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"475092976" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 237.69, "providers": [{ "billed_charge": 1116.00, "npi": [1447973532] } ] }, { "allowed_amount": 93.21, "providers": [{ "billed_charge": 372.00, "npi": [1194709790] } ] } ] }, { "tin": { "type": "ein", "value": "634017243" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 155.35, "providers": [{ "billed_charge": 466.05, "npi": [1992718381] } ] } ] }, { "tin": { "type": "ein", "value": "853163633" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4505.15, "providers": [{ "billed_charge": 477909.85, "npi": [1063011898] } ] } ] }, { "tin": { "type": "ein", "value": "814221217" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.63, "providers": [{ "billed_charge": 35985.60, "npi": [1134697196] } ] } ] }, { "tin": { "type": "ein", "value": "850612245" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.98, "providers": [{ "billed_charge": 2212.00, "npi": [1083830715] } ] } ] } ] }, { "name": "URINALYSIS AUTO W/SCOPE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "81001", "description": "URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.32, "providers": [{ "billed_charge": 1536.00, "npi": [1740265347] } ] } ] } ] }, { "name": "MICROSCOPIC EXAM OF URINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "81015", "description": "URINALYSIS; MICROSCOPIC ONLY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.53, "providers": [{ "billed_charge": 9.15, "npi": [1306940689] } ] } ] } ] }, { "name": "MICROALBUMIN, QUANTITATIVE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82043", "description": "ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.35, "providers": [{ "billed_charge": 555.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.68, "providers": [{ "billed_charge": 210.00, "npi": [1306940689] } ] } ] } ] }, { "name": "HEMO/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "821", "description": "HEMODIALYSIS - OUTPT OR HOME - HEMODIALYSIS/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "822567183" }, "service_code": ["65"], "billing_class": "institutional", "payments": [{ "allowed_amount": 22320.00, "providers": [{ "billed_charge": 114577.20, "npi": [1922518448] } ] } ] } ] }, { "name": "VITAMIN D 25 HYDROXY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82306", "description": "VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 976.80, "providers": [{ "billed_charge": 5860.80, "npi": [1306940689] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 814.00, "providers": [{ "billed_charge": 6600.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY OF URINE CREATININE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82570", "description": "CREATININE; OTHER SOURCE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.93, "providers": [{ "billed_charge": 891.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.08, "providers": [{ "billed_charge": 186.48, "npi": [1306940689] } ] } ] } ] }, { "name": "VITAMIN B-12", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82607", "description": "CYANOCOBALAMIN (VITAMIN B-12);", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.80, "providers": [{ "billed_charge": 1480.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.10, "providers": [{ "billed_charge": 678.60, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF ESTRADIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82670", "description": "ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.76, "providers": [{ "billed_charge": 670.56, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82728", "description": "FERRITIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 156.86, "providers": [{ "billed_charge": 1978.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID SERUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82746", "description": "FOLIC ACID; SERUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.50, "providers": [{ "billed_charge": 740.00, "npi": [1740265347] } ] } ] } ] }, { "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": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.87, "providers": [{ "billed_charge": 166.68, "npi": [1306940689] } ] } ] } ] }, { "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": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.78, "providers": [{ "billed_charge": 167.22, "npi": [1306940689] } ] } ] } ] }, { "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": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.76, "providers": [{ "billed_charge": 466.08, "npi": [1306940689] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 656.10, "providers": [{ "billed_charge": 6480.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "730930123" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.30, "providers": [{ "billed_charge": 60.00, "npi": [1114901204] } ] } ] } ] }, { "name": "ASSAY OF IRON", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83540", "description": "IRON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.00, "providers": [{ "billed_charge": 825.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY OF MAGNESIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83735", "description": "MAGNESIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.80, "providers": [{ "billed_charge": 376.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.72, "providers": [{ "billed_charge": 250.32, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF TOTAL TESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84403", "description": "TESTOSTERONE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.91, "providers": [{ "billed_charge": 110.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY OF FREE THYROXINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84439", "description": "THYROXINE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 302.17, "providers": [{ "billed_charge": 1813.02, "npi": [1306940689] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.06, "providers": [{ "billed_charge": 414.00, "npi": [1740265347] } ] } ] } ] }, { "name": "ASSAY THYROID STIM HORMONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84443", "description": "THYROID STIMULATING HORMONE (TSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1083.60, "providers": [{ "billed_charge": 10836.