"providers":[{"billed_charge":595.00,"npi":[1356017610]}]},{"allowed_amount":64.99,"providers":[{"billed_charge":170.00,"npi":[1871326371]}]},{"allowed_amount":61.92,"providers":[{"billed_charge":170.00,"npi":[1831939891]}]},{"allowed_amount":312.44,"providers":[{"billed_charge":850.00,"npi":[1033888466]}]}]},{"tin":{"type":"ein","value":"843032154"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":840.35,"providers":[{"billed_charge":2607.76,"npi":[1891732467]}]}]},{"tin":{"type":"ein","value":"824221156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":626.95,"providers":[{"billed_charge":3180.00,"npi":[1790934008]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":488.27,"providers":[{"billed_charge":1581.16,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"200619466"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1304.09,"providers":[{"billed_charge":4477.98,"npi":[1740013945]}]}]},{"tin":{"type":"ein","value":"861003167"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":320.70,"providers":[{"billed_charge":1050.00,"npi":[1922824739]}]}]}]},{"name":"GAIT TRAINING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97116","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING)","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":528.57,"providers":[{"billed_charge":630.00,"npi":[1972556421]}]}]}]},{"name":"MANUAL THERAPY 1/> REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97140","description":"MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTIO","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1956.76,"providers":[{"billed_charge":2400.00,"npi":[1972556421]}]}]},{"tin":{"type":"ein","value":"823481322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":268.27,"providers":[{"billed_charge":850.00,"npi":[1356017610]}]},{"allowed_amount":78.79,"providers":[{"billed_charge":255.00,"npi":[1033888466]}]}]},{"tin":{"type":"ein","value":"843032154"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":872.67,"providers":[{"billed_charge":2567.72,"npi":[1891732467]}]},{"allowed_amount":94.68,"providers":[{"billed_charge":279.10,"npi":[1871979195]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":935.90,"providers":[{"billed_charge":3637.11,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"861003167"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":246.28,"providers":[{"billed_charge":910.00,"npi":[1922824739]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"850973957"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2325.51,"providers":[{"billed_charge":3542.64,"npi":[1396503942]}]}]},{"tin":{"type":"ein","value":"872628511"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1575.00,"providers":[{"billed_charge":3500.00,"npi":[1780064949]}]}]}]},{"name":"THERAPEUTIC ACTIVITIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97530","description":"THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FU","allowed_amounts":[{"tin":{"type":"ein","value":"475433333"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":123.34,"providers":[{"billed_charge":355.07,"npi":[1629623657]}]}]},{"tin":{"type":"ein","value":"823481322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":302.46,"providers":[{"billed_charge":765.00,"npi":[1033888466]}]},{"allowed_amount":134.54,"providers":[{"billed_charge":340.00,"npi":[1831939891]}]}]},{"tin":{"type":"ein","value":"843032154"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1113.70,"providers":[{"billed_charge":3627.56,"npi":[1891732467]}]}]},{"tin":{"type":"ein","value":"824221156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1225.40,"providers":[{"billed_charge":6480.00,"npi":[1790934008]}]}]},{"tin":{"type":"ein","value":"861003167"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":150.68,"providers":[{"billed_charge":510.00,"npi":[1922824739]}]}]},{"tin":{"type":"ein","value":"200619466"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":132.48,"providers":[{"billed_charge":361.28,"npi":[1740013945]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1884.71,"providers":[{"billed_charge":5423.54,"npi":[1234567893]}]}]}]},{"name":"PRO FEE/ER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"981","description":"PROFESSIONAL FEES - EMERGENCY ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"721561132"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":10200.60,"providers":[{"billed_charge":18890.00,"npi":[1700910189]}]}]}]},{"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":"999999999"},"service_code":["11","17","20"],"billing_class":"professional","payments":[{"allowed_amount":177.61,"providers":[{"billed_charge":302.00,"npi":[1234567893]}]},{"allowed_amount":134.57,"providers":[{"billed_charge":275.00,"npi":[1234567893]}]},{"allowed_amount":98.47,"providers":[{"billed_charge":186.47,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":145.00,"providers":[{"billed_charge":471.79,"npi":[1234567893]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"812124295"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":559.28,"providers":[{"billed_charge":1600.00,"npi":[1932557675]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","17","20","10"],"billing_class":"professional","payments":[{"allowed_amount":355.00,"providers":[{"billed_charge":783.65,"npi":[1234567893]}]},{"allowed_amount":349.79,"providers":[{"billed_charge":2075.40,"npi":[1234567893]}]},{"allowed_amount":1604.37,"providers":[{"billed_charge":3310.28,"npi":[1234567893]}]},{"allowed_amount":160.70,"providers":[{"billed_charge":303.92,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"61040288"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":5400.00,"providers":[{"billed_charge":5400.00,"npi":[1952430647]}]}]},{"tin":{"type":"ein","value":"860795005"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3639.50,"providers":[{"billed_charge":4950.00,"npi":[1760456487]}]},{"allowed_amount":75.89,"providers":[{"billed_charge":105.00,"npi":[1760456487]}]}]},{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1383.44,"providers":[{"billed_charge":2310.00,"npi":[1003395484]}]}]},{"tin":{"type":"ein","value":"215731283"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1995.00,"providers":[{"billed_charge":2025.00,"npi":[1720127715]}]}]}]},{"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":"203134104"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":104.57,"providers":[{"billed_charge":315.70,"npi":[1336327212]}]},{"allowed_amount":1150.27,"providers":[{"billed_charge":3472.70,"npi":[1336327212]}]},{"allowed_amount":1360.92,"providers":[{"billed_charge":4104.10,"npi":[1639243058]}]}]},{"tin":{"type":"ein","value":"873164803"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2320.06,"providers":[{"billed_charge":4240.48,"npi":[1407016348]}]}]},{"tin":{"type":"ein","value":"812124295"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1874.72,"providers":[{"billed_charge":4750.00,"npi":[1932557675]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","02","17","20","10"],"billing_class":"professional","payments":[{"allowed_amount":329.74,"providers":[{"billed_charge":622.00,"npi":[1234567893]}]},{"allowed_amount":113.39,"providers":[{"billed_charge":214.32,"npi":[1234567893]}]},{"allowed_amount":500.00,"providers":[{"billed_charge":1467.86,"npi":[1234567893]}]},{"allowed_amount":3070.63,"providers":[{"billed_charge":6333.41,"npi":[1234567893]}]},{"allowed_amount":138.59,"providers":[{"billed_charge":211.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"454995568"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":8955.98,"providers":[{"billed_charge":14875.00,"npi":[1891971628]}]},{"allowed_amount":4202.45,"providers":[{"billed_charge":7000.00,"npi":[1891971628]}]}]},{"tin":{"type":"ein","value":"270630232"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9473.70,"providers":[{"billed_charge":16524.00,"npi":[1003395484]}]}]},{"tin":{"type":"ein","value":"860795005"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":107.09,"providers":[{"billed_charge":135.00,"npi":[1760456487]}]}]}]},{"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":"134310760"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":70.37,"providers":[{"billed_charge":105.00,"npi":[1710017355]}]},{"allowed_amount":72.45,"providers":[{"billed_charge":105.00,"npi":[1952788143]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":719.55,"providers":[{"billed_charge":1299.