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"ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.13, "providers": [{ "billed_charge": 896.52, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3615.98, "providers": [{ "billed_charge": 24829.90, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 418.77, "providers": [{ "billed_charge": 1241.00, "npi": [1174172845] } ] } ] } ] }, { "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": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1173.60, "providers": [{ "billed_charge": 2794.40, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 333.00, "providers": [{ "billed_charge": 1264.68, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3182.34, "providers": [{ "billed_charge": 24300.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 303.52, "providers": [{ "billed_charge": 1190.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3164.99, "providers": [{ "billed_charge": 17529.60, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1596850.42, "providers": [{ "billed_charge": 6385887.08, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30530.44, "providers": [{ "billed_charge": 121832.52, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4911.66, "providers": [{ "billed_charge": 13197.60, "npi": [1730617523] } ] } ] } ] }, { "name": "ELECTROLYTE PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80051", "description": "ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (BICARBONATE) (82374) CHLORI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 148.18, "providers": [{ "billed_charge": 2635.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.46, "providers": [{ "billed_charge": 434.16, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 277.59, "providers": [{ "billed_charge": 1448.21, "npi": [1234567893] } ] } ] } ] }, { "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": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3089.56, "providers": [{ "billed_charge": 20844.00, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.00, "providers": [{ "billed_charge": 40.00, "npi": [1265493688] } ] }, { "allowed_amount": 36.96, "providers": [{ "billed_charge": 791.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "474075276" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.28, "providers": [{ "billed_charge": 15.84, "npi": [1629454053] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 512.16, "providers": [{ "billed_charge": 2048.64, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1082.40, "providers": [{ "billed_charge": 2870.00, "npi": [1487429874] } ] }, { "allowed_amount": 52.80, "providers": [{ "billed_charge": 140.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 274.56, "providers": [{ "billed_charge": 1820.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 116953.20, "providers": [{ "billed_charge": 1846134.92, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 274.56, "providers": [{ "billed_charge": 549.12, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "933753059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 75.39, "providers": [{ "billed_charge": 221.76, "npi": [1730956350] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 47.52, "providers": [{ "billed_charge": 423.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 301.98, "providers": [{ "billed_charge": 5334.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.92, "providers": [{ "billed_charge": 364.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 121.44, "providers": [{ "billed_charge": 805.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4524.96, "providers": [{ "billed_charge": 18120.06, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.28, "providers": [{ "billed_charge": 47.00, "npi": [1234567893] } ] }, { "allowed_amount": 150788.65, "providers": [{ "billed_charge": 1008192.49, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.08, "providers": [{ "billed_charge": 493.92, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 71.90, "providers": [{ "billed_charge": 264.00, "npi": [1730617523] } ] } ] } ] }, { "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": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 154.10, "providers": [{ "billed_charge": 643.54, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 696.28, "providers": [{ "billed_charge": 1560.00, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 254410.44, "providers": [{ "billed_charge": 5365782.97, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.50, "providers": [{ "billed_charge": 85.00, "npi": [1841798667] } ] }, { "allowed_amount": 1159.10, "providers": [{ "billed_charge": 2941.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 102.42, "providers": [{ "billed_charge": 990.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 901.00, "providers": [{ "billed_charge": 3930.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 395.30, "providers": [{ "billed_charge": 1580.02, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "881682015" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.76, "providers": [{ "billed_charge": 200.00, "npi": [1932873445] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 395.30, "providers": [{ "billed_charge": 790.01, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 160.74, "providers": [{ "billed_charge": 486.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "813193170" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.72, "providers": [{ "billed_charge": 80.00, "npi": [1033524327] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.20, "providers": [{ "billed_charge": 360.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 951.40, "providers": [{ "billed_charge": 4754.16, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 118.43, "providers": [{ "billed_charge": 2093.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 740.35, "providers": [{ "billed_charge": 4199.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15054.90, "providers": [{ "billed_charge": 126112.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.70, "providers": [{ "billed_charge": 191.40, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140249.06, "providers": [{ "billed_charge": 1423792.76, "npi": [1234567893] } ] }, { "allowed_amount": 18.10, "providers": [{ "billed_charge": 60.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 829.01, "providers": [{ "billed_charge": 3046.68, "npi": [1730617523] } ] } ] } ] }, { "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": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.73, "providers": [{ "billed_charge": 315.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1756.30, "providers": [{ "billed_charge": 29034.84, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 235.17, "providers": [{ "billed_charge": 1652.47, "npi": [1234567893] } ] } ] } ] }, { "name": "ACUTE HEPATITIS PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80074", "description": "ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24462.90, "providers": [{ "billed_charge": 491671.10, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18484.32, "providers": [{ "billed_charge": 149760.24, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21844.21, "providers": [{ "billed_charge": 277640.07, "npi": [1234567893] } ] } ] } ] }, { "name": "HEPATIC FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80076", "description": "HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2163.60, "providers": [{ "billed_charge": 32537.48, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 348.84, "providers": [{ "billed_charge": 1881.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1550.64, "providers": [{ "billed_charge": 11463.07, "npi": [1234567893] } ] } ] } ] }, { "name": "OBSTETRIC PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80081", "description": "OBSTETRIC PANEL (INCLUDES HIV TESTING)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6886.71, "providers": [{ "billed_charge": 85048.50, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23135.55, "providers": [{ "billed_charge": 240555.80, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY DIPROPYLACETIC ACD TOT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80164", "description": "VALPROIC ACID (DIPROPYLACETIC ACID); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 284.06, "providers": [{ "billed_charge": 4684.40, "npi": [1790721538] } ] } ] } ] }, { "name": "DRUG SCRN QUAN LEVETIRACETAM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80177", "description": "LEVETIRACETAM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 174.62, "providers": [{ "billed_charge": 2463.12, "npi": [1790721538] } ] } ] }, { "tin": { "type": 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46.16, "providers": [{ "billed_charge": 230.64, "npi": [1376699199] } ] } ] } ] }, { "name": "ASSAY OF ERYTHROPOIETIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82668", "description": "ERYTHROPOIETIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 461.37, "providers": [{ "billed_charge": 8968.75, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF ESTRADIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82670", "description": "ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18933.21, "providers": [{ "billed_charge": 287654.10, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 796.29, "providers": [{ "billed_charge": 3185.16, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 195.58, "providers": [{ "billed_charge": 1302.