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 512.40, "providers": [{ "billed_charge": 3074.40, "npi": [1306940689] } ] } ] } ] }, { "name": "ASSAY OF TRANSFERRIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84466", "description": "TRANSFERRIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 159.50, "providers": [{ "billed_charge": 1000.00, "npi": [1740265347] } ] } ] } ] }, { "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": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.82, "providers": [{ "billed_charge": 304.92, "npi": [1306940689] } ] } ] } ] }, { "name": "COMPLETE CBC W/AUTO DIFF WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.40, "providers": [{ "billed_charge": 325.50, "npi": [1427827948] } ] } ] }, { "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1007.51, "providers": [{ "billed_charge": 9065.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.91, "providers": [{ "billed_charge": 442.89, "npi": [1306940689] } ] } ] }, { "tin": { "type": "ein", "value": "730944337" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.78, "providers": [{ "billed_charge": 110.00, "npi": [1427164888] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.24, "providers": [{ "billed_charge": 32.00, "npi": [1740265347] } ] } ] } ] }, { "name": "CCPD/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "851", "description": "CCPD - OUTPT OR HOME - CCPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "203035983" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 52269.00, "providers": [{ "billed_charge": 802038.33, "npi": [1922049782] } ] } ] } ] }, { "name": "RBC SED RATE, AUTOMATED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85652", "description": "SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16.20, "providers": [{ "billed_charge": 324.00, "npi": [1740265347] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86140", "description": "C-REACTIVE PROTEIN;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.90, "providers": [{ "billed_charge": 420.00, "npi": [1740265347] } ] } ] } ] }, { "name": "T CELLS, TOTAL COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86359", "description": "T CELLS; TOTAL COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.01, "providers": [{ "billed_charge": 4324.00, "npi": [1740265347] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86361", "description": "T CELLS; ABSOLUTE CD4 COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 307.97, "providers": [{ "billed_charge": 4347.00, "npi": [1740265347] } ] } ] } ] }, { "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": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.42, "providers": [{ "billed_charge": 84.00, "npi": [1740265347] } ] } ] } ] }, { "name": "RUBELLA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86762", "description": "ANTIBODY; RUBELLA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.40, "providers": [{ "billed_charge": 84.00, "npi": [1740265347] } ] } ] } ] }, { "name": "TREPONEMA PALLIDUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86780", "description": "ANTIBODY; TREPONEMA PALLIDUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "141841340" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.40, "providers": [{ "billed_charge": 1300.00, "npi": [1740265347] } ] } ] }, { "tin": { "type": "ein", "value": "736017987" }, "service_code": ["71"], "billing_class": "professional", "payments": [{ "allowed_amount": 72.08, "providers": [{ "billed_charge": 183.36, "npi": [1518197524] } ] } ] } ] }, 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23065.02, "providers": [{ "billed_charge": 24300.00, "npi": [1740207646] } ] }, { "allowed_amount": 24773.54, "providers": [{ "billed_charge": 26100.00, "npi": [1457378150] } ] } ] } ] }, { "name": "AMB SERVICE BLS EMERGENCY TR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A0429", "description": "AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "421674975" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 39825.24, "providers": [{ "billed_charge": 48020.00, "npi": [1306946371] } ] } ] }, { "tin": { "type": "ein", "value": "736005359" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 11700.00, "providers": [{ "billed_charge": 11700.00, "npi": [1356110407] } ] } ] }, { "tin": { "type": "ein", "value": "330995734" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 69707.82, "providers": [{ "billed_charge": 71400.00, "npi": [1235173089] } ] } ] }, { "tin": { "type": "ein", "value": "736061037" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 61506.90, "providers": [{ "billed_charge": 68171.40, "npi": [1770525883] } ] } ] }, { "tin": { "type": "ein", "value": "730717399" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 15750.00, "providers": [{ "billed_charge": 15750.00, "npi": [1891735866] } ] } ] }, { "tin": { "type": "ein", "value": "730968231" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 5520.84, "providers": [{ "billed_charge": 6000.00, "npi": [1104818434] } ] } ] }, { "tin": { "type": "ein", "value": "731489396" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 20703.15, "providers": [{ "billed_charge": 20703.15, "npi": [1093760456] 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}, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 425.44, "providers": [{ "billed_charge": 1740.92, "npi": [1234567893] } ] } ] } ] }, { "name": "CONTINUOUS POS AIRWAY PRESSU", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E0601", "description": "CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 191.40, "providers": [{ "billed_charge": 3498.88, "npi": [1234567893] } ] } ] } ] }, { "name": "O2 CONC 85%/>02 CONC PRSC FL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1390", "description": "OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCEN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 7800.00, "providers": [{ "billed_charge": 61535.04, "npi": [1234567893] } ] } ] } ] }, { "name": "PORTABLE OXYGEN CONCENTRATOR", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E1392", "description": "PORTABLE OXYGEN CONCENTRATOR, RENTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 550.92, "providers": [{ "billed_charge": 2520.00, "npi": [1234567893] } ] } ] } ] }, { "name": "NEG PRSS WND TX PUMP