{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"1.0.0","last_updated_on":"2025-07-31","out_of_network":[{"name":"ALCOHL&/RX SRVC; SUB-AC DTOX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"ALCOHOL AND/OR DRUG SERVICES; SUBACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)","allowed_amounts":[{"tin":{"type":"ein","value":"922726178"},"service_code":["55"],"billing_class":"institutional","payments":[{"allowed_amount":800.00,"providers":[{"billed_charge":2000.00,"npi":[1124723606]}]}]}]},{"name":"ANESTH, PROCEDURES ON EYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"140","description":"ANESTHESIA FOR PROCEDURES ON EYE; NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"223157867"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":582.00,"providers":[{"billed_charge":13296.00,"npi":[1245289487]}]}]}]},{"name":"ANESTH, LENS SURGERY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"142","description":"ANESTHESIA FOR PROCEDURES ON EYE; LENS SURGERY","allowed_amounts":[{"tin":{"type":"ein","value":"223157867"},"service_code":["22","24"],"billing_class":"professional","payments":[{"allowed_amount":1320.00,"providers":[{"billed_charge":29916.00,"npi":[1245289487]}]},{"allowed_amount":50.00,"providers":[{"billed_charge":1301.90,"npi":[1245289487]}]}]},{"tin":{"type":"ein","value":"814504190"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":11905.19,"providers":[{"billed_charge":155871.36,"npi":[1891235404]}]}]},{"tin":{"type":"ein","value":"43431956"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":282.00,"providers":[{"billed_charge":6465.00,"npi":[1952548265]}]}]},{"tin":{"type":"ein","value":"113154725"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":96.00,"providers":[{"billed_charge":7200.00,"npi":[1992745806]}]}]}]},{"name":"ANESTH, INDUCED AB PROCEDURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"1966","description":"ANESTHESIA FOR INDUCED ABORTION PROCEDURES","allowed_amounts":[{"tin":{"type":"ein","value":"452786562"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":460.00,"providers":[{"billed_charge":33600.00,"npi":[1548480544]}]}]}]},{"name":"INJECTION FLUOROURACIL 500 M","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, FLUOROURACIL, 500 MG","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJ PALONOSETRON HCL 25 MCG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, PALONOSETRON HCL, 25 MCG","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJ HEPARIN SODIUM PER 1000","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, HEPARIN SODIUM, PER 1000 UNITS","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJ CEFOXITIN SODIUM 1 GM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, CEFOXITIN SODIUM, 1 G","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"Pharmacy (Also see 063X, an extension of 250X) General","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"Pharmacy (Also see 063X, an extension of 250X) General","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJ ATROPINE SULFATE 0.01MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, ATROPINE SULFATE, 0.01 MG","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJ FOSAPREPITANT, 1 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, FOSAPREPITANT, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"INJECTION IRINOTECAN 20 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"INJECTION, IRINOTECAN, 20 MG","allowed_amounts":[{"tin":{"type":"ein","value":"521958352"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":22.41,"providers":[{"billed_charge":22.41,"npi":[1053384776]}]},{"allowed_amount":12.10,"providers":[{"billed_charge":139.61,"npi":[1053384776]}]},{"allowed_amount":37.60,"providers":[{"billed_charge":37.60,"npi":[1053384776]}]},{"allowed_amount":50.34,"providers":[{"billed_charge":453.51,"npi":[1053384776]}]},{"allowed_amount":172.21,"providers":[{"billed_charge":206.73,"npi":[1053384776]}]},{"allowed_amount":74.04,"providers":[{"billed_charge":476.80,"npi":[1053384776]}]},{"allowed_amount":7.50,"providers":[{"billed_charge":21.96,"npi":[1053384776]}]},{"allowed_amount":129.78,"providers":[{"billed_charge":347.04,"npi":[1053384776]}]}]}]},{"name":"SYRINGE WITH OR WITHOUT NEED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"270","description":"SYRINGE, WITH OR WITHOUT NEEDLE, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":4.62,"providers":[{"billed_charge":2627.24,"npi":[1891437281]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"HEMATOCRIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"BLOOD COUNT; HEMATOCRIT (HCT)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"SARSCOV2&INF A&B&RSV AMP PRB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY OF SERUM SODIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"SODIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY OF BLOOD CHLORIDE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"CHLORIDE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"CULTR BACTERIA, EXCEPT BLOOD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATIO","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"CHORIONIC GONADOTROPIN TEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"SMEAR, GRAM STAIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"COMPLETE CBC, AUTOMATED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"RBC ANTIBODY SCREEN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY OF LACTIC ACID","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LACTATE (LACTIC ACID)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ALANINE AMINO (ALT) (SGPT)","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"TRANSFERASE; ALANINE AMINO (ALT) (SGPT)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"CULTURE OTHR SPECIMN AEROBIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESU","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY, BLOOD CARBON DIOXIDE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"CARBON DIOXIDE (BICARBONATE)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.04,"providers":[{"billed_charge":120.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":23.58,"npi":[1578778726]}]},{"allowed_amount":18.78,"providers":[{"billed_charge":220.00,"npi":[1578778726]}]},{"allowed_amount":10.74,"providers":[{"billed_charge":58.56,"npi":[1578778726]}]},{"allowed_amount":2.02,"providers":[{"billed_charge":24.00,"npi":[1578778726]}]},{"allowed_amount":2.99,"providers":[{"billed_charge":24.90,"npi":[1578778726]}]},{"allowed_amount":5.61,"providers":[{"billed_charge":144.00,"npi":[1578778726]}]},{"allowed_amount":5.52,"providers":[{"billed_charge":27.60,"npi":[1578778726]}]},{"allowed_amount":171.18,"providers":[{"billed_charge":1711.56,"npi":[1578778726]}]},{"allowed_amount":3.20,"providers":[{"billed_charge":38.82,"npi":[1578778726]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":31.80,"npi":[1578778726]}]},{"allowed_amount":10.58,"providers":[{"billed_charge":57.72,"npi":[1578778726]}]},{"allowed_amount":12.49,"providers":[{"billed_charge":120.00,"npi":[1578778726]}]},{"allowed_amount":27.10,"providers":[{"billed_charge":260.00,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"60646659"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.97,"providers":[{"billed_charge":361.00,"npi":[1609846088]}]},{"allowed_amount":4.12,"providers":[{"billed_charge":44.00,"npi":[1609846088]}]},{"allowed_amount":11.36,"providers":[{"billed_charge":97.00,"npi":[1609846088]}]},{"allowed_amount":11.04,"providers":[{"billed_charge":104.00,"npi":[1609846088]}]},{"allowed_amount":65.40,"providers":[{"billed_charge":144.00,"npi":[1609846088]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":47.00,"npi":[1609846088]}]},{"allowed_amount":9.88,"providers":[{"billed_charge":77.00,"npi":[1609846088]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF SERUM ALBUMIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF CK (CPK)","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CREATINE KINASE (CK), (CPK); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF GGT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"GLUTAMYLTRANSFERASE, GAMMA (GGT)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY, BLD/SERUM CHOLESTEROL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF SERUM SODIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"SODIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF PROTEIN SERUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"LACTATE (LD) (LDH) ENZYME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LACTATE DEHYDROGENASE (LD), (LDH);","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF PROTEIN, URINE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY, BLOOD CARBON DIOXIDE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CARBON DIOXIDE (BICARBONATE)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"CREATININE CLEARANCE TEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CREATININE; CLEARANCE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CALCIUM; IONIZED","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY ALKALINE PHOSPHATASE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"PHOSPHATASE, ALKALINE;","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"BILIRUBIN, TOTAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"BILIRUBIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF TRIGLYCERIDES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"TRIGLYCERIDES","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF UREA NITROGEN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"UREA NITROGEN; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF SWEAT SODIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"SODIUM; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CALCIUM; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ALANINE AMINO (ALT) (SGPT)","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"TRANSFERASE; ALANINE AMINO (ALT) (SGPT)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF SERUM POTASSIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"CHORIONIC GONADOTROPIN ASSAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"ASSAY OF CREATININE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"CREATININE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA","allowed_amounts":[{"tin":{"type":"ein","value":"131624096"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3.95,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.88,"providers":[{"billed_charge":23.00,"npi":[1033206362]}]},{"allowed_amount":89.43,"providers":[{"billed_charge":1280.00,"npi":[1033206362]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":380.00,"npi":[1033206362]}]},{"allowed_amount":9.52,"providers":[{"billed_charge":70.00,"npi":[1033206362]}]},{"allowed_amount":3.67,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":4.81,"providers":[{"billed_charge":40.00,"npi":[1033206362]}]},{"allowed_amount":51.82,"providers":[{"billed_charge":600.00,"npi":[1033206362]}]},{"allowed_amount":9.57,"providers":[{"billed_charge":90.00,"npi":[1033206362]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":138.43,"providers":[{"billed_charge":945.00,"npi":[1033206362]}]},{"allowed_amount":205.27,"providers":[{"billed_charge":1900.00,"npi":[1033206362]}]},{"allowed_amount":60.16,"providers":[{"billed_charge":880.00,"npi":[1033206362]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":30.00,"npi":[1033206362]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":80.00,"npi":[1033206362]},{"billed_charge":60.00,"npi":[1033206362]}]},{"allowed_amount":86.38,"providers":[{"billed_charge":1430.00,"npi":[1033206362]}]}]},{"tin":{"type":"ein","value":"60646652"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":173.00,"npi":[1578778726]}]},{"allowed_amount":4.40,"providers":[{"billed_charge":22.02,"npi":[1578778726]}]},{"allowed_amount":11.18,"providers":[{"billed_charge":138.00,"npi":[1578778726]},{"billed_charge":61.44,"npi":[1578778726]}]}]},{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":17.07,"providers":[{"billed_charge":129.60,"npi":[1669236261]}]},{"allowed_amount":6.02,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":45.15,"providers":[{"billed_charge":168.47,"npi":[1669236261]}]},{"allowed_amount":7.07,"providers":[{"billed_charge":89.61,"npi":[1669236261]}]},{"allowed_amount":19.21,"providers":[{"billed_charge":71.69,"npi":[1669236261]}]},{"allowed_amount":121.99,"providers":[{"billed_charge":1217.40,"npi":[1669236261]}]},{"allowed_amount":5.94,"providers":[{"billed_charge":43.20,"npi":[1669236261]}]},{"allowed_amount":5.83,"providers":[{"billed_charge":67.62,"npi":[1669236261]}]},{"allowed_amount":24.09,"providers":[{"billed_charge":172.80,"npi":[1669236261]}]},{"allowed_amount":5.42,"providers":[{"billed_charge":39.86,"npi":[1669236261]}]},{"allowed_amount":12.20,"providers":[{"billed_charge":123.56,"npi":[1669236261]},{"billed_charge":95.38,"npi":[1669236261]}]},{"allowed_amount":6.10,"providers":[{"billed_charge":43.20,"npi":[1669236261]},{"billed_charge":43.30,"npi":[1669236261]}]},{"allowed_amount":122.00,"providers":[{"billed_charge":1100.00,"npi":[1669236261]}]},{"allowed_amount":18.30,"providers":[{"billed_charge":72.40,"npi":[1669236261]}]},{"allowed_amount":134.20,"providers":[{"billed_charge":2357.52,"npi":[1669236261]}]},{"allowed_amount":24.40,"providers":[{"billed_charge":201.72,"npi":[1669236261]}]}]},{"tin":{"type":"ein","value":"42697983"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.93,"providers":[{"billed_charge":68.00,"npi":[1023049236]}]},{"allowed_amount":15.24,"providers":[{"billed_charge":312.00,"npi":[1023049236]},{"billed_charge":684.00,"npi":[1023049236]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":64.00,"npi":[1023049236]}]},{"allowed_amount":4.95,"providers":[{"billed_charge":66.00,"npi":[1023049236]}]},{"allowed_amount":4.74,"providers":[{"billed_charge":76.00,"npi":[1023049236]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.16,"providers":[{"billed_charge":92.00,"npi":[1700828852]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF PROTEIN SERUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF CREATININE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"CREATININE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"CALCIUM; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF UREA NITROGEN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"UREA NITROGEN; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY ALKALINE PHOSPHATASE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"PHOSPHATASE, ALKALINE;","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF SERUM ALBUMIN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"ASSAY OF URINE/UREA-N","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"UREA NITROGEN, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"CREATININE CLEARANCE TEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"CREATININE; CLEARANCE","allowed_amounts":[{"tin":{"type":"ein","value":"463938699"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":826.10,"npi":[1497518591]}]},{"allowed_amount":16.26,"providers":[{"billed_charge":670.83,"npi":[1497518591]}]},{"allowed_amount":38.16,"providers":[{"billed_charge":1603.40,"npi":[1497518591]}]},{"allowed_amount":11.88,"providers":[{"billed_charge":433.30,"npi":[1497518591]}]},{"allowed_amount":46.46,"providers":[{"billed_charge":1867.50,"npi":[1497518591]}]},{"allowed_amount":58.46,"providers":[{"billed_charge":2413.32,"npi":[1497518591]}]},{"allowed_amount":5.08,"providers":[{"billed_charge":226.18,"npi":[1497518591]},{"billed_charge":292.86,"npi":[1497518591]}]},{"allowed_amount":32.52,"providers":[{"billed_charge":1357.08,"npi":[1497518591]}]},{"allowed_amount":70.12,"providers":[{"billed_charge":2927.47,"npi":[1497518591]},{"billed_charge":3679.91,"npi":[1497518591]},{"billed_charge":4966.52,"npi":[1497518591]}]},{"allowed_amount":10.16,"providers":[{"billed_charge":415.50,"npi":[1497518591]}]}]}]},{"name":"RADIATION TREATMENT DELIVERY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"RADIATION TREATMENT DELIVERY, => 1 MEV; COMPLEX","allowed_amounts":[{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1833.88,"providers":[{"billed_charge":58780.30,"npi":[1669236261]}]},{"allowed_amount":308.84,"providers":[{"billed_charge":3342.84,"npi":[1669236261]}]}]}]},{"name":"NTSTY MODUL RAD TX DLVR CPLX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"INTENSITY MODULATED RADIATION TREATMENT DELIVERY (IMRT), INCLUDES GUIDANCE AND TRACKING, WHEN PERFOR","allowed_amounts":[{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1833.88,"providers":[{"billed_charge":58780.30,"npi":[1669236261]}]},{"allowed_amount":308.84,"providers":[{"billed_charge":3342.84,"npi":[1669236261]}]}]}]},{"name":"CT ABD & PELV 1/> REGNS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLL","allowed_amounts":[{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":165.73,"providers":[{"billed_charge":3749.34,"npi":[1669236261]}]},{"allowed_amount":84.44,"providers":[{"billed_charge":867.54,"npi":[1669236261]}]}]}]},{"name":"CT THORAX LUNG CANCER SCR C-","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-","allowed_amounts":[{"tin":{"type":"ein","value":"150622079"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":165.73,"providers":[{"billed_charge":3749.34,"npi":[1669236261]}]},{"allowed_amount":84.44,"providers":[{"billed_charge":867.54,"npi":[1669236261]}]}]}]},{"name":"BLOOD TRANSFUSION SERVICE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"TRANSFUSION, BLOOD OR BLOOD COMPONENTS","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"RPR S/N/AX/GEN/TRNK 2.5CM/<","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREM","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"OB US LIMITED FETUS(S)","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED (EG, FETAL HEART BEAT, PLAC","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"DRAINAGE OF SKIN ABSCESS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"CRITICAL CARE, FIRST HOUR","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJURED PATIENT; FIRST","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"HYDRATION IV INFUSION INIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"INTRAVENOUS INFUSION, HYDRATION; INITIAL, 31 MINUTES TO 1 HOUR","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"THER/PROPH/DIAG IV INF INIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); INITIAL, U","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"HYDRATE IV INFUSION ADD-ON","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"INTRAVENOUS INFUSION, HYDRATION; EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMA","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"TREAT FRACTURE RADIUS/ULNA","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"CLOSED TRTMNT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION, INCLUDE","allowed_amounts":[{"tin":{"type":"ein","value":"221487602"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":954.66,"providers":[{"billed_charge":2388.00,"npi":[1669462420]}]},{"allowed_amount":1169.61,"providers":[{"billed_charge":13620.00,"npi":[1669462420]}]},{"allowed_amount":156.85,"providers":[{"billed_charge":4535.00,"npi":[1669462420]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":903.00,"npi":[1669462420]}]},{"allowed_amount":651.01,"providers":[{"billed_charge":1997.00,"npi":[1669462420]}]}]},{"tin":{"type":"ein","value":"60646597"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":177.22,"providers":[{"billed_charge":601.00,"npi":[1548293343]}]},{"allowed_amount":1623.45,"providers":[{"billed_charge":27072.00,"npi":[1548293343]}]},{"allowed_amount":16.03,"providers":[{"billed_charge":109.00,"npi":[1548293343]}]}]},{"tin":{"type":"ein","value":"221487576"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":399.71,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":488.33,"providers":[{"billed_charge":2860.00,"npi":[1730692344]}]},{"allowed_amount":1477.96,"providers":[{"billed_charge":2092.00,"npi":[1457456279]}]},{"allowed_amount":219.25,"providers":[{"billed_charge":2090.00,"npi":[1730692344]}]},{"allowed_amount":333.09,"providers":[{"billed_charge":1430.00,"npi":[1457456279]}]},{"allowed_amount":170.55,"providers":[{"billed_charge":2090.00,"npi":[1760994412]}]},{"allowed_amount":5403.56,"providers":[{"billed_charge":90809.53,"npi":[1457456279]}]}]},{"tin":{"type":"ein","value":"222783298"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":663.94,"providers":[{"billed_charge":1000.00,"npi":[1689744856]}]},{"allowed_amount":1346.58,"providers":[{"billed_charge":23858.00,"npi":[1689744856]}]}]},{"tin":{"type":"ein","value":"42133860"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":428.11,"providers":[{"billed_charge":3106.09,"npi":[1730112251]}]}]},{"tin":{"type":"ein","value":"221487307"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":474.64,"providers":[{"billed_charge":334.00,"npi":[1013912633]}]},{"allowed_amount":488.00,"providers":[{"billed_charge":488.00,"npi":[1013912633]}]},{"allowed_amount":4707.85,"providers":[{"billed_charge":49471.00,"npi":[1013912633]}]}]},{"tin":{"type":"ein","value":"465143606"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1610.61,"providers":[{"billed_charge":33567.00,"npi":[1396194197]}]}]},{"tin":{"type":"ein","value":"221487173"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":202.49,"providers":[{"billed_charge":2289.00,"npi":[1083612881]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TR","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"133957095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45482.00,"providers":[{"billed_charge":81592.70,"npi":[1174628473]}]},{"allowed_amount":2585.00,"providers":[{"billed_charge":10690.07,"npi":[1174628473]}]},{"allowed_amount":52558.00,"providers":[{"billed_charge":106691.20,"npi":[1174628473]}]},{"allowed_amount":2738.00,"providers":[{"billed_charge":6212.16,"npi":[1174628473]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"133957095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45482.00,"providers":[{"billed_charge":81592.70,"npi":[1174628473]}]},{"allowed_amount":2585.00,"providers":[{"billed_charge":10690.07,"npi":[1174628473]}]},{"allowed_amount":52558.00,"providers":[{"billed_charge":106691.20,"npi":[1174628473]}]},{"allowed_amount":2738.00,"providers":[{"billed_charge":6212.16,"npi":[1174628473]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"SPECIALTY CARE TRANSPORT (SCT)","allowed_amounts":[{"tin":{"type":"ein","value":"133957095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45482.00,"providers":[{"billed_charge":81592.70,"npi":[1174628473]}]},{"allowed_amount":2585.00,"providers":[{"billed_charge":10690.07,"npi":[1174628473]}]},{"allowed_amount":52558.00,"providers":[{"billed_charge":106691.20,"npi":[1174628473]}]},{"allowed_amount":2738.00,"providers":[{"billed_charge":6212.16,"npi":[1174628473]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"133957095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45482.00,"providers":[{"billed_charge":81592.70,"npi":[1174628473]}]},{"allowed_amount":2585.00,"providers":[{"billed_charge":10690.07,"npi":[1174628473]}]},{"allowed_amount":52558.00,"providers":[{"billed_charge":106691.20,"npi":[1174628473]}]},{"allowed_amount":2738.00,"providers":[{"billed_charge":6212.16,"npi":[1174628473]}]}]}]},{"name":"HEPB VACC 4 DOSE IMMUNSUP IM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"HEPATITIS B VACCINE (HEPB), DIALYSIS OR IMMUNOSUPPRESSED PATIENT DOSAGE, 4 DOSE SCHEDULE, FOR INTRAM","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INFUS NORMAL SALINE SOLUTION","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INFUSION, NORMAL SALINE SOLUTION, 250 CC","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INFUS NORMAL SALINE SOL STER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT)","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJ PEGFILGRASTIM EXC BIOSIM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECT PEGFILGRASTIM EXCLUDES BIOSIMILAR 0.5 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJ HEPARIN SODIUM PER 1000","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECTION, HEPARIN SODIUM, PER 1000 UNITS","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJECTION CARBOPLATIN 50 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECTION, CARBOPLATIN, 50 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJECTION CETUXIMAB 10 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECTION, CETUXIMAB, 10 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"NETUPITANT 300 MG AND PALONO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"NETUPITANT 300 MG AND PALONOSETRON 0.5 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJECTION IRON SUCROSE 1 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECTION, IRON SUCROSE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"INJECTION, PACLITAXEL, 1 MG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"INJECTION, PACLITAXEL, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":9846.00,"npi":[1891437281]}]},{"allowed_amount":173.08,"providers":[{"billed_charge":10661.36,"npi":[1891437281]}]},{"allowed_amount":1.98,"providers":[{"billed_charge":1884.87,"npi":[1891437281]}]}]},{"tin":{"type":"ein","value":"346004382"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7701.60,"providers":[{"billed_charge":16944.00,"npi":[1700828852]}]},{"allowed_amount":5.04,"providers":[{"billed_charge":9.00,"npi":[1700828852]}]},{"allowed_amount":240.02,"providers":[{"billed_charge":350.00,"npi":[1700828852]}]},{"allowed_amount":13605.60,"providers":[{"billed_charge":30018.00,"npi":[1700828852]}]},{"allowed_amount":828.12,"providers":[{"billed_charge":1550.00,"npi":[1700828852]}]},{"allowed_amount":5.62,"providers":[{"billed_charge":20.00,"npi":[1700828852]}]},{"allowed_amount":104.00,"providers":[{"billed_charge":164.00,"npi":[1700828852]}]}]}]},{"name":"CT HEAD/BRAIN W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70450","description":"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"412007905"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":373.47,"providers":[{"billed_charge":1404.00,"npi":[1558455600]}]},{"allowed_amount":35.17,"providers":[{"billed_charge":156.00,"npi":[1558455600]}]},{"allowed_amount":40.09,"providers":[{"billed_charge":156.00,"npi":[1558455600]}]}]},{"tin":{"type":"ein","value":"112548304"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":115.35,"providers":[{"billed_charge":882.00,"npi":[1750318986]}]},{"allowed_amount":35.17,"providers":[{"billed_charge":294.00,"npi":[1750318986]}]}]},{"tin":{"type":"ein","value":"680578730"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":124.49,"providers":[{"billed_charge":615.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":2355.50,"providers":[{"billed_charge":36946.00,"npi":[1255962783]}]},{"allowed_amount":23890.13,"providers":[{"billed_charge":385010.02,"npi":[1255962783]}]},{"allowed_amount":477.22,"providers":[{"billed_charge":7644.00,"npi":[1255962783]}]},{"allowed_amount":82.29,"providers":[{"billed_charge":1274.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"161201211"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":168.80,"providers":[{"billed_charge":500.00,"npi":[1407814825]}]},{"allowed_amount":40.09,"providers":[{"billed_charge":125.00,"npi":[1407814825]}]},{"allowed_amount":42.20,"providers":[{"billed_charge":125.00,"npi":[1407814825]}]}]}]},{"name":"CT MAXILLOFACIAL W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70486","description":"COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19"],"billing_class":"professional","payments":[{"allowed_amount":354.68,"providers":[{"billed_charge":6579.00,"npi":[1255962783]}]},{"allowed_amount":42.56,"providers":[{"billed_charge":731.00,"npi":[1255962783]}]},{"allowed_amount":1347.77,"providers":[{"billed_charge":24854.00,"npi":[1255962783]}]}]}]},{"name":"CT SOFT TISSUE NECK W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70491","description":"COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1673.82,"providers":[{"billed_charge":23530.00,"npi":[1255962783]}]},{"allowed_amount":277.04,"providers":[{"billed_charge":3620.00,"npi":[1255962783]}]},{"allowed_amount":135.06,"providers":[{"billed_charge":1810.00,"npi":[1255962783]}]}]}]},{"name":"CT ANGIOGRAPHY HEAD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70496","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":235.20,"providers":[{"billed_charge":3537.00,"npi":[1255962783]}]},{"allowed_amount":1324.54,"providers":[{"billed_charge":18864.00,"npi":[1255962783]}]},{"allowed_amount":11467.51,"providers":[{"billed_charge":166418.00,"npi":[1255962783]}]}]}]},{"name":"CT ANGIOGRAPHY NECK","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70498","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1609.98,"providers":[{"billed_charge":26961.00,"npi":[1255962783]}]},{"allowed_amount":334.96,"providers":[{"billed_charge":5676.00,"npi":[1255962783]}]},{"allowed_amount":11482.62,"providers":[{"billed_charge":197420.00,"npi":[1255962783]}]}]}]},{"name":"MR ANGIOGRAPHY HEAD W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70544","description":"MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":108.49,"providers":[{"billed_charge":1630.00,"npi":[1255962783]}]},{"allowed_amount":121.10,"providers":[{"billed_charge":1630.00,"npi":[1255962783]}]},{"allowed_amount":287.11,"providers":[{"billed_charge":4075.00,"npi":[1255962783]}]}]}]},{"name":"MRI BRAIN STEM W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70551","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":3501.48,"providers":[{"billed_charge":53193.00,"npi":[1255962783]}]},{"allowed_amount":2807.78,"providers":[{"billed_charge":41720.00,"npi":[1255962783]}]},{"allowed_amount":2681.43,"providers":[{"billed_charge":39634.00,"npi":[1255962783]}]}]}]},{"name":"MRI BRAIN STEM W/O & W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70553","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FO","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":3960.69,"providers":[{"billed_charge":61938.00,"npi":[1255962783]}]},{"allowed_amount":965.42,"providers":[{"billed_charge":15066.00,"npi":[1255962783]}]},{"allowed_amount":114.25,"providers":[{"billed_charge":1674.00,"npi":[1255962783]}]},{"allowed_amount":2777.25,"providers":[{"billed_charge":43524.