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1159.51, "providers": [{ "billed_charge": 9720.96, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12208.23, "providers": [{ "billed_charge": 111227.27, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 181.61, "providers": [{ "billed_charge": 472.16, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 530.86, "providers": [{ "billed_charge": 1456.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1083.57, "providers": [{ "billed_charge": 3981.45, "npi": [1730617523] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2029.32, "providers": [{ "billed_charge": 35131.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1778.26, "providers": [{ "billed_charge": 20973.39, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ESTRIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82677", "description": "ESTRIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.79, "providers": [{ "billed_charge": 152.25, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY DIR MEAS FR ESTRADIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82681", "description": "ASSAY OF DIRECT MEASUREMENT FREE ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 147.22, "providers": [{ "billed_charge": 1308.42, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", 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"providers": [{ "billed_charge": 13284.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 613.80, "providers": [{ "billed_charge": 5138.10, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.10, "providers": [{ "billed_charge": 88.55, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27480.60, "providers": [{ "billed_charge": 218936.27, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 231.75, "providers": [{ "billed_charge": 852.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID SERUM", 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88.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 735.00, "providers": [{ "billed_charge": 2940.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2675.40, "providers": [{ "billed_charge": 22429.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.85, "providers": [{ "billed_charge": 210.21, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21551.16, "providers": [{ "billed_charge": 224530.87, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 565.95, "providers": [{ "billed_charge": 1734.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 580.58, "providers": [{ "billed_charge": 2131.50, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID, RBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82747", "description": "FOLIC ACID; RBC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44.15, "providers": [{ "billed_charge": 176.50, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 507.16, "providers": [{ "billed_charge": 9388.80, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2614.00, "providers": [{ "billed_charge": 33126.87, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1082.14, "providers": [{ "billed_charge": 12673.06, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2743.04, "providers": [{ "billed_charge": 31207.14, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 697.23, "providers": [{ "billed_charge": 6987.35, "npi": [1234567893] } ] } ] } ] }, { "name": "IGG 1 2 3 OR 4 EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82787", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 91.38, "providers": [{ "billed_charge": 2322.94, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY, GLUCOSE, BLOOD QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82947", "description": "GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)", 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"providers": [{ "billed_charge": 80.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 789.60, "providers": [{ "billed_charge": 8759.76, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 362.42, "providers": [{ "billed_charge": 6061.31, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 232.44, "providers": [{ "billed_charge": 2387.06, "npi": [1234567893] } ] } ] } ] }, { "name": "GTT-ADDED 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"professional", "payments": [{ "allowed_amount": 23.28, "providers": [{ "billed_charge": 463.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 195.17, "providers": [{ "billed_charge": 2463.56, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE BLOOD TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82962", "description": "GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752354465" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 125.30, "providers": [{ "billed_charge": 371.00, "npi": [1144282989] } ] }, { "allowed_amount": 23.10, "providers": [{ "billed_charge": 77.00, "npi": [1144282989] } ] }, { "allowed_amount": 2.80, "providers": [{ "billed_charge": 7.00, "npi": [1144282989] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.28, "providers": [{ "billed_charge": 30.00, "npi": [1982050241] } ] }, { "allowed_amount": 1.64, "providers": [{ "billed_charge": 15.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.88, "providers": [{ "billed_charge": 64.00, "npi": [1326017872] } ] }, { "allowed_amount": 23.24, "providers": [{ "billed_charge": 80.00, "npi": [1265493688] } ] }, { "allowed_amount": 3.36, "providers": [{ "billed_charge": 8.00, "npi": [1326017872] } ] }, { "allowed_amount": 36.96, "providers": [{ "billed_charge": 88.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.95, "providers": [{ "billed_charge": 75.05, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "741951476" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.60, "providers": [{ "billed_charge": 42.00, "npi": [1174028120] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.96, "providers": [{ "billed_charge": 66.00, "npi": [1174172845] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1499.15, "providers": [{ "billed_charge": 19921.04, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.00, "providers": [{ "billed_charge": 754.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5964.57, "providers": [{ "billed_charge": 35365.40, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 367.20, "providers": [{ "billed_charge": 1200.00, "npi": [1174172845] } ] } ] } ] }, { "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": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.87, "providers": [{ "billed_charge": 72.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14768.20, "providers": [{ "billed_charge": 204808.38, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 408.76, "providers": [{ "billed_charge": 1635.04, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1792.97, "providers": [{ "billed_charge": 15036.63, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 213.67, "providers": [{ "billed_charge": 1426.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.90, "providers": [{ "billed_charge": 241.50, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10992.13, "providers": [{ "billed_charge": 110455.10, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 715.33, "providers": [{ "billed_charge": 2150.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 354.20, "providers": [{ "billed_charge": 1300.60, "npi": [1730617523] } ] } ] } ] }, { "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": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.52, "providers": [{ "billed_charge": 48.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11995.06, "providers": [{ "billed_charge": 166707.15, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.38, "providers": [{ "billed_charge": 481.52, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.04, "providers": [{ "billed_charge": 248.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1713.10, "providers": [{ "billed_charge": 14363.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.08, "providers": [{ "billed_charge": 192.56, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9393.51, "providers": [{ "billed_charge": 95367.31, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 657.46, "providers": [{ "billed_charge": 1974.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 705.60, "providers": [{ "billed_charge": 2592.80, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF HAPTOGLOBIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83010", "description": "HAPTOGLOBIN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.77, "providers": [{ "billed_charge": 925.33, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52408.51, "providers": [{ "billed_charge": 336459.36, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10238.72, "providers": [{ "billed_charge": 85828.