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[{ "billed_charge": 237.00, "npi": [1740265347] } ] } ] } ] }, { "name": "DRUG TEST PRSMV DIR OPT OBS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80305", "description": "DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "824665477" }, "service_code": ["55"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.60, "providers": [{ "billed_charge": 2400.00, "npi": [1720082241] } ] } ] }, { "tin": { "type": "ein", "value": "834439721" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.60, "providers": [{ "billed_charge": 360.00, "npi": [1003256819] } ] } ] } ] }, { "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": "455080644" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 155.35, "providers": [{ "billed_charge": 935.00, "npi": [1861413023] } ] } ] }, { "tin": { "type": "ein", "value": "634017243" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.14, "providers": [{ "billed_charge": 186.42, "npi": [1992718381] } ] } ] }, { "tin": { "type": "ein", "value": "843045583" }, "service_code": ["55", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 186.42, "providers": [{ "billed_charge": 25651.68, "npi": [1508499393] } ] }, { "allowed_amount": 26937.69, "providers": [{ "billed_charge": 3702718.72, "npi": [1508499393] } ] } ] }, { "tin": { "type": "ein", "value": "843172409" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5530.46, "providers": [{ "billed_charge": 747315.20, "npi": [1003437500] } ] } ] }, { "tin": { "type": "ein", "value": "823268636" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 341.77, "providers": [{ "billed_charge": 19500.00, "npi": [1457863391] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2019.55, "providers": [{ "billed_charge": 8078.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "452215107" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5437.25, "providers": [{ "billed_charge": 32623.50, "npi": [1801226543] } ] } ] }, { "tin": { "type": "ein", "value": "853163633" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1895.27, "providers": [{ "billed_charge": 201051.73, "npi": [1063011898] } ] } ] }, { "tin": { "type": "ein", "value": "850612245" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 217.49, "providers": [{ "billed_charge": 1106.00, "npi": [1083830715] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39.75, "providers": [{ "billed_charge": 800.00, "npi": [1740265347] } ] } ] } ] }, { "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": 226.16, "providers": [{ "billed_charge": 2016.73, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 636.40, "providers": [{ "billed_charge": 3818.40, "npi": [1306940689] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 310.80, "providers": [{ "billed_charge": 2520.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.95, "providers": [{ "billed_charge": 165.00, "npi": [1740265347] } ] } ] } ] }, { "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": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.62, "providers": [{ "billed_charge": 135.72, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82728", "description": "FERRITIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.82, "providers": [{ "billed_charge": 86.00, "npi": [1740265347] } ] } ] } ] }, { "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": 229.16, "providers": [{ "billed_charge": 2138.54, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 340.20, "providers": [{ "billed_charge": 3360.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 87.39, "npi": [1306940689] } ] } ] } ] }, { "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": 8.98, "providers": [{ "billed_charge": 66.08, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.48, "providers": [{ "billed_charge": 66.00, "npi": [1740265347] } ] } ] } ] }, { "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": 6.07, "providers": [{ "billed_charge": 44.66, "npi": [1265418669] } ] } ] } ] }, { "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": 56.34, "providers": [{ "billed_charge": 839.79, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.48, "providers": [{ "billed_charge": 1298.88, "npi": [1306940689] } ] } ] } ] }, { "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": 653.52, "providers": [{ "billed_charge": 5274.18, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 487.20, "providers": [{ "billed_charge": 4872.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 352.80, "providers": [{ "billed_charge": 2116.80, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF TRANSFERRIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84466", "description": "TRANSFERRIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.76, "providers": [{ "billed_charge": 80.00, "npi": [1740265347] } ] } ] } ] }, { "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": 468.93, "providers": [{ "billed_charge": 2759.34, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 567.94, "providers": [{ "billed_charge": 5110.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.35, "providers": [{ "billed_charge": 349.65, "npi": [1306940689] } ] } ] } ] }, { "name": "CCPD/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "851", "description": "CCPD - OUTPT OR HOME - CCPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "203035983" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 29127.00, "providers": [{ "billed_charge": 630610.29, "npi": [1922049782] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.50, "providers": [{ "billed_charge": 270.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.72, "providers": [{ "billed_charge": 336.00, "npi": [1740265347] } ] } ] } ] }, { "name": "T CELLS, TOTAL COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86359", "description": "T CELLS; TOTAL COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.48, "providers": [{ "billed_charge": 752.00, "npi": [1740265347] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86361", "description": "T CELLS; ABSOLUTE CD4 COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.56, "providers": [{ "billed_charge": 756.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.62, "providers": [{ "billed_charge": 65.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 57.12, "providers": [{ "billed_charge": 504.00, "npi": [1740265347] } ] } ] } ] }, { "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": 67.32, "providers": [{ "billed_charge": 581.92, "npi": [1265418669] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.56, "providers": [{ "billed_charge": 672.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.94, "providers": [{ "billed_charge": 399.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 337.12, "providers": [{ "billed_charge": 2800.00, "npi": [1740265347] } ] } ] } ] }, { "name": "CORONAVIRUS AG IA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87426", "description": "IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "452568950" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.70, "providers": [{ "billed_charge": 1310.00, "npi": [1811987712] } ] } ] } ] }, { "name": "SARSCOV & INF VIR A&B AG IA", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87428", "description": "IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B", "allowed_amounts": [{ "tin": { "type": "ein", "value": "452568950" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 1019.35, "providers": [{ "billed_charge": 2465.00, "npi": [1811987712] } ] } ] } ] }, { "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": "20619423" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 421.20, "providers": [{ "billed_charge": 1728.00, "npi": [1619994522] } ] } ] } ] }, { "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": "20619423" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 421.20, "providers": [{ "billed_charge": 1728.00, "npi": [1619994522] } ] } ] } ] }, { "name": "HPV HIGH-RISK TYPES", "billing_code_type": "CPT", 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[1285150748] } ] } ] } ] }, { "name": "VISIT CPLX INHERENT E&M ASSO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2211", "description": "VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "834439721" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 409.46, "providers": [{ "billed_charge": 1034.00, "npi": [1003256819] } ] } ] }, { "tin": { "type": "ein", "value": "850612245" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.53, "providers": [{ "billed_charge": 121.06, "npi": [1083830715] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC; INTENSV OP;", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0015", "description": "ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS", "allowed_amounts": [{ "tin": { "type": "ein", "value": 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108.00, "providers": [{ "billed_charge": 360.00, "npi": [1548304892] } ] } ] } ] }, { "name": "BPN/NLX O >6 MG BUT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0574", "description": "BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 6 MG, BUT LESS THAN OR EQUAL TO 10 MG BUPRENORPHINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "736045246" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.50, "providers": [{ "billed_charge": 315.00, "npi": [1235146036] } ] } ] } ] }, { "name": "INJ DEXMETH SODM PHOSHA 1MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1100", "description": "INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "452568950" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.84, "providers": [{ "billed_charge": 132.00, "npi": [1811987712] } ] } ] } 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