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM CHEST 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71045","description":"RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"412007905"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":164.96,"providers":[{"billed_charge":612.00,"npi":[1558455600]}]},{"allowed_amount":74.00,"providers":[{"billed_charge":272.00,"npi":[1558455600]}]},{"allowed_amount":27.75,"providers":[{"billed_charge":102.00,"npi":[1558455600]}]}]},{"tin":{"type":"ein","value":"680578730"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":326.84,"providers":[{"billed_charge":936.00,"npi":[1881920452]}]},{"allowed_amount":16.96,"providers":[{"billed_charge":52.00,"npi":[1881920452]}]},{"allowed_amount":75.55,"providers":[{"billed_charge":234.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"112548304"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":7.71,"providers":[{"billed_charge":42.00,"npi":[1568408599]}]},{"allowed_amount":294.47,"providers":[{"billed_charge":1386.00,"npi":[1841428539]}]},{"allowed_amount":18.50,"providers":[{"billed_charge":84.00,"npi":[1841428539]}]}]},{"tin":{"type":"ein","value":"263381883"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":26.21,"providers":[{"billed_charge":129.00,"npi":[1790171288]}]},{"allowed_amount":9.25,"providers":[{"billed_charge":43.00,"npi":[1790171288]}]},{"allowed_amount":7.71,"providers":[{"billed_charge":43.00,"npi":[1790171288]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","11","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":8475.38,"providers":[{"billed_charge":167601.24,"npi":[1255962783]}]},{"allowed_amount":9.25,"providers":[{"billed_charge":176.00,"npi":[1346297645]}]},{"allowed_amount":235.89,"providers":[{"billed_charge":4752.00,"npi":[1649277427]}]},{"allowed_amount":32.38,"providers":[{"billed_charge":704.00,"npi":[1831414812]}]},{"allowed_amount":24.67,"providers":[{"billed_charge":528.00,"npi":[1831414812]}]},{"allowed_amount":7.71,"providers":[{"billed_charge":176.00,"npi":[1255962783]}]},{"allowed_amount":18.50,"providers":[{"billed_charge":194.77,"npi":[1649277427]}]},{"allowed_amount":52.42,"providers":[{"billed_charge":1056.00,"npi":[1346297645]}]},{"allowed_amount":16.96,"providers":[{"billed_charge":352.00,"npi":[1346297645]}]},{"allowed_amount":2787.04,"providers":[{"billed_charge":54578.77,"npi":[1255962783]}]},{"allowed_amount":53.96,"providers":[{"billed_charge":1056.00,"npi":[1255962783]}]},{"allowed_amount":274.43,"providers":[{"billed_charge":5456.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"10510040"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":74.00,"providers":[{"billed_charge":224.00,"npi":[1669488011]}]}]},{"tin":{"type":"ein","value":"161201211"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":46.25,"providers":[{"billed_charge":90.00,"npi":[1407814825]}]},{"allowed_amount":37.00,"providers":[{"billed_charge":72.00,"npi":[1407814825]}]}]}]},{"name":"X-RAY EXAM CHEST 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71046","description":"RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"412007905"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":10.99,"providers":[{"billed_charge":41.00,"npi":[1558455600]}]},{"allowed_amount":76.93,"providers":[{"billed_charge":287.00,"npi":[1558455600]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","11","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":186.84,"providers":[{"billed_charge":3528.00,"npi":[1255962783]}]},{"allowed_amount":117.23,"providers":[{"billed_charge":2156.00,"npi":[1255962783]}]},{"allowed_amount":38.47,"providers":[{"billed_charge":784.00,"npi":[1255962783]}]},{"allowed_amount":62.28,"providers":[{"billed_charge":1176.00,"npi":[1649277427]}]},{"allowed_amount":6223.89,"providers":[{"billed_charge":117622.38,"npi":[1255962783]}]},{"allowed_amount":206.98,"providers":[{"billed_charge":3724.00,"npi":[1255962783]}]},{"allowed_amount":3147.85,"providers":[{"billed_charge":58800.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"843038369"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":10.99,"providers":[{"billed_charge":43.00,"npi":[1427041508]}]}]}]},{"name":"X-RAY EXAM UNILAT RIBS/CHEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71101","description":"RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":26.86,"providers":[{"billed_charge":306.00,"npi":[1255962783]}]},{"allowed_amount":13.43,"providers":[{"billed_charge":153.00,"npi":[1255962783]}]}]}]},{"name":"CT THORAX W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71250","description":"COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":53.90,"providers":[{"billed_charge":731.00,"npi":[1255962783]}]},{"allowed_amount":989.55,"providers":[{"billed_charge":14620.00,"npi":[1255962783]}]},{"allowed_amount":1000.76,"providers":[{"billed_charge":13889.00,"npi":[1255962783]}]},{"allowed_amount":1385.72,"providers":[{"billed_charge":19737.00,"npi":[1255962783]}]}]}]},{"name":"CT THORAX W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71260","description":"COMPUTED TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1207.96,"providers":[{"billed_charge":17930.00,"npi":[1255962783]}]},{"allowed_amount":277.09,"providers":[{"billed_charge":4075.00,"npi":[1255962783]}]},{"allowed_amount":2051.71,"providers":[{"billed_charge":31785.00,"npi":[1255962783]}]}]}]},{"name":"CT ANGIOGRAPHY CHEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71275","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST (NONCORONARY), WITH CONTRAST MATERIAL(S), INCLUDING NONCONTR","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":90.89,"providers":[{"billed_charge":1665.00,"npi":[1255962783]}]},{"allowed_amount":511.25,"providers":[{"billed_charge":9990.00,"npi":[1255962783]}]},{"allowed_amount":13242.71,"providers":[{"billed_charge":258261.22,"npi":[1255962783]}]},{"allowed_amount":1291.41,"providers":[{"billed_charge":24975.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM NECK SPINE 2-3 VW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72040","description":"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 2 OR 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["11","22","23","20","21"],"billing_class":"professional","payments":[{"allowed_amount":11.35,"providers":[{"billed_charge":183.00,"npi":[1255962783]}]},{"allowed_amount":73.78,"providers":[{"billed_charge":1281.00,"npi":[1255962783]}]},{"allowed_amount":20.81,"providers":[{"billed_charge":366.00,"npi":[1255962783]}]},{"allowed_amount":168.37,"providers":[{"billed_charge":2928.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM NECK SPINE 4/5VWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72050","description":"RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":36.80,"providers":[{"billed_charge":693.00,"npi":[1255962783]}]},{"allowed_amount":13.80,"providers":[{"billed_charge":231.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM THORAC SPINE 2VWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72070","description":"RADIOLOGIC EXAMINATION, SPINE; THORACIC, 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":75.17,"providers":[{"billed_charge":1184.00,"npi":[1255962783]}]},{"allowed_amount":48.11,"providers":[{"billed_charge":740.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM L-S SPINE 2/3 VWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72100","description":"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; 2 OR 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","11","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":620.03,"providers":[{"billed_charge":11078.00,"npi":[1255962783]}]},{"allowed_amount":68.10,"providers":[{"billed_charge":1146.00,"npi":[1255962783]}]},{"allowed_amount":20.81,"providers":[{"billed_charge":382.00,"npi":[1255962783]}]},{"allowed_amount":22.70,"providers":[{"billed_charge":382.00,"npi":[1255962783]}]},{"allowed_amount":657.87,"providers":[{"billed_charge":11842.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM L-2 SPINE 4/>VWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72110","description":"RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF 4 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":91.02,"providers":[{"billed_charge":1968.00,"npi":[1255962783]}]},{"allowed_amount":37.06,"providers":[{"billed_charge":738.00,"npi":[1255962783]}]}]}]},{"name":"CT NECK SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72125","description":"COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":242.05,"providers":[{"billed_charge":3610.00,"npi":[1255962783]}]},{"allowed_amount":50.08,"providers":[{"billed_charge":722.00,"npi":[1255962783]}]},{"allowed_amount":5269.20,"providers":[{"billed_charge":79624.98,"npi":[1255962783]}]}]}]},{"name":"CT CHEST SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72128","description":"COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":97.66,"providers":[{"billed_charge":1430.00,"npi":[1255962783]}]}]}]},{"name":"CT LUMBAR SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72131","description":"COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":3137.49,"providers":[{"billed_charge":45048.49,"npi":[1255962783]}]},{"allowed_amount":100.16,"providers":[{"billed_charge":1362.00,"npi":[1255962783]}]},{"allowed_amount":324.68,"providers":[{"billed_charge":4767.00,"npi":[1255962783]}]}]}]},{"name":"MRI NECK SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72141","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATER","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":668.57,"providers":[{"billed_charge":8955.00,"npi":[1255962783]}]},{"allowed_amount":275.16,"providers":[{"billed_charge":3980.00,"npi":[1255962783]}]},{"allowed_amount":220.37,"providers":[{"billed_charge":2985.00,"npi":[1255962783]}]},{"allowed_amount":74.70,"providers":[{"billed_charge":995.00,"npi":[1255962783]}]}]}]},{"name":"MRI LUMBAR SPINE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72148","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIA","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":510.45,"providers":[{"billed_charge":7301.00,"npi":[1255962783]}]},{"allowed_amount":1030.24,"providers":[{"billed_charge":15645.00,"npi":[1255962783]}]},{"allowed_amount":634.95,"providers":[{"billed_charge":9387.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF PELVIS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"72170","description":"RADIOLOGIC EXAMINATION, PELVIS; 1 OR 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":26.76,"providers":[{"billed_charge":420.00,"npi":[1255962783]}]},{"allowed_amount":8.92,"providers":[{"billed_charge":140.00,"npi":[1255962783]}]},{"allowed_amount":35.68,"providers":[{"billed_charge":560.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF SHOULDER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73030","description":"RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","11","23","19","20"],"billing_class":"professional","payments":[{"allowed_amount":355.98,"providers":[{"billed_charge":5967.00,"npi":[1255962783]}]},{"allowed_amount":8.02,"providers":[{"billed_charge":153.00,"npi":[1255962783]}]},{"allowed_amount":19.24,"providers":[{"billed_charge":306.00,"npi":[1255962783]}]},{"allowed_amount":94.60,"providers":[{"billed_charge":1530.00,"npi":[1255962783]}]},{"allowed_amount":1061.54,"providers":[{"billed_charge":17633.98,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF HUMERUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73060","description":"RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8.21,"providers":[{"billed_charge":122.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF ELBOW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73070","description":"RADIOLOGIC EXAMINATION, ELBOW; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":17.14,"providers":[{"billed_charge":226.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF ELBOW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73080","description":"RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":25.27,"providers":[{"billed_charge":381.00,"npi":[1255962783]}]},{"allowed_amount":87.69,"providers":[{"billed_charge":1397.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF FOREARM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73090","description":"RADIOLOGIC EXAMINATION; FOREARM, 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23","20"],"billing_class":"professional","payments":[{"allowed_amount":147.77,"providers":[{"billed_charge":2318.00,"npi":[1255962783]}]},{"allowed_amount":8.21,"providers":[{"billed_charge":122.00,"npi":[1255962783]}]}]}]},{"name":"ANES UPR GI NDSC PX NOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"731","description":"ANESTHESIA FOR UPPER GASTROINTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED PROXIMAL TO DUODEN","allowed_amounts":[{"tin":{"type":"ein","value":"134157749"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1020.00,"providers":[{"billed_charge":52855.46,"npi":[1376640052]}]},{"allowed_amount":2270.00,"providers":[{"billed_charge":111111.98,"npi":[1093711475]}]},{"allowed_amount":1056.00,"providers":[{"billed_charge":52793.02,"npi":[1790883320]}]}]},{"tin":{"type":"ein","value":"861908119"},"service_code":["22","24","21"],"billing_class":"professional","payments":[{"allowed_amount":574.00,"providers":[{"billed_charge":22950.00,"npi":[1619633898]}]},{"allowed_amount":84.00,"providers":[{"billed_charge":3150.00,"npi":[1619633898]}]},{"allowed_amount":72.00,"providers":[{"billed_charge":2700.00,"npi":[1770664328]}]},{"allowed_amount":280.00,"providers":[{"billed_charge":14400.00,"npi":[1619633898]}]}]},{"tin":{"type":"ein","value":"841682974"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":6650.00,"npi":[1700963733]}]},{"allowed_amount":1918.00,"providers":[{"billed_charge":159600.00,"npi":[1558672394]}]}]},{"tin":{"type":"ein","value":"264363837"},"service_code":["11","24"],"billing_class":"professional","payments":[{"allowed_amount":2304.00,"providers":[{"billed_charge":83000.00,"npi":[1306880547]}]},{"allowed_amount":3502.00,"providers":[{"billed_charge":128500.00,"npi":[1306880547]}]}]},{"tin":{"type":"ein","value":"133901519"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":1812.00,"providers":[{"billed_charge":1134000.00,"npi":[1851353270]}]}]},{"tin":{"type":"ein","value":"813269041"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":84.00,"providers":[{"billed_charge":7000.00,"npi":[1033168067]}]}]},{"tin":{"type":"ein","value":"113154725"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":204.00,"providers":[{"billed_charge":7200.00,"npi":[1093737801]}]}]},{"tin":{"type":"ein","value":"474035304"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3754.00,"providers":[{"billed_charge":271925.00,"npi":[1790985596]}]},{"allowed_amount":140.00,"providers":[{"billed_charge":7430.36,"npi":[1033168067]}]},{"allowed_amount":252.00,"providers":[{"billed_charge":13403.52,"npi":[1134498959]}]},{"allowed_amount":1520.00,"providers":[{"billed_charge":88130.06,"npi":[1205358538]}]}]},{"tin":{"type":"ein","value":"473625728"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":43397.00,"providers":[{"billed_charge":193611.58,"npi":[1063455590]}]},{"allowed_amount":2914.00,"providers":[{"billed_charge":40864.60,"npi":[1972526671]}]},{"allowed_amount":1332.00,"providers":[{"billed_charge":8023.54,"npi":[1285702621]}]},{"allowed_amount":24474.00,"providers":[{"billed_charge":104437.06,"npi":[1851570303]}]}]},{"tin":{"type":"ein","value":"273478440"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2052.00,"providers":[{"billed_charge":78000.00,"npi":[1982653622]}]}]},{"tin":{"type":"ein","value":"270694919"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1458.00,"providers":[{"billed_charge":46900.00,"npi":[1902063258]}]}]},{"tin":{"type":"ein","value":"821143618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":524.00,"providers":[{"billed_charge":18800.00,"npi":[1891757274]}]}]},{"tin":{"type":"ein","value":"473696105"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":532.00,"providers":[{"billed_charge":49000.00,"npi":[1811383300]}]}]},{"tin":{"type":"ein","value":"800797091"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":956.00,"providers":[{"billed_charge":16400.00,"npi":[1871869305]}]}]},{"tin":{"type":"ein","value":"272857609"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1664.00,"providers":[{"billed_charge":27600.00,"npi":[1750365110]}]}]},{"tin":{"type":"ein","value":"271357264"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3636.00,"providers":[{"billed_charge":124800.00,"npi":[1629051230]}]}]},{"tin":{"type":"ein","value":"821243243"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":46070.00,"providers":[{"billed_charge":334693.31,"npi":[1598294266]}]}]},{"tin":{"type":"ein","value":"273106454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11020.00,"providers":[{"billed_charge":56000.00,"npi":[1477710341]}]}]},{"tin":{"type":"ein","value":"274614930"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":192.00,"providers":[{"billed_charge":6300.00,"npi":[1639496748]}]}]}]},{"name":"X-RAY