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"860739774"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":850.00,"providers":[{"billed_charge":1000.00,"npi":[1265678569]}]}]}]},{"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":"449571869"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3315.98,"providers":[{"billed_charge":7000.00,"npi":[1407879489]}]}]},{"tin":{"type":"ein","value":"831138429"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1312.50,"providers":[{"billed_charge":3750.00,"npi":[1285745646]}]}]},{"tin":{"type":"ein","value":"261627833"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":805.42,"providers":[{"billed_charge":1145.00,"npi":[1356307375]}]}]},{"tin":{"type":"ein","value":"900990197"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":160.00,"providers":[{"billed_charge":200.00,"npi":[1952488694]}]}]},{"tin":{"type":"ein","value":"452049401"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":750.00,"providers":[{"billed_charge":1500.00,"npi":[1710954847]}]}]},{"tin":{"type":"ein","value":"860678845"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3799.20,"providers":[{"billed_charge":12240.00,"npi":[1992746408]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99308","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"471098491"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":60.65,"providers":[{"billed_charge":101.09,"npi":[1467560565]}]}]}]},{"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":"473350388"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":2673.25,"providers":[{"billed_charge":3145.00,"npi":[1659771186]}]}]},{"tin":{"type":"ein","value":"814984542"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":649.80,"providers":[{"billed_charge":722.00,"npi":[1649265406]}]}]}]},{"name":"PHONE E/M PHYS/QHP 5-10 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99441","description":"TELEPHONE EVALUATION AND MANAGEMENT SERVICE BY A PHYS OR OTH QUAL HEALTH CARE PROF WHO MAY RPT EVALU","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1850.00,"providers":[{"billed_charge":4181.00,"npi":[1234567893]}]}]}]},{"name":"BLS ROUTINE DISPOSABLE SUPPL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0382","description":"BLS ROUTINE DISPOSABLE SUPPLIES","allowed_amounts":[{"tin":{"type":"ein","value":"465332224"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2313.77,"providers":[{"billed_charge":2313.77,"npi":[1932652815]}]}]}]},{"name":"ALS ROUTNE DISPSABLE SUPPLS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0398","description":"ALS ROUTINE DISPOSABLE SUPPLIES","allowed_amounts":[{"tin":{"type":"ein","value":"465332224"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":293.54,"providers":[{"billed_charge":293.54,"npi":[1932652815]}]}]}]},{"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":"465332224"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2440.00,"providers":[{"billed_charge":2440.00,"npi":[1932652815]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3132.02,"providers":[{"billed_charge":8569.53,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10122.09,"providers":[{"billed_charge":34092.80,"npi":[1234567893]}]}]}]},{"name":"SPLY ALW NONIMPL CGM 1 MO SP=1 UOS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4239","description":"SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":401.88,"providers":[{"billed_charge":2100.00,"npi":[1234567893]}]}]}]},{"name":"PRTBLE GASEOUS O2 SYS RENTAL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0431","description":"PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, HUMIDIFIE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":423.30,"providers":[{"billed_charge":1726.20,"npi":[1234567893]}]}]}]},{"name":"NEBULIZER WITH COMPRESSOR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0570","description":"NEBULIZER, WITH COMPRESSOR","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":440.80,"providers":[{"billed_charge":1471.17,"npi":[1234567893]}]}]}]},{"name":"O2 CONC 85%/>02 CONC PRSC FL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E1390","description":"OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCEN","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":5536.08,"providers":[{"billed_charge":18702.36,"npi":[1234567893]}]}]}]},{"name":"PROSTATE CANCER SCREENING","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0103","description":"PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3691.58,"providers":[{"billed_charge":30743.75,"npi":[1740262880]}]}]}]},{"name":"SCR CERV/VAG THIN LAY W/PHYS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0123","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":326.13,"providers":[{"billed_charge":1299.00,"npi":[1740262880]}]}]}]},{"name":"SCR CERV/VAG THIN LAY PHYS I","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0124","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":517.65,"providers":[{"billed_charge":2707.55,"npi":[1740262880]}]}]}]},{"name":"SCR CERV/VAG AUTO&MNL RSCR