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9589.90, "providers": [{ "billed_charge": 63592.29, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI DRUG ADMIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83014", "description": "HELICOBACTER PYLORI; DRUG ADMINISTRATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2309.35, "providers": [{ "billed_charge": 29003.10, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 522.69, "providers": [{ "billed_charge": 4381.02, "npi": [1235186800] } ] } ] } ] }, { "name": "HEMOGLOBIN ELECTROPHORESIS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83020", "description": "HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (EG, A2, S, C, AND/OR F)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1079.54, "providers": [{ "billed_charge": 34119.87, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1230.91, "providers": [{ "billed_charge": 16842.06, "npi": [1234567893] } ] } ] } ] }, { "name": "GLYCOSYLATED HEMOGLOBIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83036", "description": "HEMOGLOBIN; GLYCOSYLATED (A1C)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 155.36, "providers": [{ "billed_charge": 426.24, "npi": [1689687360] } ] }, { "allowed_amount": 8.25, "providers": [{ "billed_charge": 26.64, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.20, "providers": [{ "billed_charge": 388.40, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "742357970" }, "service_code": ["11", "50"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.86, "providers": [{ "billed_charge": 45.00, "npi": [1134223175] } ] }, { "allowed_amount": 9.72, "providers": [{ "billed_charge": 90.00, "npi": [1134223175] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 78.47, "providers": [{ "billed_charge": 760.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 291.60, "providers": [{ "billed_charge": 1165.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 811.62, "providers": [{ "billed_charge": 2171.00, "npi": [1487429874] } ] }, { "allowed_amount": 19.44, "providers": [{ "billed_charge": 52.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 163387.17, "providers": [{ "billed_charge": 2381082.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 491.56, "providers": [{ "billed_charge": 2425.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "743001674" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.58, "providers": [{ "billed_charge": 180.00, "npi": [1972819589] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.60, "providers": [{ "billed_charge": 450.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 437.14, "providers": [{ "billed_charge": 1280.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.86, "providers": [{ "billed_charge": 74.00, "npi": [1417335571, 1942400601] } ] }, { "allowed_amount": 53.46, "providers": [{ "billed_charge": 814.00, "npi": [1982050241] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 675.54, "providers": [{ "billed_charge": 3374.92, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 527.31, "providers": [{ "billed_charge": 2604.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.62, "providers": [{ "billed_charge": 544.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11007.90, "providers": [{ "billed_charge": 92083.12, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "751414940" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 325.62, "providers": [{ "billed_charge": 1273.00, "npi": [1578897765] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.13, "providers": [{ "billed_charge": 44.00, "npi": [1234567893] } ] }, { "allowed_amount": 92323.61, "providers": [{ "billed_charge": 1010698.65, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 140.94, "providers": [{ "billed_charge": 365.98, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 614.73, "providers": [{ "billed_charge": 2258.04, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF HOMOCYSTINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83090", "description": "HOMOCYSTEINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.17, "providers": [{ "billed_charge": 12217.18, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 322.56, "providers": [{ "billed_charge": 1000.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE 17-D", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83498", "description": "HYDROXYPROGESTERONE, 17-D", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1628.50, "providers": [{ "billed_charge": 19034.84, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1830.39, "providers": [{ "billed_charge": 16677.35, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83516", "description": "IMMUNOASSAY FOR ANALYTE OTH THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 904.98, "providers": [{ "billed_charge": 13747.69, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.68, "providers": [{ "billed_charge": 4508.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 547.94, "providers": [{ "billed_charge": 9674.67, "npi": [1234567893] } ] } ] } ] }, { "name": "RIA NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83519", "description": "IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.08, "providers": [{ "billed_charge": 770.05, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7334.32, "providers": [{ "billed_charge": 93205.62, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 565.91, "providers": [{ "billed_charge": 5144.86, "npi": [1234567893] } ] } ] } ] }, { "name": "IG LIGHT CHAINS FREE EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83521", "description": "IMMUNOGLOBULIN LIGHT CHAINS FREE EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 481.60, "providers": [{ "billed_charge": 9234.48, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1092.80, "providers": [{ "billed_charge": 12708.43, "npi": [1234567893] } ] } ] } ] }, { "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": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 205.92, "providers": [{ "billed_charge": 822.96, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3870.05, "providers": [{ "billed_charge": 23417.12, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1658.80, "providers": [{ "billed_charge": 13902.60, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10079.38, "providers": [{ "billed_charge": 134476.80, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.24, "providers": [{ "billed_charge": 252.45, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 662.94, "providers": [{ "billed_charge": 1702.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 427.90, "providers": [{ "billed_charge": 1571.90, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF IRON", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83540", "description": "IRON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.88, "providers": [{ "billed_charge": 155.28, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1231.80, "providers": [{ "billed_charge": 15744.84, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.32, "providers": [{ "billed_charge": 162.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.56, "providers": [{ "billed_charge": 245.86, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.20, "providers": [{ "billed_charge": 64.70, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13694.39, "providers": [{ "billed_charge": 156541.34, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 158.58, "providers": [{ "billed_charge": 465.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 369.36, "providers": [{ "billed_charge": 1844.52, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 436.59, "providers": [{ "billed_charge": 7722.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 317.52, "providers": [{ "billed_charge": 2660.70, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9507.24, "providers": [{ "billed_charge": 53790.49, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.08, "providers": [{ "billed_charge": 142.97, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.87, "providers": [{ "billed_charge": 113.26, "npi": [1730617523] } ] }, { "allowed_amount": 83.79, "providers": [{ "billed_charge": 307.42, "npi": [1730617523] } ] } ] } ] }, { "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": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1660.70, "providers": [{ "billed_charge": 21272.36, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.48, "providers": [{ "billed_charge": 69.92, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39.33, "providers": [{ "billed_charge": 99.