EXAM OF WRIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73110","description":"RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":120.39,"providers":[{"billed_charge":1905.00,"npi":[1255962783]}]},{"allowed_amount":17.84,"providers":[{"billed_charge":254.00,"npi":[1255962783]}]},{"allowed_amount":448.92,"providers":[{"billed_charge":6731.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF HAND","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73130","description":"RADIOLOGIC EXAMINATION, HAND; MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":8.92,"providers":[{"billed_charge":134.00,"npi":[1255962783]}]},{"allowed_amount":14.49,"providers":[{"billed_charge":268.00,"npi":[1255962783]}]},{"allowed_amount":753.63,"providers":[{"billed_charge":11944.04,"npi":[1255962783]}]},{"allowed_amount":263.11,"providers":[{"billed_charge":4154.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF FINGER(S)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73140","description":"RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","20"],"billing_class":"professional","payments":[{"allowed_amount":7.18,"providers":[{"billed_charge":106.00,"npi":[1255962783]}]},{"allowed_amount":82.56,"providers":[{"billed_charge":1272.00,"npi":[1255962783]}]},{"allowed_amount":27.52,"providers":[{"billed_charge":424.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM HIP UNI 2-3 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73502","description":"RADIOLOGIC EXAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 2-3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":11.35,"providers":[{"billed_charge":223.00,"npi":[1255962783]}]},{"allowed_amount":332.49,"providers":[{"billed_charge":7136.00,"npi":[1255962783]}]},{"allowed_amount":20.81,"providers":[{"billed_charge":446.00,"npi":[1255962783]}]},{"allowed_amount":43.51,"providers":[{"billed_charge":892.00,"npi":[1255962783]}]},{"allowed_amount":166.47,"providers":[{"billed_charge":3345.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF FEMUR 2/>","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73552","description":"RADIOLOGIC EXAMINATION, FEMUR; MINIMUM 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":24.67,"providers":[{"billed_charge":510.00,"npi":[1255962783]}]},{"allowed_amount":35.46,"providers":[{"billed_charge":680.00,"npi":[1255962783]}]},{"allowed_amount":18.50,"providers":[{"billed_charge":340.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF KNEE 1 OR 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73560","description":"RADIOLOGIC EXAMINATION, KNEE; 1 OR 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["11","22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":39.99,"providers":[{"billed_charge":740.00,"npi":[1255962783]}]},{"allowed_amount":169.96,"providers":[{"billed_charge":3108.00,"npi":[1255962783]}]},{"allowed_amount":228.52,"providers":[{"billed_charge":4144.00,"npi":[1255962783]}]},{"allowed_amount":15.71,"providers":[{"billed_charge":296.00,"npi":[1255962783]}]},{"allowed_amount":59.99,"providers":[{"billed_charge":1036.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF KNEE 3","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73562","description":"RADIOLOGIC EXAMINATION, KNEE; 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":38.48,"providers":[{"billed_charge":560.00,"npi":[1255962783]}]},{"allowed_amount":692.72,"providers":[{"billed_charge":10398.98,"npi":[1255962783]}]},{"allowed_amount":9.62,"providers":[{"billed_charge":140.00,"npi":[1255962783]}]},{"allowed_amount":649.44,"providers":[{"billed_charge":10080.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM KNEE 4 OR MORE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73564","description":"RADIOLOGIC EXAMINATION, KNEE; COMPLETE, 4 OR MORE VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":425.65,"providers":[{"billed_charge":7320.00,"npi":[1255962783]}]},{"allowed_amount":138.10,"providers":[{"billed_charge":2379.00,"npi":[1255962783]}]},{"allowed_amount":52.97,"providers":[{"billed_charge":915.00,"npi":[1255962783]}]},{"allowed_amount":9.46,"providers":[{"billed_charge":183.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF LOWER LEG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73590","description":"RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19"],"billing_class":"professional","payments":[{"allowed_amount":51.99,"providers":[{"billed_charge":889.00,"npi":[1255962783]}]},{"allowed_amount":15.05,"providers":[{"billed_charge":254.00,"npi":[1255962783]}]},{"allowed_amount":277.76,"providers":[{"billed_charge":4445.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF ANKLE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73610","description":"RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["11","22","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":16.35,"providers":[{"billed_charge":268.00,"npi":[1255962783]}]},{"allowed_amount":643.65,"providers":[{"billed_charge":10184.00,"npi":[1255962783]}]},{"allowed_amount":322.57,"providers":[{"billed_charge":5092.00,"npi":[1255962783]}]},{"allowed_amount":8.92,"providers":[{"billed_charge":134.00,"npi":[1255962783]}]},{"allowed_amount":25.27,"providers":[{"billed_charge":402.00,"npi":[1255962783]}]},{"allowed_amount":7.43,"providers":[{"billed_charge":134.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF FOOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73620","description":"RADIOLOGIC EXAMINATION, FOOT; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":6.54,"providers":[{"billed_charge":113.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM OF FOOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73630","description":"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","20","21"],"billing_class":"professional","payments":[{"allowed_amount":507.82,"providers":[{"billed_charge":8001.00,"npi":[1255962783]}]},{"allowed_amount":670.46,"providers":[{"billed_charge":10414.00,"npi":[1255962783]}]},{"allowed_amount":94.16,"providers":[{"billed_charge":1397.00,"npi":[1255962783]}]},{"allowed_amount":17.12,"providers":[{"billed_charge":254.00,"npi":[1255962783]}]},{"allowed_amount":8.56,"providers":[{"billed_charge":127.00,"npi":[1255962783]}]}]}]},{"name":"CT LOWER EXTREMITY W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73700","description":"COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":321.33,"providers":[{"billed_charge":4767.00,"npi":[1255962783]}]},{"allowed_amount":50.08,"providers":[{"billed_charge":681.00,"npi":[1255962783]}]},{"allowed_amount":41.73,"providers":[{"billed_charge":681.00,"npi":[1255962783]}]}]}]},{"name":"MRI JNT OF LWR EXTRE W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73721","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":68.80,"providers":[{"billed_charge":948.00,"npi":[1255962783]}]},{"allowed_amount":57.33,"providers":[{"billed_charge":948.00,"npi":[1255962783]}]},{"allowed_amount":1066.39,"providers":[{"billed_charge":15168.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM ABDOMEN 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74018","description":"RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","20","21"],"billing_class":"professional","payments":[{"allowed_amount":77.09,"providers":[{"billed_charge":1449.00,"npi":[1255962783]}]},{"allowed_amount":265.17,"providers":[{"billed_charge":4669.00,"npi":[1255962783]}]},{"allowed_amount":92.51,"providers":[{"billed_charge":1771.00,"npi":[1255962783]}]},{"allowed_amount":37.00,"providers":[{"billed_charge":644.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY EXAM ABDOMEN 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74019","description":"RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":33.15,"providers":[{"billed_charge":609.00,"npi":[1255962783]}]},{"allowed_amount":19.50,"providers":[{"billed_charge":406.00,"npi":[1255962783]}]},{"allowed_amount":9.75,"providers":[{"billed_charge":203.00,"npi":[1255962783]}]}]}]},{"name":"CT ANGIO ABD&PELV W/O&W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74174","description":"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRA","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":3523.72,"providers":[{"billed_charge":64294.00,"npi":[1255962783]}]},{"allowed_amount":503.13,"providers":[{"billed_charge":9455.00,"npi":[1255962783]}]},{"allowed_amount":290.62,"providers":[{"billed_charge":5673.00,"npi":[1255962783]}]}]}]},{"name":"CT ABD & PELVIS W/O CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74176","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":493.28,"providers":[{"billed_charge":9702.00,"npi":[1255962783]}]},{"allowed_amount":1900.58,"providers":[{"billed_charge":37191.00,"npi":[1255962783]}]},{"allowed_amount":15768.28,"providers":[{"billed_charge":307586.56,"npi":[1255962783]}]},{"allowed_amount":1679.33,"providers":[{"billed_charge":30901.28,"npi":[1255962783]}]}]}]},{"name":"CT ABD & PELV W/CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74177","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"680578730"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":167.29,"providers":[{"billed_charge":316.00,"npi":[1881920452]}]},{"allowed_amount":182.50,"providers":[{"billed_charge":316.00,"npi":[1881920452]}]},{"allowed_amount":1444.79,"providers":[{"billed_charge":2528.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"412007905"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":167.29,"providers":[{"billed_charge":668.00,"npi":[1558455600]}]},{"allowed_amount":2372.50,"providers":[{"billed_charge":8684.00,"npi":[1558455600]}]},{"allowed_amount":365.00,"providers":[{"billed_charge":1336.00,"npi":[1558455600]}]}]},{"tin":{"type":"ein","value":"112548304"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":76.04,"providers":[{"billed_charge":615.00,"npi":[1538690458]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":64511.05,"providers":[{"billed_charge":1262979.76,"npi":[1255962783]}]},{"allowed_amount":2915.42,"providers":[{"billed_charge":57528.00,"npi":[1255962783]}]},{"allowed_amount":349.79,"providers":[{"billed_charge":6768.00,"npi":[1255962783]}]},{"allowed_amount":4649.91,"providers":[{"billed_charge":93060.00,"npi":[1255962783]}]},{"allowed_amount":2448.52,"providers":[{"billed_charge":47562.94,"npi":[1649277427]}]}]}]},{"name":"CT ABD & PELV 1/> REGNS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74178","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1665.64,"providers":[{"billed_charge":29340.00,"npi":[1255962783]}]},{"allowed_amount":199.88,"providers":[{"billed_charge":3260.00,"npi":[1255962783]}]},{"allowed_amount":183.22,"providers":[{"billed_charge":3260.00,"npi":[1255962783]}]}]}]},{"name":"MRI ABDOMEN W/O & W/DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74183","description":"MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CON","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":636.77,"providers":[{"billed_charge":11496.00,"npi":[1255962783]}]},{"allowed_amount":309.29,"providers":[{"billed_charge":5748.00,"npi":[1255962783]}]}]}]},{"name":"X-RAY UPPER GI DELAY W/O KUB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74240","description":"RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED IMAGES, WITHOUT KUB","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":113.70,"providers":[{"billed_charge":1146.00,"npi":[1255962783]}]},{"allowed_amount":160.52,"providers":[{"billed_charge":1528.00,"npi":[1255962783]}]}]}]},{"name":"US EXAM OF HEAD AND NECK","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76536","description":"ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":1735.21,"providers":[{"billed_charge":24862.00,"npi":[1255962783]}]},{"allowed_amount":58.00,"providers":[{"billed_charge":802.00,"npi":[1255962783]}]},{"allowed_amount":29.00,"providers":[{"billed_charge":401.00,"npi":[1255962783]}]}]}]},{"name":"ULTRASOUND BREAST COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76641","description":"ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED;","allowed_amounts":[{"tin":{"type":"ein","value":"464186362"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":593.73,"providers":[{"billed_charge":1345.00,"npi":[1508273319]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":3434.05,"providers":[{"billed_charge":50986.00,"npi":[1255962783]}]},{"allowed_amount":14086.70,"providers":[{"billed_charge":215007.00,"npi":[1255962783]}]},{"allowed_amount":444.68,"providers":[{"billed_charge":6734.00,"npi":[1316166531]}]}]}]},{"name":"ULTRASOUND BREAST LIMITED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76642","description":"ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED;","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":645.24,"providers":[{"billed_charge":10340.00,"npi":[1255962783]}]},{"allowed_amount":3880.56,"providers":[{"billed_charge":58750.00,"npi":[1255962783]}]}]}]},{"name":"US