STATN", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "E2402", "description": "NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 8954.58, "providers": [{ "billed_charge": 37288.27, "npi": [1234567893] } ] } ] } ] }, { "name": "PROSTATE CANCER SCREENING", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0103", "description": "PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "731199725" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.64, "providers": [{ "billed_charge": 224.34, "npi": [1306940689] } ] } ] } ] }, { "name": "E-STIM 1/>NOT WND CARE PART", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G0283", "description": "ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "472483971" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.60, "providers": [{ "billed_charge": 240.00, "npi": [1285150748] } ] } ] } ] }, { "name": "VISIT CPLX INHERENT E&M ASSO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G2211", "description": "VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "270919068" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.82, "providers": [{ "billed_charge": 120.00, "npi": [1164403986] } ] } ] }, { "tin": { "type": "ein", "value": "834439721" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 553.15, "providers": [{ "billed_charge": 1303.00, "npi": [1003256819] } ] } ] }, { "tin": { "type": "ein", "value": "760825755" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 66.08, "providers": [{ "billed_charge": 161.00, "npi": [1376353532] } ] } ] }, { "tin": { "type": "ein", "value": "850612245" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 209.30, "providers": [{ "billed_charge": 418.60, "npi": [1083830715] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC; INTENSV OP;", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0015", "description": "ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "823552173" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5400.00, "providers": [{ "billed_charge": 21600.00, "npi": [1750149357] } ] } ] }, { "tin": { "type": "ein", "value": "932572939" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 42412.50, "providers": [{ "billed_charge": 169650.00, "npi": [1790120483] } ] } ] }, { "tin": { "type": "ein", "value": "853005640" }, "service_code": ["22"], "billing_class": "professional", "payments": [{ "allowed_amount": 3144.75, "providers": [{ "billed_charge": 12579.00, "npi": [1053919423] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 562.50, "providers": [{ "billed_charge": 2250.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ORAL MEDADMIN DIR OBSERV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0033", "description": "ORAL MEDICATION ADMINISTRATION, DIRECT OBSERVATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "736045246" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 2997.00, "providers": [{ "billed_charge": 9990.00, "npi": [1235146036] } ] } ] } ] }, { "name": "MENTAL HLTH PART HOSP TX <24", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0035", "description": "MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "823552173" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 6300.00, "providers": [{ "billed_charge": 25200.00, "npi": [1750149357] } ] } ] }, { "tin": { "type": "ein", "value": "932572939" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 306600.00, "providers": [{ "billed_charge": 1226400.00, "npi": [1790120483] } ] } ] }, { "tin": { "type": "ein", "value": "921987610" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1375.00, "providers": [{ "billed_charge": 5500.00, "npi": [1932472883] } ] } ] } ] }, { "name": "INJ AMPCLLN SODIM/SULBACTAM-", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0295", "description": "INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 G", "allowed_amounts": [{ "tin": { "type": "ein", "value": "991458508" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.68, "providers": [{ "billed_charge": 7200.00, "npi": [1558507962] } ] } ] } ] }, { "name": "BUPRENORPHINE ORAL 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0571", "description": "BUPRENORPHINE, ORAL, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "736045246" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.20, "providers": [{ "billed_charge": 144.00, "npi": [1548304892] } ] } ] } ] }, { "name": "BPN/NLX O >6 MG BUT", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0574", "description": "BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 6 MG, BUT LESS THAN OR EQUAL TO 10 MG BUPRENORPHINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "736045246" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 2376.00, "providers": [{ "billed_charge": 7920.00, "npi": [1235146036] } ] } ] } ] }, { "name": "INJECTION DAPTOMYCIN 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0878", "description": "INJECTION, DAPTOMYCIN, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "991458508" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 66.00, "providers": [{ "billed_charge": 4361.36, "npi": [1558507962] } ] } ] } ] }, { "name": "INJ DEXMETH SODM PHOSHA 1MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1100", "description": "INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "452568950" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.40, "providers": [{ "billed_charge": 360.00, "npi": [1811987712] } ] } ] } ] }, { "name": "INJ ERTAPENEM SODIUM 500MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1335", "description": "INJECTION, ERTAPENEM SODIUM, 500 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "991458508" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 201.96, "providers": [{ "billed_charge": 3090.66, "npi": [1558507962] } ] } ] } ] }, { "name": "Injection, nafcillin sodium, 20 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2290", "description": "Injection, nafcillin sodium, 20 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "991458508" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.40, "providers": [{ "billed_charge": 1152.00, "npi": [1558507962] } ] } ] } ] }, { "name": "INFUS NORMAL SALINE SOL 1000", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J7030", "description": "INFUSION, NORMAL SALINE SOLUTION, 1,000 CC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "991458508" }, 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