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16715.79, "providers": [{ "billed_charge": 187475.11, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8824.32, "providers": [{ "billed_charge": 70612.66, "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": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.70, "providers": [{ "billed_charge": 920.00, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 571.60, "providers": [{ "billed_charge": 9352.02, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3433.56, "providers": [{ "billed_charge": 7408.33, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 314.08, "providers": [{ "billed_charge": 975.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LDH ENZYMES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83625", "description": "LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.29, "providers": [{ "billed_charge": 630.55, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF LEAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83655", "description": "LEAD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473975088" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 133.90, "providers": [{ "billed_charge": 780.00, "npi": [1497225478] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2708.42, "providers": [{ "billed_charge": 41309.10, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 824.18, "providers": [{ "billed_charge": 8132.50, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LIPASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83690", "description": "LIPASE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 93.15, "providers": [{ "billed_charge": 465.21, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2351.10, "providers": [{ "billed_charge": 42539.10, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2021.94, "providers": [{ "billed_charge": 25409.37, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 251.67, "providers": [{ "billed_charge": 825.00, "npi": [1174172845] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 613.14, "providers": [{ "billed_charge": 2059.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 902.16, "providers": [{ "billed_charge": 7560.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 382.36, "providers": [{ "billed_charge": 5259.78, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 304.15, "providers": [{ "billed_charge": 858.00, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN", "billing_code_type": "CPT", 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[{ "billed_charge": 1308.78, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 414.75, "providers": [{ "billed_charge": 1155.00, "npi": [1174172845] } ] } ] } ] }, { "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": 37.20, "providers": [{ "billed_charge": 325.97, "npi": [1083698534] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.45, "providers": [{ "billed_charge": 93.80, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 348.40, "providers": [{ "billed_charge": 1742.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.28, "providers": [{ "billed_charge": 1053.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.05, "providers": [{ "billed_charge": 117.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 127.30, "providers": [{ "billed_charge": 760.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4885.94, "providers": [{ "billed_charge": 77245.54, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.70, "providers": [{ "billed_charge": 617.76, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.35, "providers": [{ "billed_charge": 8.71, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4833.52, "providers": [{ "billed_charge": 40964.60, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.55, "providers": [{ "billed_charge": 99.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF METANEPHRINES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83835", "description": "METANEPHRINES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.48, "providers": [{ "billed_charge": 907.26, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF NATRIURETIC PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83880", "description": "NATRIURETIC PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4142.48, "providers": [{ "billed_charge": 38911.33, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6344.43, "providers": [{ "billed_charge": 59277.17, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 922.61, "providers": [{ "billed_charge": 1218.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY, NEPHELOMETRY NOT SPEC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83883", "description": "NEPHELOMETRY, EACH ANALYTE NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 236.40, "providers": [{ "billed_charge": 1878.52, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 789.88, "providers": [{ "billed_charge": 20671.36, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF OXALATE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83945", "description": "OXALATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 72.24, "providers": [{ "billed_charge": 632.48, "npi": [1083698534] } ] } ] } ] }, { "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": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1460.68, "providers": [{ "billed_charge": 25792.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18503.35, "providers": [{ "billed_charge": 201348.17, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.56, "providers": [{ "billed_charge": 330.24, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 144.48, "providers": [{ "billed_charge": 375.62, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6952.04, "providers": [{ "billed_charge": 47389.72, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1609.92, "providers": [{ "billed_charge": 2805.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, 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"billed_charge": 8794.09, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.18, "providers": [{ "billed_charge": 121.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.65, "providers": [{ "billed_charge": 651.75, "npi": [1730617523] } ] }, { "allowed_amount": 3.23, "providers": [{ "billed_charge": 11.85, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF URINE PHOSPHORUS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84105", "description": "PHOSPHORUS INORGANIC (PHOSPHATE); URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.88, "providers": [{ "billed_charge": 252.67, "npi": 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"professional", "payments": [{ "allowed_amount": 9.52, "providers": [{ "billed_charge": 27.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF URINE POTASSIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84133", "description": "POTASSIUM; URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.92, "providers": [{ "billed_charge": 208.34, "npi": [1083698534] } ] } ] } ] }, { "name": "ASSAY OF PREALBUMIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84134", "description": "PREALBUMIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.78, "providers": [{ "billed_charge": 702.54, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PREGNENOLONE", "billing_code_type": "CPT", 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"810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 312.90, "providers": [{ "billed_charge": 2623.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.29, "providers": [{ "billed_charge": 210.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 83.44, "providers": [{ "billed_charge": 333.76, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4953.93, "providers": [{ "billed_charge": 48883.06, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 417.20, "providers": [{ "billed_charge": 1344.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 397.60, "providers": [{ "billed_charge": 1460.20, "npi": [1730617523] } ] } ] } ] }, { "name": "PROCALCITONIN (PCT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84145", "description": "PROCALCITONIN (PCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "371520288" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 122.49, "providers": [{ "billed_charge": 227.70, "npi": [1538117007] } ] } ] } ] }, { "name": "ASSAY OF PROLACTIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84146", "description": "PROLACTIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10220.98, "providers": [{ "billed_charge": 164005.66, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 426.36, "providers": [{ "billed_charge": 3574.56, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.76, "providers": [{ "billed_charge": 260.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8081.42, "providers": [{ "billed_charge": 90815.72, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 377.91, "providers": [{ "billed_charge": 1144.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 356.13, "providers": [{ "billed_charge": 1308.15, "npi": [1730617523] } ] } ] } ] }, { "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": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 92.00, "providers": [{ "billed_charge": 459.