EXAM, ABDOM, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76700","description":"ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1651.53,"providers":[{"billed_charge":24376.00,"npi":[1255962783]}]},{"allowed_amount":4493.10,"providers":[{"billed_charge":66480.00,"npi":[1255962783]}]},{"allowed_amount":695.58,"providers":[{"billed_charge":9501.73,"npi":[1255962783]}]}]}]},{"name":"ECHO EXAM OF ABDOMEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76705","description":"ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":1751.74,"providers":[{"billed_charge":28644.00,"npi":[1255962783]}]},{"allowed_amount":1096.78,"providers":[{"billed_charge":18018.00,"npi":[1255962783]}]},{"allowed_amount":60.04,"providers":[{"billed_charge":924.00,"npi":[1255962783]}]},{"allowed_amount":5676.81,"providers":[{"billed_charge":92579.73,"npi":[1255962783]}]}]}]},{"name":"US EXAM ABDO BACK WALL, COMP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76770","description":"ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":1490.02,"providers":[{"billed_charge":22764.00,"npi":[1255962783]}]},{"allowed_amount":854.89,"providers":[{"billed_charge":13550.00,"npi":[1255962783]}]},{"allowed_amount":672.74,"providers":[{"billed_charge":10298.00,"npi":[1255962783]}]}]}]},{"name":"US EXAM ABDO BACK WALL, LIM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76775","description":"ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":24.43,"providers":[{"billed_charge":394.00,"npi":[1255962783]}]},{"allowed_amount":195.46,"providers":[{"billed_charge":2758.00,"npi":[1255962783]}]},{"allowed_amount":53.75,"providers":[{"billed_charge":788.00,"npi":[1255962783]}]}]}]},{"name":"OB US < 14 WKS SINGLE FETUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76801","description":"ULTRSND, PREGNANT UTERUS, REAL TIME W IMG DOCUMENTATION, FETAL AND MATERNAL EVALUATION, FIRST TRIMES","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":282.46,"providers":[{"billed_charge":3630.00,"npi":[1255962783]}]},{"allowed_amount":2045.40,"providers":[{"billed_charge":26862.00,"npi":[1255962783]}]},{"allowed_amount":58.44,"providers":[{"billed_charge":726.00,"npi":[1255962783]}]}]}]},{"name":"OB US LIMITED FETUS(S)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76815","description":"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED (EG, FETAL HEART BEAT, PLAC","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":115.44,"providers":[{"billed_charge":1305.00,"npi":[1255962783]}]},{"allowed_amount":5239.91,"providers":[{"billed_charge":63945.00,"npi":[1255962783]}]},{"allowed_amount":2923.03,"providers":[{"billed_charge":36540.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"843038369"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":38.48,"providers":[{"billed_charge":128.00,"npi":[1427041508]}]}]}]},{"name":"TRANSVAGINAL US, OBSTETRIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76817","description":"ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":44.18,"providers":[{"billed_charge":608.00,"npi":[1255962783]}]},{"allowed_amount":7599.22,"providers":[{"billed_charge":112480.00,"npi":[1255962783]}]},{"allowed_amount":1104.52,"providers":[{"billed_charge":15808.00,"npi":[1255962783]}]}]}]},{"name":"FETAL BIOPHYS PROFILE W/NST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76818","description":"FETAL BIOPHYSICAL PROFILE; WITH NON-STRESS TESTING","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":240.50,"providers":[{"billed_charge":2904.00,"npi":[1255962783]}]}]}]},{"name":"FETAL BIOPHYS PROFIL W/O NST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76819","description":"FETAL BIOPHYSICAL PROFILE; WITHOUT NON-STRESS TESTING","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":382.38,"providers":[{"billed_charge":5310.00,"npi":[1255962783]}]},{"allowed_amount":976.17,"providers":[{"billed_charge":12213.00,"npi":[1255962783]}]},{"allowed_amount":46.12,"providers":[{"billed_charge":531.00,"npi":[1255962783]}]}]}]},{"name":"TRANSVAGINAL US, NON-OB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76830","description":"ULTRASOUND, TRANSVAGINAL","allowed_amounts":[{"tin":{"type":"ein","value":"680578730"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":34.91,"providers":[{"billed_charge":61.00,"npi":[1881920452]}]},{"allowed_amount":69.82,"providers":[{"billed_charge":122.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":232.73,"providers":[{"billed_charge":3507.00,"npi":[1255962783]}]},{"allowed_amount":5643.69,"providers":[{"billed_charge":88677.00,"npi":[1255962783]}]},{"allowed_amount":261.82,"providers":[{"billed_charge":3577.74,"npi":[1255962783]}]},{"allowed_amount":4740.42,"providers":[{"billed_charge":72715.74,"npi":[1255962783]}]}]}]},{"name":"US EXAM, PELVIC, COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76856","description":"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE","allowed_amounts":[{"tin":{"type":"ein","value":"680578730"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":34.91,"providers":[{"billed_charge":75.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":3671.37,"providers":[{"billed_charge":52432.00,"npi":[1255962783]}]},{"allowed_amount":168.73,"providers":[{"billed_charge":2320.00,"npi":[1255962783]}]},{"allowed_amount":3338.75,"providers":[{"billed_charge":48720.00,"npi":[1255962783]}]},{"allowed_amount":196.07,"providers":[{"billed_charge":2390.01,"npi":[1255962783]}]}]}]},{"name":"US EXAM, PELVIC, LIMITED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76857","description":"ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":589.64,"providers":[{"billed_charge":7150.00,"npi":[1255962783]}]},{"allowed_amount":270.42,"providers":[{"billed_charge":3300.00,"npi":[1255962783]}]}]}]},{"name":"US EXAM, SCROTUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76870","description":"ULTRASOUND, SCROTUM AND CONTENTS","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":743.05,"providers":[{"billed_charge":10584.00,"npi":[1255962783]}]},{"allowed_amount":427.53,"providers":[{"billed_charge":6174.00,"npi":[1255962783]}]}]}]},{"name":"US XTR NON-VASC LMTD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76882","description":"ULTRASOUND, LIMITED, JOINT OR OTHER NONVASCULAR EXTREMITY STRUCTURE(S) (EG, JOINT SPACE, PERI-ARTICU","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":945.94,"providers":[{"billed_charge":17640.00,"npi":[1255962783]}]},{"allowed_amount":697.44,"providers":[{"billed_charge":12600.00,"npi":[1255962783]}]},{"allowed_amount":40.08,"providers":[{"billed_charge":840.00,"npi":[1255962783]}]},{"allowed_amount":1134.34,"providers":[{"billed_charge":20209.80,"npi":[1255962783]}]}]}]},{"name":"CT SCAN FOR THERAPY GUIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77014","description":"COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS","allowed_amounts":[{"tin":{"type":"ein","value":"160743134"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":46.61,"providers":[{"billed_charge":79.78,"npi":[1891292553]}]}]}]},{"name":"MRI BREAST C-+ W/CAD BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77049","description":"MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":324.70,"providers":[{"billed_charge":3042.00,"npi":[1255962783]}]},{"allowed_amount":439.30,"providers":[{"billed_charge":4056.00,"npi":[1255962783]}]}]}]},{"name":"BREAST TOMOSYNTHESIS UNI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77061","description":"DIGITAL BREAST TOMOSYNTHESIS; UNILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"464186362"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":83.64,"providers":[{"billed_charge":270.00,"npi":[1508273319]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19","21"],"billing_class":"professional","payments":[{"allowed_amount":23.23,"providers":[{"billed_charge":284.00,"npi":[1255962783]}]},{"allowed_amount":213.74,"providers":[{"billed_charge":2272.00,"npi":[1255962783]}]},{"allowed_amount":1510.09,"providers":[{"billed_charge":16472.00,"npi":[1255962783]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77062","description":"DIGITAL BREAST TOMOSYNTHESIS; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":469.91,"providers":[{"billed_charge":4828.00,"npi":[1255962783]}]},{"allowed_amount":2067.60,"providers":[{"billed_charge":21300.00,"npi":[1255962783]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77063","description":"SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P","allowed_amounts":[{"tin":{"type":"ein","value":"161070301"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":61.48,"providers":[{"billed_charge":270.00,"npi":[1821030362]}]}]},{"tin":{"type":"ein","value":"464186362"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":2028.84,"providers":[{"billed_charge":3960.00,"npi":[1508273319]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","15","19"],"billing_class":"professional","payments":[{"allowed_amount":1685.60,"providers":[{"billed_charge":11343.00,"npi":[1255962783]}]},{"allowed_amount":12178.59,"providers":[{"billed_charge":83182.00,"npi":[1255962783]}]},{"allowed_amount":25.62,"providers":[{"billed_charge":199.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"843038369"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":184.44,"providers":[{"billed_charge":702.00,"npi":[1427041508]}]}]}]},{"name":"DX MAMMO INCL CAD UNI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77065","description":"DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"464186362"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":414.90,"providers":[{"billed_charge":720.00,"npi":[1508273319]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19","21"],"billing_class":"professional","payments":[{"allowed_amount":3403.82,"providers":[{"billed_charge":25201.00,"npi":[1255962783]}]},{"allowed_amount":445.64,"providers":[{"billed_charge":3190.00,"npi":[1255962783]}]},{"allowed_amount":38.42,"providers":[{"billed_charge":319.00,"npi":[1255962783]}]}]}]},{"name":"DX MAMMO INCL CAD BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77066","description":"DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":925.02,"providers":[{"billed_charge":7218.00,"npi":[1255962783]}]},{"allowed_amount":4538.64,"providers":[{"billed_charge":34887.00,"npi":[1255962783]}]}]}]},{"name":"SCR MAMMO BI INCL CAD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77067","description":"SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (","allowed_amounts":[{"tin":{"type":"ein","value":"161070301"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":92.20,"providers":[{"billed_charge":340.00,"npi":[1821030362]}]}]},{"tin":{"type":"ein","value":"464186362"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":3015.25,"providers":[{"billed_charge":4912.50,"npi":[1508273319]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","15","19"],"billing_class":"professional","payments":[{"allowed_amount":20215.33,"providers":[{"billed_charge":136585.00,"npi":[1255962783]}]},{"allowed_amount":2512.48,"providers":[{"billed_charge":16815.00,"npi":[1255962783]}]},{"allowed_amount":38.42,"providers":[{"billed_charge":295.00,"npi":[1255962783]}]}]},{"tin":{"type":"ein","value":"843038369"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":276.60,"providers":[{"billed_charge":894.00,"npi":[1427041508]}]}]}]},{"name":"DXA BONE DENSITY, AXIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77080","description":"DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIP","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":72.88,"providers":[{"billed_charge":1552.00,"npi":[1255962783]}]}]}]},{"name":"ANES LWR INTST NDSC NOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"811","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; NOT","allowed_amounts":[{"tin":{"type":"ein","value":"473625728"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19164.00,"providers":[{"billed_charge":89699.10,"npi":[1063455590]}]},{"allowed_amount":3478.00,"providers":[{"billed_charge":21190.62,"npi":[1851570303]}]},{"allowed_amount":2352.00,"providers":[{"billed_charge":20098.32,"npi":[1972526671]}]}]},{"tin":{"type":"ein","value":"134157749"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":874.00,"providers":[{"billed_charge":42704.93,"npi":[1093711475]}]},{"allowed_amount":144.00,"providers":[{"billed_charge":7022.50,"npi":[1376640052]}]},{"allowed_amount":142.00,"providers":[{"billed_charge":7696.66,"npi":[1790883320]}]}]},{"tin":{"type":"ein","value":"273478440"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1478.00,"providers":[{"billed_charge":59400.00,"npi":[1982653622]}]}]},{"tin":{"type":"ein","value":"273296990"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":5223.00,"providers":[{"billed_charge":18000.00,"npi":[1144248071]}]}]},{"tin":{"type":"ein","value":"264363837"},"service_code":["11","24"],"billing_class":"professional","payments":[{"allowed_amount":1540.00,"providers":[{"billed_charge":66000.00,"npi":[1306880547]}]},{"allowed_amount":2250.00,"providers":[{"billed_charge":107400.00,"npi":[1306880547]}]}]},{"tin":{"type":"ein","value":"202829616"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":512.00,"providers":[{"billed_charge":5670.00,"npi":[1821193889]}]}]},{"tin":{"type":"ein","value":"272857609"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":456.00,"providers":[{"billed_charge":8400.00,"npi":[1750365110]}]}]},{"tin":{"type":"ein","value":"821243243"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3374.00,"providers":[{"billed_charge":113446.66,"npi":[1598294266]}]}]},{"tin":{"type":"ein","value":"271357264"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1058.00,"providers":[{"billed_charge":38400.00,"npi":[1629051230]}]}]},{"tin":{"type":"ein","value":"273106454"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6644.00,"providers":[{"billed_charge":51200.00,"npi":[1477710341]}]}]},{"tin":{"type":"ein","value":"262487820"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":1770.00,"providers":[{"billed_charge":97500.00,"npi":[1952644429]}]}]}]},{"name":"ANES LWR INTST SCR COLSC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"812","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; SCRE","allowed_amounts":[{"tin":{"type":"ein","value":"861908119"},"service_code":["22","24","21"],"billing_class":"professional","payments":[{"allowed_amount":300.00,"providers":[{"billed_charge":13500.00,"npi":[1619633898]}]},{"allowed_amount":180.00,"providers":[{"billed_charge":8100.00,"npi":[1619633898]}]},{"allowed_amount":326.00,"providers":[{"billed_charge":20700.00,"npi":[1619633898]}]}]},{"tin":{"type":"ein","value":"262798973"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":290.00,"providers":[{"billed_charge":7670.00,"npi":[1114187986]}]}]},{"tin":{"type":"ein","value":"133901519"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":930.00,"providers":[{"billed_charge":448000.00,"npi":[1851353270]}]}]},{"tin":{"type":"ein","value":"800797091"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":730.00,"providers":[{"billed_charge":15200.00,"npi":[1871869305]}]}]},{"tin":{"type":"ein","value":"113154725"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":380.00,"providers":[{"billed_charge":14000.00,"npi":[1093737801]}]}]},{"tin":{"type":"ein","value":"474035304"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":88.00,"providers":[{"billed_charge":10631.04,"npi":[1205358538]}]},{"allowed_amount":2072.00,"providers":[{"billed_charge":150650.60,"npi":[1790985596]}]}]}]},{"name":"ANES