P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0145","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13905.50,"providers":[{"billed_charge":63149.02,"npi":[1740262880]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":406.00,"providers":[{"billed_charge":2087.78,"npi":[1234567893]}]}]}]},{"name":"DX DIGTL BRST TOMOSYN UNI/BI","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0279","description":"DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 770","allowed_amounts":[{"tin":{"type":"ein","value":"200382536"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":88.47,"providers":[{"billed_charge":488.00,"npi":[1154558039]}]}]}]},{"name":"E-STIM 1/>NOT WND CARE PART","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0283","description":"ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, A","allowed_amounts":[{"tin":{"type":"ein","value":"204761143"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":305.12,"providers":[{"billed_charge":400.00,"npi":[1972556421]}]}]}]},{"name":"COLOREC CA SCR; FOB TST IMMU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0328","description":"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS DETERMINATIONS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":253.00,"providers":[{"billed_charge":2479.00,"npi":[1740262880]}]}]}]},{"name":"HEP C ABO SC IND HI RSK&OTH","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0472","description":"HEPATITIS C ANTIBODY SCREENING FOR INDIVIDUAL AT HIGH RISK AND OTHER COVERED INDICATION(S)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":868.00,"providers":[{"billed_charge":4420.16,"npi":[1740262880]}]}]}]},{"name":"HIV ANTIGEN/ANTIBODY, COMBIN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0475","description":"HIV ANTIGEN/ANTIBODY, COMBINATION ASSAY, SCREENING","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":315.90,"providers":[{"billed_charge":3064.40,"npi":[1740262880]}]}]}]},{"name":"MED ASST TX METHADONE;WEEKLY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2067","description":"MEDICATION ASSISSTED TX METHADONE; WEEKLY BUNDLE","allowed_amounts":[{"tin":{"type":"ein","value":"201264723"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":21984.82,"providers":[{"billed_charge":87942.14,"npi":[1346718269]}]}]}]},{"name":"MAT BUPRENORPHINE ORAL; WKLY","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2068","description":"MED ASST TX BUPRENORPHINE ORAL; WEEKLY BUNDLE","allowed_amounts":[{"tin":{"type":"ein","value":"201264723"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":2867.84,"providers":[{"billed_charge":11471.04,"npi":[1346718269]}]}]}]},{"name":"PA;PRD Q PERS DET APPR COMB","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2077","description":"PA;ASSESS PRD Q PERS DET MOST APPR COMB SRVC&TX","allowed_amounts":[{"tin":{"type":"ein","value":"201264723"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":2628.50,"providers":[{"billed_charge":10514.00,"npi":[1346718269]}]}]}]},{"name":"TH SUP METHADONE;TO 7 ADD D","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2078","description":"TAKE HOME SUP METHADONE; UP TO 7 ADD DAY SUP;","allowed_amounts":[{"tin":{"type":"ein","value":"201264723"},"service_code":["58"],"billing_class":"professional","payments":[{"allowed_amount":301.12,"providers":[{"billed_charge":1204.48,"npi":[1346718269]}]}]}]},{"name":"STANDARD WHEELCHAIR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"K0001","description":"STANDARD WHEELCHAIR","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":149.07,"providers":[{"billed_charge":438.75,"npi":[1234567893]}]}]}]},{"name":"GLBAL FEE URGNT CARE CENTERS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9083","description":"GLOBAL FEE URGENT CARE CENTERS","allowed_amounts":[{"tin":{"type":"ein","value":"205824138"},"service_code":["02","20"],"billing_class":"professional","payments":[{"allowed_amount":132080.00,"providers":[{"billed_charge":180275.00,"npi":[1043371826]}]},{"allowed_amount":8636.00,"providers":[{"billed_charge":11280.00,"npi":[1043371826]}]}]},{"tin":{"type":"ein","value":"215731283"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1260.00,"providers":[{"billed_charge":2520.00,"npi":[1720127715]}]}]}]},{"name":"LACTATION CLASS NON-PHYS PRO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9443","description":"LACTATION CLASSES, NONPHYSICIAN PROVIDER, PER SESSION","allowed_amounts":[{"tin":{"type":"ein","value":"850867370"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":600.00,"providers":[{"billed_charge":1500.00,"npi":[1699369124]}]}]}]}]}