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53310.18, "providers": [{ "billed_charge": 777561.55, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.60, "providers": [{ "billed_charge": 140.34, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.20, "providers": [{ "billed_charge": 23.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3413.20, "providers": [{ "billed_charge": 28549.99, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14437.63, "providers": [{ "billed_charge": 146607.96, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 125.20, "providers": [{ "billed_charge": 459.80, "npi": [1730617523] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7788.85, "providers": [{ "billed_charge": 74526.33, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.00, "providers": [{ "billed_charge": 385.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2465.04, "providers": [{ "billed_charge": 19047.93, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PROTEIN SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84155", "description": "PROTEIN, TOTAL, EXCEPT 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94.28, "providers": [{ "billed_charge": 269.80, "npi": [1194929778] } ] }, { "allowed_amount": 23.57, "providers": [{ "billed_charge": 67.45, "npi": [1194929778] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1221.92, "providers": [{ "billed_charge": 16788.45, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 764.39, "providers": [{ "billed_charge": 8024.76, "npi": [1234567893] } ] } ] } ] }, { "name": "PROTEIN E-PHORESIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84166", "description": "PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, OTHER FLUIDS WITH CONCENTRATION (EG, URINE,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", 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103.73, "providers": [{ "billed_charge": 414.92, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 365.31, "providers": [{ "billed_charge": 1461.24, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.79, "providers": [{ "billed_charge": 481.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 347.27, "providers": [{ "billed_charge": 1092.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 428.45, "providers": [{ "billed_charge": 2142.25, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": 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[{ "allowed_amount": 183.04, "providers": [{ "billed_charge": 3276.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 591.69, "providers": [{ "billed_charge": 4424.28, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5392.72, "providers": [{ "billed_charge": 6590.86, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 36.26, "providers": [{ "billed_charge": 132.00, "npi": [1174172845] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 684.41, "providers": [{ "billed_charge": 5978.28, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3679.82, "providers": [{ "billed_charge": 5155.03, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TRANSFERRIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84466", "description": "TRANSFERRIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 860.31, "providers": [{ "billed_charge": 15246.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.80, "providers": [{ "billed_charge": 255.20, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.07, "providers": [{ "billed_charge": 916.16, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 357.28, "providers": [{ "billed_charge": 2950.08, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.38, "providers": [{ "billed_charge": 16.58, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 221.50, "providers": [{ "billed_charge": 2344.93, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 293.48, "providers": [{ "billed_charge": 930.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF TRIGLYCERIDES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84478", "description": "TRIGLYCERIDES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17.20, "providers": [{ "billed_charge": 244.45, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.53, "providers": [{ "billed_charge": 169.00, "npi": [1174172845] } ] } ] } ] }, { "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)", 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"professional", "payments": [{ "allowed_amount": 6179.97, "providers": [{ "billed_charge": 107588.73, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14059.20, "providers": [{ "billed_charge": 162181.94, "npi": [1234567893] } ] } ] } ] }, { "name": "FREE ASSAY (FT-3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84481", "description": "TRIIODOTHYRONINE T3; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 847.00, "providers": [{ "billed_charge": 1694.00, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 830.06, "providers": [{ "billed_charge": 4150.30, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15440.84, "providers": [{ "billed_charge": 393586.49, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 143.99, "providers": [{ "billed_charge": 575.96, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 296.45, "providers": [{ "billed_charge": 770.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 355.74, "providers": [{ "billed_charge": 1422.96, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 347.27, "providers": [{ "billed_charge": 2911.41, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24112.78, "providers": [{ "billed_charge": 513556.33, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.29, "providers": [{ "billed_charge": 154.14, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 669.13, "providers": [{ "billed_charge": 1802.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.53, "providers": [{ "billed_charge": 42.35, "npi": [1730617523] } ] }, { "allowed_amount": 726.39, "providers": [{ "billed_charge": 2668.05, "npi": [1730617523] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 160.73, "providers": [{ "billed_charge": 5300.01, "npi": [1790721538] } ] } ] } ] }, { "name": "ASSAY OF TROPONIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84484", "description": "TROPONIN, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.92, "providers": [{ "billed_charge": 622.80, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 85.69, "providers": [{ "billed_charge": 1928.85, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF UREA NITROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84520", "description": "UREA NITROGEN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 228.65, "providers": [{ "billed_charge": 4080.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 184.62, "providers": [{ "billed_charge": 750.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4602.23, "providers": [{ "billed_charge": 5770.09, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.94, "providers": [{ "billed_charge": 27.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF URINE/UREA-N", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84540", "description": "UREA NITROGEN, URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.84, "providers": [{ "billed_charge": 242.24, "npi": [1083698534] } ] } ] } ] }, { "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": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 103.96, "providers": [{ "billed_charge": 519.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6721.35, "providers": [{ "billed_charge": 121359.98, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 250.86, "providers": [{ "billed_charge": 2101.23, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.68, "providers": [{ "billed_charge": 105.66, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7295.57, "providers": [{ "billed_charge": 49879.19, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 117.52, "providers": [{ "billed_charge": 374.