UPR LWR GI NDSC PX","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"813","description":"ANESTHESIA FOR COMBINED UPPER AND LOWER GASTROINTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED","allowed_amounts":[{"tin":{"type":"ein","value":"202829616"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":616.00,"providers":[{"billed_charge":5040.00,"npi":[1821193889]}]}]}]},{"name":"DIALYSIS PROCEDURE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"UNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":3900.00,"providers":[{"billed_charge":136658.52,"npi":[1891437281]}]},{"allowed_amount":7475.00,"providers":[{"billed_charge":261928.83,"npi":[1891437281]}]}]}]},{"name":"HEMODIALYSIS ONE EVALUATION","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"HEMODIALYSIS PROCEDURE WITH SINGLE EVALUATION BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSI","allowed_amounts":[{"tin":{"type":"ein","value":"862871674"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":3900.00,"providers":[{"billed_charge":136658.52,"npi":[1891437281]}]},{"allowed_amount":7475.00,"providers":[{"billed_charge":261928.83,"npi":[1891437281]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"830604071"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":42.70,"providers":[{"billed_charge":273.00,"npi":[1972094423]}]}]}]},{"name":"ASSAY TEST FOR BLOOD, FECAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82274","description":"BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE, FECES, 1-3 SIMULTANEOU","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":44.63,"providers":[{"billed_charge":437.80,"npi":[1013905074]}]}]}]},{"name":"PANCREATIC ELASTASE, FECAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82656","description":"ELASTASE, PANCREATIC (EL-1), FECAL, QUALITATIVE OR SEMI-QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":75.60,"providers":[{"billed_charge":360.00,"npi":[1013905074]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"830604071"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":41.68,"providers":[{"billed_charge":273.00,"npi":[1972094423]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":61.68,"providers":[{"billed_charge":858.00,"npi":[1982606992]}]}]}]},{"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":"830604071"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":42.70,"providers":[{"billed_charge":309.00,"npi":[1972094423]}]}]}]},{"name":"LACTOFERRIN, FECAL (QUANT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83631","description":"LACTOFERRIN, FECAL; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":132.14,"providers":[{"billed_charge":490.70,"npi":[1013905074]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"830604071"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":41.68,"providers":[{"billed_charge":249.00,"npi":[1972094423]}]}]}]},{"name":"ASSAY FOR CALPROTECTIN FECAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83993","description":"CALPROTECTIN, FECAL","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":145.81,"providers":[{"billed_charge":686.56,"npi":[1013905074]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84100","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":54.05,"providers":[{"billed_charge":570.00,"npi":[1982606992]}]}]}]},{"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":"830604071"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":37.94,"providers":[{"billed_charge":203.00,"npi":[1972094423]}]}]}]},{"name":"OVA AND PARASITES SMEARS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87177","description":"OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.36,"providers":[{"billed_charge":44.50,"npi":[1013905074]}]}]}]},{"name":"SMEAR, COMPLEX STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87209","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; COMPLEX SPECIAL STAIN (EG, TRICHROME, IRON HEMOTOXYLIN) F","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.00,"providers":[{"billed_charge":89.90,"npi":[1013905074]}]}]}]},{"name":"HPYLORI STOOL IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87338","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HELICOBACTER PYLORI, STOOL; (EG, ENZYME","allowed_amounts":[{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.92,"providers":[{"billed_charge":143.80,"npi":[1013905074]}]}]}]},{"name":"SARS-COV-2 COVID19 W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87811","description":"IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"812775347"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":29.80,"providers":[{"billed_charge":268.00,"npi":[1376991414]}]},{"allowed_amount":84.43,"providers":[{"billed_charge":804.00,"npi":[1942966429]}]}]}]},{"name":"CYTOPATH CELL ENHANCE TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88112","description":"CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (EG, LIQUID BASED SLIDE","allowed_amounts":[{"tin":{"type":"ein","value":"134192391"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":640.39,"providers":[{"billed_charge":6802.00,"npi":[1902018161]}]}]},{"tin":{"type":"ein","value":"273813114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3644.44,"providers":[{"billed_charge":24640.00,"npi":[1811917370]}]}]}]},{"name":"CYTP URNE 3-5 PROBES EA SPEC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88120","description":"CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN W MORPHOMETRIC ANALYSIS, 3-5","allowed_amounts":[{"tin":{"type":"ein","value":"134192391"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":215.26,"providers":[{"billed_charge":1208.00,"npi":[1902018161]}]}]},{"tin":{"type":"ein","value":"273813114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19696.18,"providers":[{"billed_charge":216310.00,"npi":[1811917370]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88304","description":"LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION, INDUCED ABSCESS ANEURYSM","allowed_amounts":[{"tin":{"type":"ein","value":"831187935"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":30.70,"providers":[{"billed_charge":32.00,"npi":[1720051907]}]}]},{"tin":{"type":"ein","value":"113626555"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":86.98,"providers":[{"billed_charge":165.00,"npi":[1811952245]}]},{"allowed_amount":296.74,"providers":[{"billed_charge":550.00,"npi":[1730145525]}]},{"allowed_amount":56.28,"providers":[{"billed_charge":110.00,"npi":[1811952245]}]},{"allowed_amount":61.40,"providers":[{"billed_charge":110.00,"npi":[1730145525]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"571205544"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13871.14,"providers":[{"billed_charge":256266.00,"npi":[1255485611]}]}]},{"tin":{"type":"ein","value":"800352966"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4833.10,"providers":[{"billed_charge":43650.00,"npi":[1902018161]}]}]},{"tin":{"type":"ein","value":"813269041"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7219.32,"providers":[{"billed_charge":82500.00,"npi":[1912151499]}]}]},{"tin":{"type":"ein","value":"133763856"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6534.28,"providers":[{"billed_charge":13400.00,"npi":[1689621120]}]}]},{"tin":{"type":"ein","value":"990514049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8176.88,"providers":[{"billed_charge":39200.00,"npi":[1376716894]}]}]},{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2119.93,"providers":[{"billed_charge":5520.00,"npi":[1659655124]}]}]},{"tin":{"type":"ein","value":"454103341"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1779.69,"providers":[{"billed_charge":3600.00,"npi":[1689621120]}]}]},{"tin":{"type":"ein","value":"113355732"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7860.34,"providers":[{"billed_charge":72900.00,"npi":[1275779894]}]}]},{"tin":{"type":"ein","value":"273325779"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4782.74,"providers":[{"billed_charge":10850.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"201862514"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":27323.52,"providers":[{"billed_charge":113365.00,"npi":[1386848778]}]}]},{"tin":{"type":"ein","value":"461741824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23388.98,"providers":[{"billed_charge":240500.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"834443268"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16417.50,"providers":[{"billed_charge":43950.00,"npi":[1679757892]}]}]},{"tin":{"type":"ein","value":"202933120"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10503.66,"providers":[{"billed_charge":53000.00,"npi":[1427100726]}]}]},{"tin":{"type":"ein","value":"831187935"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":104.68,"providers":[{"billed_charge":210.00,"npi":[1720051907]}]},{"allowed_amount":8435.84,"providers":[{"billed_charge":17010.00,"npi":[1720051907]}]}]},{"tin":{"type":"ein","value":"274775263"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5304.21,"providers":[{"billed_charge":51000.00,"npi":[1821213265]}]}]},{"tin":{"type":"ein","value":"270174413"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":348.94,"providers":[{"billed_charge":553.00,"npi":[1154591378]}]}]},{"tin":{"type":"ein","value":"464885763"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13949.72,"providers":[{"billed_charge":42900.00,"npi":[1356773899]}]}]},{"tin":{"type":"ein","value":"812567436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":20178.50,"providers":[{"billed_charge":263496.75,"npi":[1922007665]}]}]},{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1875.65,"providers":[{"billed_charge":7972.00,"npi":[1013905074]}]}]},{"tin":{"type":"ein","value":"113513346"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":314.06,"providers":[{"billed_charge":900.00,"npi":[1811917370]}]}]},{"tin":{"type":"ein","value":"474809148"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3193.01,"providers":[{"billed_charge":28350.00,"npi":[1710997499]}]}]},{"tin":{"type":"ein","value":"113626555"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":52.34,"providers":[{"billed_charge":115.00,"npi":[1245222975]}]},{"allowed_amount":357.68,"providers":[{"billed_charge":805.00,"npi":[1811952245]}]},{"allowed_amount":1308.60,"providers":[{"billed_charge":2990.00,"npi":[1710979372]}]},{"allowed_amount":366.40,"providers":[{"billed_charge":805.00,"npi":[1750678462]}]},{"allowed_amount":715.37,"providers":[{"billed_charge":1725.00,"npi":[1750678462]}]},{"allowed_amount":680.46,"providers":[{"billed_charge":1610.00,"npi":[1578555033]}]},{"allowed_amount":209.37,"providers":[{"billed_charge":460.00,"npi":[1982696548]}]},{"allowed_amount":200.65,"providers":[{"billed_charge":460.00,"npi":[1245222975]}]},{"allowed_amount":4117.70,"providers":[{"billed_charge":9545.00,"npi":[1811952245]}]},{"allowed_amount":340.23,"providers":[{"billed_charge":805.00,"npi":[1730145525]}]},{"allowed_amount":3114.44,"providers":[{"billed_charge":7130.00,"npi":[1730145525]}]},{"allowed_amount":130.86,"providers":[{"billed_charge":345.00,"npi":[1710979372]}]}]},{"tin":{"type":"ein","value":"161391026"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":706.65,"providers":[{"billed_charge":770.00,"npi":[1477965606]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88307","description":"LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ADRENAL, RESECTION BONE - BIOPSY/CUR","allowed_amounts":[{"tin":{"type":"ein","value":"462333282"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":528.45,"providers":[{"billed_charge":978.00,"npi":[1538503461]}]}]}]},{"name":"SPECIAL STAINS GROUP 1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88312","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN","allowed_amounts":[{"tin":{"type":"ein","value":"461741824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3465.96,"providers":[{"billed_charge":140400.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"201862514"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2222.77,"providers":[{"billed_charge":48544.00,"npi":[1386848778]}]}]},{"tin":{"type":"ein","value":"202933120"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1078.16,"providers":[{"billed_charge":12250.00,"npi":[1427100726]}]}]},{"tin":{"type":"ein","value":"834443268"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":998.33,"providers":[{"billed_charge":6000.00,"npi":[1679757892]}]}]},{"tin":{"type":"ein","value":"274775263"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.89,"providers":[{"billed_charge":1200.00,"npi":[1821213265]}]}]},{"tin":{"type":"ein","value":"464885763"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":953.00,"providers":[{"billed_charge":9450.00,"npi":[1356773899]}]}]},{"tin":{"type":"ein","value":"812567436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1237.83,"providers":[{"billed_charge":45426.00,"npi":[1922007665]}]}]},{"tin":{"type":"ein","value":"133763856"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":13.31,"providers":[{"billed_charge":70.00,"npi":[1689621120]}]}]},{"tin":{"type":"ein","value":"990514049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3839.21,"providers":[{"billed_charge":19800.00,"npi":[1376716894]}]}]},{"tin":{"type":"ein","value":"474809148"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.86,"providers":[{"billed_charge":1600.00,"npi":[1710997499]}]}]},{"tin":{"type":"ein","value":"273325779"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":735.00,"providers":[{"billed_charge":900.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"113355732"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":322.08,"providers":[{"billed_charge":7150.00,"npi":[1275779894]}]}]}]},{"name":"SPECIAL STAINS GROUP 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88313","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT","allowed_amounts":[{"tin":{"type":"ein","value":"571205544"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2075.81,"providers":[{"billed_charge":244650.00,"npi":[1255485611]}]}]},{"tin":{"type":"ein","value":"134192391"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":225.60,"providers":[{"billed_charge":5360.00,"npi":[1902018161]}]}]},{"tin":{"type":"ein","value":"133763856"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1389.23,"providers":[{"billed_charge":4410.00,"npi":[1689621120]}]}]},{"tin":{"type":"ein","value":"990514049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1980.03,"providers":[{"billed_charge":9900.00,"npi":[1376716894]}]}]},{"tin":{"type":"ein","value":"273325779"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.96,"providers":[{"billed_charge":450.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"113355732"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1261.45,"providers":[{"billed_charge":37375.00,"npi":[1275779894]}]}]},{"tin":{"type":"ein","value":"461741824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3556.81,"providers":[{"billed_charge":145350.