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF URINE/URIC ACID", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84560", "description": "URIC ACID; OTHER SOURCE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.32, "providers": [{ "billed_charge": 229.96, "npi": [1083698534] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 201.85, "providers": [{ "billed_charge": 5210.78, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.36, "providers": [{ "billed_charge": 699.30, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN K", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84597", "description": "VITAMIN K", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1658.22, "providers": [{ "billed_charge": 40378.35, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ZINC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84630", "description": "ZINC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 293.21, "providers": [{ "billed_charge": 3706.60, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.92, "providers": [{ "billed_charge": 1188.43, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF C-PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84681", "description": "C-PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4141.04, "providers": [{ "billed_charge": 27096.25, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2748.24, "providers": [{ "billed_charge": 23023.44, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 983.28, "providers": [{ "billed_charge": 9934.33, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8001.05, "providers": [{ "billed_charge": 148515.14, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.59, "providers": [{ "billed_charge": 150.57, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 30.12, "providers": [{ "billed_charge": 200.76, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4580.72, "providers": [{ "billed_charge": 52844.53, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN ASSAY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84703", "description": "GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 973.12, "providers": [{ "billed_charge": 17513.28, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 593.50, "providers": [{ "billed_charge": 12741.14, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMATOCRIT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85014", "description": "BLOOD COUNT; HEMATOCRIT (HCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.40, "providers": [{ "billed_charge": 2030.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.10, "providers": [{ "billed_charge": 1323.18, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.80, "providers": [{ "billed_charge": 862.50, "npi": [1234567893] } ] } ] } ] }, { "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": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 145.80, "providers": [{ "billed_charge": 2610.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 231.23, "providers": [{ "billed_charge": 1504.28, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.79, "providers": [{ "billed_charge": 1031.10, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLETE CBC W/AUTO DIFF WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1469.28, "providers": [{ "billed_charge": 11293.22, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "272310190" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.78, "providers": [{ "billed_charge": 60.00, "npi": [1780698134] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.34, "providers": [{ "billed_charge": 282.00, "npi": [1265493688] } ] }, { "allowed_amount": 9.00, "providers": [{ "billed_charge": 30.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 206.17, "providers": [{ "billed_charge": 1855.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.56, "providers": [{ "billed_charge": 40.00, "npi": [1841798667] } ] }, { "allowed_amount": 634.07, "providers": [{ "billed_charge": 1630.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44411.44, "providers": [{ "billed_charge": 496017.41, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 564.05, "providers": [{ "billed_charge": 2253.30, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760430777" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.91, "providers": [{ "billed_charge": 194.25, "npi": [1780730606] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 241.18, "providers": [{ "billed_charge": 481.74, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "900901336" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.40, "providers": [{ "billed_charge": 240.00, "npi": [1326464447] } ] } ] }, { "tin": { "type": "ein", "value": "933753059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.72, "providers": [{ "billed_charge": 93.24, "npi": [1730956350] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 419.80, "providers": [{ "billed_charge": 1140.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.29, "providers": [{ "billed_charge": 33.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.24, "providers": [{ "billed_charge": 560.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "710892430" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 126.00, "npi": [1154379907] } ] } ] }, { "tin": { "type": "ein", "value": "760095595" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.40, "providers": [{ "billed_charge": 630.00, "npi": [1609491059] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 655.96, "providers": [{ "billed_charge": 11656.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 405.46, "providers": [{ "billed_charge": 2090.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.26, "providers": [{ "billed_charge": 1054.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2162.84, "providers": [{ "billed_charge": 8629.56, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80182.83, "providers": [{ "billed_charge": 504019.56, "npi": [1234567893] } ] }, { "allowed_amount": 9.25, "providers": [{ "billed_charge": 36.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "833468825" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 120.59, "providers": [{ "billed_charge": 313.10, "npi": [1982165908] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.34, "providers": [{ "billed_charge": 216.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.67, "providers": [{ "billed_charge": 165.00, "npi": [1093920399] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15534.29, "providers": [{ "billed_charge": 154274.82, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.62, "providers": [{ "billed_charge": 10.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.16, "providers": [{ "billed_charge": 198.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.00, "providers": [{ "billed_charge": 678.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "751414940" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.24, "providers": [{ "billed_charge": 13.00, "npi": [1578897765] } ] } ] }, { "tin": { "type": "ein", "value": "863024305" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 208.00, "providers": [{ "billed_charge": 432.00, "npi": [1548258833] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5186.00, "providers": [{ "billed_charge": 37267.83, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED RBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85041", "description": "BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 151.88, "providers": [{ "billed_charge": 1027.69, "npi": [1790721538] } ] } ] } ] }, { "name": "AUTOMATED RETICULOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85045", "description": "BLOOD COUNT; RETICULOCYTE, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 179.52, "providers": [{ "billed_charge": 3168.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 272.36, "providers": [{ "billed_charge": 7615.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.00, "providers": [{ "billed_charge": 216.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1065.83, "providers": [{ "billed_charge": 12873.89, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 185.73, "providers": [{ "billed_charge": 528.00, "npi": [1174172845] } ] } ] } ] }, { "name": "AUTOMATED PLATELET COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85049", "description": "BLOOD COUNT; PLATELET, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.22, "providers": [{ "billed_charge": 132.41, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.86, "providers": [{ "billed_charge": 706.50, "npi": [1234567893] } ] } ] } ] }, { "name": "BLOOD SMEAR INTERPRETATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85060", "description": "BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "746106575" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.42, "providers": [{ "billed_charge": 86.00, "npi": [1497735971] } ] }, { "allowed_amount": 77.63, "providers": [{ "billed_charge": 602.00, "npi": [1497735971] } ] }, { "allowed_amount": 66.54, "providers": [{ "billed_charge": 516.00, "npi": [1497735971] } ] } ] } ] }, { "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": "202947583" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 5296.08, "providers": [{ "billed_charge": 44052.00, "npi": [1821052507] } ] } ] } ] }, { "name": "CLOT FACTOR VIII AHG 1 STAGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85240", "description": "CLOTTING; FACTOR VIII (AHG), 1-STAGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.44, "providers": [{ "billed_charge": 1798.98, "npi": [1790721538] } ] } ] } ] }, { "name": "ANTITHROMBIN III ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85300", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.27, "providers": [{ "billed_charge": 942.00, "npi": [1790721538] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT C ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85303", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.92, "providers": [{ "billed_charge": 2509.40, "npi": [1790721538] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT S FREE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85306", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.63, "providers": [{ "billed_charge": 2448.77, "npi": [1790721538] } ] } ] } ] }, { "name": "FIBRIN DEGRADATION, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85379", "description": "FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 256.32, "providers": [{ "billed_charge": 6701.94, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.14, "providers": [{ "billed_charge": 3724.75, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRINOLYSINS SCREEN I&R", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85390", "description": "FIBRINOLYSINS OR COAGULOPATHY SCREEN, INTERPRETATION AND REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.92, "providers": [{ "billed_charge": 208.00, "npi": [1255394615] } ] }, { "allowed_amount": 1101.00, "providers": [{ "billed_charge": 6552.00, "npi": [1518254309] } ] }, { "allowed_amount": 2599.77, "providers": [{ "billed_charge": 13936.00, "npi": [1518254309] } ] } ] } ] }, { "name": "CLOTTING ASSAY WHOLE BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85396", "description": "COAGULATION/FIBRINOLYSIS ASSAY, WHOLE BLOOD (EG, VISCOELASTIC CLOT ASSESSMENT), INCLUDING USE OF ANY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 342.89, "providers": [{ "billed_charge": 1156.00, "npi": [1821077728] } ] }, { "allowed_amount": 141.19, "providers": [{ "billed_charge": 476.00, "npi": [1821077728] } ] } ] } ] }, { "name": "BLOOD PLATELET AGGREGATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85576", "description": "PLATELET, AGGREGATION (IN VITRO), EACH AGENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 593.82, "providers": [{ "billed_charge": 5576.00, "npi": [1518254309] } ] }, { "allowed_amount": 1765.10, "providers": [{ "billed_charge": 14514.00, "npi": [1518254309] } ] }, { "allowed_amount": 96.03, "providers": [{ "billed_charge": 902.00, "npi": [1255394615] } ] }, { "allowed_amount": 8.73, "providers": [{ "billed_charge": 82.00, "npi": [1255394615] } ] } ] }, { "tin": { "type": "ein", "value": "760421006" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.56, "providers": [{ "billed_charge": 150.56, "npi": [1194929778] } ] } ] }, { "tin": { "type": "ein", "value": "863024305" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.00, "providers": [{ "billed_charge": 128.00, "npi": [1548258833] } ] } ] } ] }, { "name": "PROTHROMBIN TIME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85610", "description": "PROTHROMBIN TIME;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1971.78, "providers": [{ "billed_charge": 34364.66, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 918.14, "providers": [{ "billed_charge": 14539.98, "npi": [1234567893] } ] } ] } ] }, { "name": "RUSSELL VIPER VENOM, DILUTED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85613", "description": "RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 212.39, "providers": [{ "billed_charge": 3561.50, "npi": [1790721538] } ] } ] } ] }, { "name": "RBC SED RATE, NONAUTOMATED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85651", "description": "SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.00, "providers": [{ "billed_charge": 551.98, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.70, "providers": [{ "billed_charge": 42.70, "npi": [1558717827] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3606.33, "providers": [{ "billed_charge": 94540.96, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1846.99, "providers": [{ "billed_charge": 35857.17, "npi": [1234567893] } ] } ] } ] }, { "name": "RBC SICKLE CELL TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85660", "description": "SICKLING OF RBC, REDUCTION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 241.27, "providers": [{ "billed_charge": 5185.08, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1881.74, "providers": [{ "billed_charge": 30804.65, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1135.79, "providers": [{ 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14316.35, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLEMENT, TOTAL (CH50)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86162", "description": "COMPLEMENT; TOTAL HEMOLYTIC (CH50)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 304.42, "providers": [{ "billed_charge": 3474.50, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6822.69, "providers": [{ "billed_charge": 137899.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", 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}, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1515.75, "providers": [{ "billed_charge": 16915.86, "npi": [1234567893] } ] } ] } ] }, { "name": "NUCLEAR ANTIGEN ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86235", "description": "EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34244.04, "providers": [{ "billed_charge": 401003.68, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44.83, "providers": [{ "billed_charge": 375.90, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10421.87, "providers": [{ "billed_charge": 109450.35, "npi": [1234567893] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86255", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 106.00, "providers": [{ "billed_charge": 106.00, "npi": [1194929778] } ] }, { "allowed_amount": 63.60, "providers": [{ "billed_charge": 63.60, "npi": [1194929778] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1797.75, "providers": [{ "billed_charge": 41866.28, "npi": [1790721538] } ] } ] } ] }, { "name": "FLUORESCENT ANTIBODY, TITER", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86256", "description": "FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.69, "providers": [{ "billed_charge": 150.57, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "203304074" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.50, "providers": [{ "billed_charge": 49.50, "npi": [1679580849] } ] } ] } ] }, { "name": "DGP ANTIBODY EACH IG CLASS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86258", "description": "GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.46, "providers": [{ "billed_charge": 281.82, "npi": [1790721538] } ] } ] } ] }, { "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": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1072.42, "providers": [{ "billed_charge": 11460.80, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 536.38, "providers": [{ "billed_charge": 8251.61, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1109.46, "providers": [{ "billed_charge": 11623.70, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, 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"allowed_amount": 2643.20, "providers": [{ "billed_charge": 46375.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 874.27, "providers": [{ "billed_charge": 10768.70, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY INFECTIOUS AGENT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86317", "description": "IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4337.69, "providers": [{ "billed_charge": 54219.57, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5235.78, "providers": [{ "billed_charge": 45763.71, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOFIX E-PHORESIS, SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86334", "description": "IMMUNOFIXATION ELECTROPHORESIS; SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1431.88, "providers": [{ "billed_charge": 25320.50, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 212.41, "providers": [{ "billed_charge": 2180.68, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNFIX E-PHORSIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86335", "description": "IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION (EG, URINE, CSF)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 281.44, "providers": [{ "billed_charge": 3273.76, "npi": [1790721538] } ] } ] } ] }, { "name": "INSULIN ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86337", "description": "INSULIN ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 178.44, "providers": [{ "billed_charge": 2420.57, "npi": [1234567893] } ] } ] } ] }, { "name": "ISLET CELL ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86341", "description": "ISLET CELL ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 484.25, "providers": [{ "billed_charge": 9108.39, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 441.90, "providers": [{ "billed_charge": 6465.92, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 451.96, "providers": [{ "billed_charge": 4261.49, "npi": [1790721538] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT/RATIO", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86360", "description": "T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6613.73, "providers": [{ "billed_charge": 99973.61, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8385.91, "providers": [{ "billed_charge": 77452.03, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1716.79, "providers": [{ "billed_charge": 22306.29, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2007.72, "providers": [{ "billed_charge": 18774.78, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1558.43, "providers": [{ "billed_charge": 44497.14, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 91.97, "providers": [{ "billed_charge": 1579.09, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10417.47, "providers": [{ "billed_charge": 169255.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 414.94, "providers": [{ "billed_charge": 1571.40, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.56, "providers": [{ "billed_charge": 58.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 174.72, "providers": [{ "billed_charge": 1463.76, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6815.42, "providers": [{ "billed_charge": 68740.97, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 276.53, "providers": [{ "billed_charge": 918.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 613.80, "providers": [{ "billed_charge": 2255.56, "npi": [1730617523] } ] }, { "allowed_amount": 9.90, "providers": [{ "billed_charge": 36.38, "npi": [1730617523] } ] } ] } ] }, { "name": "MITOCHONDRIAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86381", "description": "MITOCHONDRIAL ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2211.27, "providers": [{ "billed_charge": 21371.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 556.83, "providers": [{ "billed_charge": 5260.25, "npi": [1234567893] } ] } ] } ] }, { "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": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65.32, "providers": [{ "billed_charge": 326.14, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4809.15, "providers": [{ "billed_charge": 94700.65, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.72, "providers": [{ "billed_charge": 190.32, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3046.13, "providers": [{ "billed_charge": 40517.09, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 221.26, "providers": [{ "billed_charge": 572.00, "npi": [1174172845] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 47403.78, "providers": [{ "billed_charge": 490646.75, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 247.92, "providers": [{ "billed_charge": 2080.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "933753059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 379.32, "providers": [{ "billed_charge": 1022.67, "npi": [1730956350] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18826.79, "providers": [{ "billed_charge": 101364.05, "npi": [1234567893] } ] } ] } ] }, { "name": "TB AG RESPONSE T-CELL SUSP", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86481", "description": "TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6449.00, "providers": [{ "billed_charge": 36785.32, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15241.13, "providers": [{ "billed_charge": 260272.50, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.24, "providers": [{ "billed_charge": 275.04, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "933753059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.88, "providers": [{ "billed_charge": 102.48, "npi": [1730956350] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11039.97, "providers": [{ "billed_charge": 166018.95, "npi": [1234567893] } ] } ] } ] }, { "name": "SYPHILIS TEST NON-TREP QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86593", "description": "SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1212.86, "providers": [{ "billed_charge": 20072.81, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.72, "providers": [{ "billed_charge": 6279.25, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86631", "description": "ANTIBODY; CHLAMYDIA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.15, "providers": [{ "billed_charge": 1681.05, "npi": [1234567893] } ] } ] } ] }, { "name": "CHLAMYDIA IGM ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86632", "description": "ANTIBODY; CHLAMYDIA, IGM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.86, "providers": [{ "billed_charge": 1034.25, "npi": [1234567893] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 366.40, "providers": [{ "billed_charge": 4946.80, "npi": [1790721538] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 901.76, "providers": [{ "billed_charge": 12184.32, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 515.64, "providers": [{ "billed_charge": 4695.96, "npi": [1234567893] } ] } ] } ] }, { "name": "EHRLICHIA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86666", "description": "ANTIBODY; EHRLICHIA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 98.98, "providers": [{ "billed_charge": 1770.72, "npi": [1234567893] } ] } ] } ] }, { "name": "FUNGUS NES ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86671", "description": "ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.63, "providers": [{ "billed_charge": 1086.27, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX NES ANTBDY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86694", "description": "ANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TEST", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.80, "providers": [{ "billed_charge": 844.62, "npi": [1235186800] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9381.09, "providers": [{ "billed_charge": 134275.71, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 204.60, "providers": [{ "billed_charge": 1713.99, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5514.32, "providers": [{ "billed_charge": 55427.76, "npi": [1234567893] } ] } ] } ] }, { "name": "HERPES SIMPLEX TYPE 2 TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86696", "description": "ANTIBODY; HERPES SIMPLEX, TYPE 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20875.60, "providers": [{ "billed_charge": 317825.02, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 358.16, "providers": [{ "billed_charge": 3002.55, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9730.56, "providers": [{ "billed_charge": 97690.79, "npi": [1234567893] } ] } ] } ] }, { "name": "HIV-1ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86701", "description": "ANTIBODY; HIV-1", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.32, "providers": [{ "billed_charge": 370.68, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.02, "providers": [{ "billed_charge": 809.28, "npi": [1234567893] } ] } ] } ] }, { "name": "HIV-2 ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86702", "description": "ANTIBODY; HIV-2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.77, "providers": [{ "billed_charge": 771.77, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.34, "providers": [{ "billed_charge": 1137.73, "npi": [1234567893] } ] } ] } ] }, { "name": "HEP B CORE ANTIBODY, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86704", "description": "HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 82.00, "providers": [{ "billed_charge": 1450.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12605.24, "providers": [{ "billed_charge": 191247.85, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9881.34, "providers": [{ "billed_charge": 119125.43, 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} ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["11", "20"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.72, "providers": [{ "billed_charge": 840.00, "npi": [1114210416] } ] }, { "allowed_amount": 3.00, "providers": [{ "billed_charge": 60.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.68, "providers": [{ "billed_charge": 1200.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "271751857" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.15, "providers": [{ "billed_charge": 360.00, "npi": [1205344561] } ] } ] } ] }, { "name": "INJ MILRINONE LACTATE 5 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2260", "description": "INJECTION, MILRINONE LACTATE, 5 MG", "allowed_amounts": [{ "tin": { "type": 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"billing_class": "professional", "payments": [{ "allowed_amount": 2160.00, "providers": [{ "billed_charge": 7200.00, "npi": [1508524828] } ] } ] } ] }, { "name": "SCR IND PARTICIP SPEC PROG P", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "T1023", "description": "SCREENING TO DETERMINE THE APPROPRIATENESS OF CONSIDERATION OF AN INDIVIDUAL FOR PARTICIPATION IN A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "746001573" }, "service_code": ["71"], "billing_class": "professional", "payments": [{ "allowed_amount": 109.14, "providers": [{ "billed_charge": 272.88, "npi": [1790858769] } ] } ] } ] }, { "name": "NON-CDC 2019 NOVEL COV RT RT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "U0002", "description": "NON-CDC 2019 NOVEL CORONAVIRUS RT RT-PCR DX", "allowed_amounts": [{ "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 487.54, "providers": [{ "billed_charge": 3325.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 6004.44, "providers": [{ "billed_charge": 46800.00, "npi": [1093920399] } ] } ] } ] } ] }