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"201862514"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2041.95,"providers":[{"billed_charge":44164.00,"npi":[1386848778]}]}]},{"tin":{"type":"ein","value":"202933120"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2083.86,"providers":[{"billed_charge":32025.00,"npi":[1427100726]}]}]},{"tin":{"type":"ein","value":"834443268"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3106.99,"providers":[{"billed_charge":8030.00,"npi":[1679757892]}]}]},{"tin":{"type":"ein","value":"274775263"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":47.90,"providers":[{"billed_charge":1000.00,"npi":[1821213265]}]}]},{"tin":{"type":"ein","value":"812567436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3141.70,"providers":[{"billed_charge":128527.35,"npi":[1922007665]}]}]},{"tin":{"type":"ein","value":"263844242"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":239.54,"providers":[{"billed_charge":4830.00,"npi":[1013905074]}]}]},{"tin":{"type":"ein","value":"474809148"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":129.74,"providers":[{"billed_charge":3200.00,"npi":[1710997499]}]}]}]},{"name":"IMMUNOHISTO ANTIBODY SLIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88341","description":"IMMUNOHISTOCHEMISTRY OR IMMUNOCYTOCHEMISTRY, PER SPECIMEN; EACH ADDITIONAL SINGLE ANTIBODY STAIN PRO","allowed_amounts":[{"tin":{"type":"ein","value":"201862514"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2684.99,"providers":[{"billed_charge":24366.00,"npi":[1386848778]}]}]},{"tin":{"type":"ein","value":"834443268"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5465.98,"providers":[{"billed_charge":22350.00,"npi":[1679757892]}]}]}]},{"name":"IMMUNOHISTO ANTB 1ST STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88342","description":"IMMUNOHISTOCHEMISTRY OR IMMUNOCYTOCHEMISTRY, PER SPECIMEN; INITIAL SINGLE ANTIBODY STAIN PROCEDURE","allowed_amounts":[{"tin":{"type":"ein","value":"571205544"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4601.42,"providers":[{"billed_charge":208250.00,"npi":[1255485611]}]}]},{"tin":{"type":"ein","value":"133763856"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":225.46,"providers":[{"billed_charge":760.00,"npi":[1689621120]}]}]},{"tin":{"type":"ein","value":"453194060"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":153.72,"providers":[{"billed_charge":1750.00,"npi":[1659655124]}]}]},{"tin":{"type":"ein","value":"990514049"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2529.61,"providers":[{"billed_charge":25200.00,"npi":[1376716894]}]}]},{"tin":{"type":"ein","value":"273325779"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1356.23,"providers":[{"billed_charge":2450.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"113355732"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3089.82,"providers":[{"billed_charge":35750.00,"npi":[1275779894]}]}]},{"tin":{"type":"ein","value":"201862514"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":830.02,"providers":[{"billed_charge":8874.00,"npi":[1386848778]}]}]},{"tin":{"type":"ein","value":"461741824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3468.80,"providers":[{"billed_charge":55350.00,"npi":[1205072352]}]}]},{"tin":{"type":"ein","value":"834443268"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9461.94,"providers":[{"billed_charge":44600.00,"npi":[1679757892]}]}]},{"tin":{"type":"ein","value":"202933120"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1798.50,"providers":[{"billed_charge":12200.00,"npi":[1427100726]}]}]},{"tin":{"type":"ein","value":"274775263"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":30.74,"providers":[{"billed_charge":300.00,"npi":[1821213265]}]}]},{"tin":{"type":"ein","value":"812567436"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":486.76,"providers":[{"billed_charge":12466.20,"npi":[1922007665]}]}]},{"tin":{"type":"ein","value":"273813114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3345.71,"providers":[{"billed_charge":23200.00,"npi":[1811917370]}]}]}]},{"name":"ALCOHL&/RX SRVC;METHDONE ADM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"900","description":"ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG BY A LI","allowed_amounts":[{"tin":{"type":"ein","value":"133224700"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":235.28,"providers":[{"billed_charge":172.83,"npi":[1881733830]}]}]}]},{"name":"ANESTH, ANORECTAL SURGERY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"902","description":"ANESTHESIA FOR; ANORECTAL PROCEDURE","allowed_amounts":[{"tin":{"type":"ein","value":"271357264"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":288.00,"providers":[{"billed_charge":9600.00,"npi":[1629051230]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"813459460"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1960.00,"providers":[{"billed_charge":1960.00,"npi":[1699103325]}]}]}]},{"name":"PSYTX W PT W E/M 45 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90836","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"821917134"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3707.97,"providers":[{"billed_charge":4900.00,"npi":[1396028767]}]},{"allowed_amount":883.92,"providers":[{"billed_charge":1400.00,"npi":[1396028767]}]}]}]},{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90837","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"874151433"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3750.00,"providers":[{"billed_charge":3750.00,"npi":[1861035644]}]}]},{"tin":{"type":"ein","value":"813459460"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1250.00,"providers":[{"billed_charge":1250.00,"npi":[1699103325]}]}]},{"tin":{"type":"ein","value":"830831389"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2000.00,"providers":[{"billed_charge":2000.00,"npi":[1437394319]}]}]},{"tin":{"type":"ein","value":"143805789"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9750.00,"providers":[{"billed_charge":9750.00,"npi":[1336652155]}]}]},{"tin":{"type":"ein","value":"464033693"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":1000.00,"providers":[{"billed_charge":1140.00,"npi":[1396095782]}]}]},{"tin":{"type":"ein","value":"471804886"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3229.04,"providers":[{"billed_charge":4950.00,"npi":[1396936704]}]}]},{"tin":{"type":"ein","value":"104548225"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1861528226]}]}]},{"tin":{"type":"ein","value":"71748296"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3000.00,"providers":[{"billed_charge":3000.00,"npi":[1093904617]}]}]},{"tin":{"type":"ein","value":"454909475"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1250.00,"providers":[{"billed_charge":1250.00,"npi":[1801074505]}]}]},{"tin":{"type":"ein","value":"461192228"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":488.14,"providers":[{"billed_charge":600.00,"npi":[1144368952]}]},{"allowed_amount":750.00,"providers":[{"billed_charge":750.00,"npi":[1144368952]}]}]},{"tin":{"type":"ein","value":"413651322"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3803.68,"providers":[{"billed_charge":4750.00,"npi":[1134596042]}]}]},{"tin":{"type":"ein","value":"96589719"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":750.00,"providers":[{"billed_charge":750.00,"npi":[1376949990]}]}]},{"tin":{"type":"ein","value":"263073888"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5410.00,"providers":[{"billed_charge":5410.00,"npi":[1356576151]}]}]},{"tin":{"type":"ein","value":"994787456"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":306.92,"providers":[{"billed_charge":560.00,"npi":[1861151565]}]}]},{"tin":{"type":"ein","value":"272123614"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":500.00,"providers":[{"billed_charge":500.00,"npi":[1619981404]}]}]}]},{"name":"TCRANIAL MAGN STIM TX DELI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90868","description":"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MA","allowed_amounts":[{"tin":{"type":"ein","value":"863089181"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4725.00,"providers":[{"billed_charge":6300.00,"npi":[1134765118]}]}]}]},{"name":"ALCOHL&/RX SRVC;METHDONE ADM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"919","description":"ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG BY A LI","allowed_amounts":[{"tin":{"type":"ein","value":"116000463"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":309.64,"providers":[{"billed_charge":258.04,"npi":[1033276662]}]},{"allowed_amount":4470.32,"providers":[{"billed_charge":3725.52,"npi":[1033276662]}]}]}]},{"name":"ALC &/ SUBSTNC ABUSE ASSESS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"919","description":"ALCOHOL AND/OR SUBSTANCE (OTH THAN TOBACCO) ABUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND BRI","allowed_amounts":[{"tin":{"type":"ein","value":"116000463"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":309.64,"providers":[{"billed_charge":258.04,"npi":[1033276662]}]},{"allowed_amount":4470.32,"providers":[{"billed_charge":3725.52,"npi":[1033276662]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"160743979"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":18.20,"providers":[{"billed_charge":108.00,"npi":[1932102241]}]}]},{"tin":{"type":"ein","value":"830535258"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":16.68,"providers":[{"billed_charge":68.26,"npi":[1063674448]}]},{"allowed_amount":42.46,"providers":[{"billed_charge":170.65,"npi":[1063674448]}]}]},{"tin":{"type":"ein","value":"825260282"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":95.54,"providers":[{"billed_charge":631.40,"npi":[1326202805]}]},{"allowed_amount":171.36,"providers":[{"billed_charge":1207.00,"npi":[1326202805]}]}]},{"tin":{"type":"ein","value":"814117521"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":69.76,"providers":[{"billed_charge":120.00,"npi":[1548426984]}]},{"allowed_amount":254.78,"providers":[{"billed_charge":435.00,"npi":[1548426984]}]},{"allowed_amount":116.76,"providers":[{"billed_charge":210.00,"npi":[1548426984]}]}]},{"tin":{"type":"ein","value":"161460136"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":118.30,"providers":[{"billed_charge":390.00,"npi":[1770645012]}]},{"allowed_amount":72.80,"providers":[{"billed_charge":240.00,"npi":[1770645012]}]}]},{"tin":{"type":"ein","value":"112050523"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":71.28,"providers":[{"billed_charge":216.00,"npi":[1467501858]}]},{"allowed_amount":241.14,"providers":[{"billed_charge":729.00,"npi":[1467501858]}]},{"allowed_amount":69.76,"providers":[{"billed_charge":216.00,"npi":[1467501858]}]}]},{"tin":{"type":"ein","value":"161276738"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":752.20,"providers":[{"billed_charge":2075.00,"npi":[1366425530]}]},{"allowed_amount":280.56,"providers":[{"billed_charge":775.00,"npi":[1366425530]}]},{"allowed_amount":63.70,"providers":[{"billed_charge":175.00,"npi":[1366425530]}]}]},{"tin":{"type":"ein","value":"205232173"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":43.98,"providers":[{"billed_charge":870.00,"npi":[1205944329]}]}]},{"tin":{"type":"ein","value":"341889082"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":18.20,"providers":[{"billed_charge":145.12,"npi":[1083861934]}]}]},{"tin":{"type":"ein","value":"112558775"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":541.40,"providers":[{"billed_charge":2480.00,"npi":[1013932250]}]},{"allowed_amount":18.20,"providers":[{"billed_charge":80.00,"npi":[1013932250,1396760344]}]},{"allowed_amount":694.56,"providers":[{"billed_charge":3200.00,"npi":[1013932250]}]}]},{"tin":{"type":"ein","value":"141744484"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":9.10,"providers":[{"billed_charge":30.00,"npi":[1861436719]}]},{"allowed_amount":18.20,"providers":[{"billed_charge":60.00,"npi":[1396774675]}]},{"allowed_amount":36.40,"providers":[{"billed_charge":120.00,"npi":[1861436719]}]},{"allowed_amount":289.68,"providers":[{"billed_charge":960.00,"npi":[1396774675]}]}]},{"tin":{"type":"ein","value":"922826272"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":445.84,"providers":[{"billed_charge":3484.00,"npi":[1073386421]}]}]},{"tin":{"type":"ein","value":"223594884"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":34.88,"providers":[{"billed_charge":336.00,"npi":[1194012542]}]}]},{"tin":{"type":"ein","value":"160743187"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":18.20,"providers":[{"billed_charge":69.00,"npi":[1285612085]}]},{"allowed_amount":98.58,"providers":[{"billed_charge":379.50,"npi":[1285612085]}]}]},{"tin":{"type":"ein","value":"453243253"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":97.06,"providers":[{"billed_charge":550.00,"npi":[1356442107]}]},{"allowed_amount":222.94,"providers":[{"billed_charge":1250.00,"npi":[1356442107]}]}]},{"tin":{"type":"ein","value":"113438973"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":323.02,"providers":[{"billed_charge":999.00,"npi":[1568469757]}]},{"allowed_amount":177.44,"providers":[{"billed_charge":540.00,"npi":[1568469757]}]},{"allowed_amount":194.12,"providers":[{"billed_charge":594.00,"npi":[1568469757]}]}]},{"tin":{"type":"ein","value":"135562308"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":262.36,"providers":[{"billed_charge":1650.00,"npi":[1326035205]}]},{"allowed_amount":248.70,"providers":[{"billed_charge":1595.00,"npi":[1326035205]}]},{"allowed_amount":57.62,"providers":[{"billed_charge":385.00,"npi":[1326035205]}]}]},{"tin":{"type":"ein","value":"132655001"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":122.82,"providers":[{"billed_charge":330.00,"npi":[1255521407]}]},{"allowed_amount":157.72,"providers":[{"billed_charge":396.00,"npi":[1255521407]}]},{"allowed_amount":87.94,"providers":[{"billed_charge":242.00,"npi":[1255521407]}]}]}]},{"name":"EXTRACRANIAL BILAT STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93880","description":"DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":72.84,"providers":[{"billed_charge":1502.00,"npi":[1255962783]}]},{"allowed_amount":103.19,"providers":[{"billed_charge":2253.00,"npi":[1255962783]}]},{"allowed_amount":352.06,"providers":[{"billed_charge":7510.00,"npi":[1255962783]}]}]}]},{"name":"EXTREMITY STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93970","description":"DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE BILA","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":121.25,"providers":[{"billed_charge":2612.00,"npi":[1255962783]}]},{"allowed_amount":743.31,"providers":[{"billed_charge":15672.00,"npi":[1255962783]}]},{"allowed_amount":817.12,"providers":[{"billed_charge":17631.00,"npi":[1255962783]}]}]}]},{"name":"EXTREMITY STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93971","description":"DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; UNILATERAL OR","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":987.78,"providers":[{"billed_charge":20850.00,"npi":[1255962783]}]},{"allowed_amount":206.50,"providers":[{"billed_charge":4170.00,"npi":[1255962783]}]},{"allowed_amount":113.58,"providers":[{"billed_charge":2502.00,"npi":[1255962783]}]}]}]},{"name":"VASCULAR STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93975","description":"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETR","allowed_amounts":[{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":82.99,"providers":[{"billed_charge":1084.00,"npi":[1255962783]}]},{"allowed_amount":152.15,"providers":[{"billed_charge":2168.00,"npi":[1255962783]}]},{"allowed_amount":1424.67,"providers":[{"billed_charge":19512.00,"npi":[1255962783]}]}]}]},{"name":"VASCULAR STUDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93976","description":"DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETR","allowed_amounts":[{"tin":{"type":"ein","value":"680578730"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":54.55,"providers":[{"billed_charge":84.00,"npi":[1881920452]}]}]},{"tin":{"type":"ein","value":"844522008"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":45.46,"providers":[{"billed_charge":757.00,"npi":[1255962783]}]},{"allowed_amount":263.66,"providers":[{"billed_charge":3785.00,"npi":[1255962783]}]},{"allowed_amount":1272.85,"providers":[{"billed_charge":18925.00,"npi":[1255962783]}]},{"allowed_amount":154.56,"providers":[{"billed_charge":2271.00,"npi":[1255962783]}]}]}]},{"name":"ANESTH HYSTEROSCOPE/GRAPH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"952","description":"ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM)","allowed_amounts":[{"tin":{"type":"ein","value":"472266439"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.00,"providers":[{"billed_charge":9600.00,"npi":[1447657275]}]}]},{"tin":{"type":"ein","value":"821243243"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":264.00,"providers":[{"billed_charge":24933.33,"npi":[1598294266]}]}]}]},{"name":"PT RE-EVAL EST PLAN CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97164","description":"RE-EVALUATION OF PHYSICAL THERAPY ESTABLISHED PLAN OF CARE, REQUIRING THESE COMPONENTS: AN EXAMINATI","allowed_amounts":[{"tin":{"type":"ein","value":"464893551"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":765.04,"providers":[{"billed_charge":2470.16,"npi":[1760807093]}]}]}]},{"name":"THERAPEUTIC ACTIVITIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97530","description":"THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FU","allowed_amounts":[{"tin":{"type":"ein","value":"113538970"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3667.76,"providers":[{"billed_charge":8800.00,"npi":[1134634843]}]}]},{"tin":{"type":"ein","value":"117826635"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5812.10,"providers":[{"billed_charge":13700.00,"npi":[1871521781]}]}]},{"tin":{"type":"ein","value":"270024065"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4270.63,"providers":[{"billed_charge":10750.00,"npi":[1194050633]}]},{"allowed_amount":1498.15,"providers":[{"billed_charge":3800.00,"npi":[1285921726]}]},{"allowed_amount":5916.79,"providers":[{"billed_charge":14700.00,"npi":[1437258233]}]}]},{"tin":{"type":"ein","value":"800071212"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":548.72,"providers":[{"billed_charge":2150.00,"npi":[1396799409]}]}]},{"tin":{"type":"ein","value":"131740114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":361.00,"providers":[{"billed_charge":5015.00,"npi":[1568079077]}]}]},{"tin":{"type":"ein","value":"464893551"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":98134.24,"providers":[{"billed_charge":522784.98,"npi":[1760807093]}]}]},{"tin":{"type":"ein","value":"991161498"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1342.92,"providers":[{"billed_charge":2480.00,"npi":[1114031978]}]}]},{"tin":{"type":"ein","value":"113180653"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5617.16,"providers":[{"billed_charge":28000.00,"npi":[1134300551]}]},{"allowed_amount":2945.76,"providers":[{"billed_charge":13600.00,"npi":[1437620077]}]},{"allowed_amount":4678.56,"providers":[{"billed_charge":21600.00,"npi":[1588058275]}]},{"allowed_amount":3869.92,"providers":[{"billed_charge":18000.00,"npi":[1558784272]}]}]},{"tin":{"type":"ein","value":"882919668"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1039.68,"providers":[{"billed_charge":3900.00,"npi":[1861905978]}]}]},{"tin":{"type":"ein","value":"161496961"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":281.58,"providers":[{"billed_charge":780.00,"npi":[1942301635]}]}]},{"tin":{"type":"ein","value":"863688506"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4794.08,"providers":[{"billed_charge":26945.20,"npi":[1255905139]}]}]},{"tin":{"type":"ein","value":"50588304"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2873.56,"providers":[{"billed_charge":4655.00,"npi":[1184238032]}]}]},{"tin":{"type":"ein","value":"20590841"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1360.00,"providers":[{"billed_charge":1360.00,"npi":[1700216702]}]}]},{"tin":{"type":"ein","value":"472667678"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":306.85,"providers":[{"billed_charge":2400.00,"npi":[1063800670]}]}]},{"tin":{"type":"ein","value":"161594035"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1234.62,"providers":[{"billed_charge":3135.00,"npi":[1215618988]}]}]},{"tin":{"type":"ein","value":"811931257"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5718.24,"providers":[{"billed_charge":31590.00,"npi":[1235775164]}]}]},{"tin":{"type":"ein","value":"141834123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2512.56,"providers":[{"billed_charge":5220.00,"npi":[1205830973]}]}]},{"tin":{"type":"ein","value":"113322995"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":866.40,"providers":[{"billed_charge":2400.00,"npi":[1619064482]}]},{"allowed_amount":1126.32,"providers":[{"billed_charge":2800.00,"npi":[1174880025]}]},{"allowed_amount":805.03,"providers":[{"billed_charge":4000.00,"npi":[1073396644]}]},{"allowed_amount":3400.62,"providers":[{"billed_charge":16985.00,"npi":[1497034748]}]}]},{"tin":{"type":"ein","value":"141637577"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":346.56,"providers":[{"billed_charge":1104.00,"npi":[1326129081]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99214","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"510523291"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2561.96,"providers":[{"billed_charge":2850.00,"npi":[1154355253]}]}]},{"tin":{"type":"ein","value":"821917134"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4522.52,"providers":[{"billed_charge":6050.00,"npi":[1396028767]}]},{"allowed_amount":2739.36,"providers":[{"billed_charge":4400.00,"npi":[1396028767]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99231","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"821516323"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":17.66,"providers":[{"billed_charge":150.00,"npi":[1245997105]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99232","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"113391292"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":1082.20,"providers":[{"billed_charge":4375.00,"npi":[1871556316]}]},{"allowed_amount":362.49,"providers":[{"billed_charge":1500.00,"npi":[1477634350]}]},{"allowed_amount":598.88,"providers":[{"billed_charge":2375.00,"npi":[1972772176]}]},{"allowed_amount":26.27,"providers":[{"billed_charge":125.00,"npi":[1477634350]}]}]},{"tin":{"type":"ein","value":"222182026"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":604.21,"providers":[{"billed_charge":3680.00,"npi":[1699871517]}]}]},{"tin":{"type":"ein","value":"202273423"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":152.35,"providers":[{"billed_charge":750.00,"npi":[1669437224]}]}]},{"tin":{"type":"ein","value":"471510827"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":430.78,"providers":[{"billed_charge":15192.80,"npi":[1114188000]}]}]},{"tin":{"type":"ein","value":"900836465"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1707.85,"providers":[{"billed_charge":5145.00,"npi":[1568592855]}]}]},{"tin":{"type":"ein","value":"54585615"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":126.08,"providers":[{"billed_charge":1200.00,"npi":[1407816556]}]}]},{"tin":{"type":"ein","value":"260155487"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":215.39,"providers":[{"billed_charge":770.00,"npi":[1669428165]}]}]},{"tin":{"type":"ein","value":"814117521"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":467.59,"providers":[{"billed_charge":2125.00,"npi":[1548426984]}]}]},{"tin":{"type":"ein","value":"770717545"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1549.93,"providers":[{"billed_charge":8850.00,"npi":[1225124738]}]}]},{"tin":{"type":"ein","value":"460873654"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3047.27,"providers":[{"billed_charge":17036.60,"npi":[1295975704]}]}]},{"tin":{"type":"ein","value":"821516323"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":341.51,"providers":[{"billed_charge":1950.00,"npi":[1710045844]}]}]},{"tin":{"type":"ein","value":"204541390"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":341.51,"providers":[{"billed_charge":2015.00,"npi":[1619511359]}]},{"allowed_amount":656.75,"providers":[{"billed_charge":3875.00,"npi":[1568497824]}]}]},{"tin":{"type":"ein","value":"65568964"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":478.07,"providers":[{"billed_charge":1600.00,"npi":[1073505343]}]}]},{"tin":{"type":"ein","value":"144587040"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":120.83,"providers":[{"billed_charge":400.00,"npi":[1043475486]}]}]},{"tin":{"type":"ein","value":"812349627"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":26.27,"providers":[{"billed_charge":480.20,"npi":[1326126392]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99233","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"204541390"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":602.40,"providers":[{"billed_charge":4560.00,"npi":[1568497824]}]},{"allowed_amount":451.80,"providers":[{"billed_charge":3420.00,"npi":[1619511359]}]}]},{"tin":{"type":"ein","value":"109723313"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1159.62,"providers":[{"billed_charge":4000.00,"npi":[1023273380]}]}]},{"tin":{"type":"ein","value":"144587040"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1129.50,"providers":[{"billed_charge":3550.00,"npi":[1043475486]}]}]},{"tin":{"type":"ein","value":"462611247"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":542.16,"providers":[{"billed_charge":6579.12,"npi":[1659599256]}]}]},{"tin":{"type":"ein","value":"825260282"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":849.03,"providers":[{"billed_charge":6882.00,"npi":[1285012211]}]}]},{"tin":{"type":"ein","value":"104760655"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1249.98,"providers":[{"billed_charge":43500.00,"npi":[1790983450]}]}]},{"tin":{"type":"ein","value":"843217480"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":587.34,"providers":[{"billed_charge":2951.00,"npi":[1366675548]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99284","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"223586664"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":45.02,"providers":[{"billed_charge":1255.00,"npi":[1497783419]}]}]},{"tin":{"type":"ein","value":"845095889"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":315.12,"providers":[{"billed_charge":8052.00,"npi":[1457987521]}]}]},{"tin":{"type":"ein","value":"383784101"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":54.02,"providers":[{"billed_charge":738.00,"npi":[1003075029]}]}]},{"tin":{"type":"ein","value":"991240790"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":216.08,"providers":[{"billed_charge":4096.00,"npi":[1710609862]}]},{"allowed_amount":432.16,"providers":[{"billed_charge":8192.00,"npi":[1487484523]}]},{"allowed_amount":108.04,"providers":[{"billed_charge":2048.00,"npi":[1336187657]}]},{"allowed_amount":486.18,"providers":[{"billed_charge":9216.00,"npi":[1790911931]}]}]},{"tin":{"type":"ein","value":"852130594"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1170.48,"providers":[{"billed_charge":18996.00,"npi":[1912510041]}]}]},{"tin":{"type":"ein","value":"922099454"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":621.24,"providers":[{"billed_charge":8136.00,"npi":[1043917180]}]}]},{"tin":{"type":"ein","value":"464852005"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1980.74,"providers":[{"billed_charge":42615.12,"npi":[1336564798]}]}]},{"tin":{"type":"ein","value":"205168942"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2088.82,"providers":[{"billed_charge":42066.00,"npi":[1174627293]}]},{"allowed_amount":747.28,"providers":[{"billed_charge":14364.00,"npi":[1669710497]}]}]},{"tin":{"type":"ein","value":"205232173"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":369.14,"providers":[{"billed_charge":16744.00,"npi":[1821768771]}]},{"allowed_amount":7761.02,"providers":[{"billed_charge":361192.00,"npi":[1205944329]}]},{"allowed_amount":666.26,"providers":[{"billed_charge":31096.00,"npi":[1013403005]}]},{"allowed_amount":504.20,"providers":[{"billed_charge":23920.00,"npi":[1952483505]}]}]},{"tin":{"type":"ein","value":"752746578"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":450.18,"providers":[{"billed_charge":10494.00,"npi":[1790736940]}]}]},{"tin":{"type":"ein","value":"272020746"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2340.90,"providers":[{"billed_charge":30060.00,"npi":[1164749115]}]},{"allowed_amount":162.06,"providers":[{"billed_charge":2100.00,"npi":[1649705617]}]}]},{"tin":{"type":"ein","value":"341889082"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":108.04,"providers":[{"billed_charge":2007.66,"npi":[1285120337]}]},{"allowed_amount":1179.44,"providers":[{"billed_charge":22084.26,"npi":[1609816024]}]}]},{"tin":{"type":"ein","value":"922826272"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":90.04,"providers":[{"billed_charge":1748.00,"npi":[1023262037]}]},{"allowed_amount":13136.06,"providers":[{"billed_charge":221122.00,"npi":[1073386421]}]}]},{"tin":{"type":"ein","value":"223594884"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1260.48,"providers":[{"billed_charge":24192.00,"npi":[1710291190]}]}]},{"tin":{"type":"ein","value":"474961193"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":306.12,"providers":[{"billed_charge":5616.00,"npi":[1740266774]}]},{"allowed_amount":405.16,"providers":[{"billed_charge":7488.00,"npi":[1326496118]}]},{"allowed_amount":153.06,"providers":[{"billed_charge":2808.00,"npi":[1861661704]}]},{"allowed_amount":261.10,"providers":[{"billed_charge":4680.00,"npi":[1609034842]}]},{"allowed_amount":9858.78,"providers":[{"billed_charge":176904.00,"npi":[1922460542]}]},{"allowed_amount":252.10,"providers":[{"billed_charge":4680.00,"npi":[1831539196]}]},{"allowed_amount":207.08,"providers":[{"billed_charge":3744.00,"npi":[1023051497]}]}]},{"tin":{"type":"ein","value":"473937523"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1008.40,"providers":[{"billed_charge":17325.00,"npi":[1396123360]}]}]},{"tin":{"type":"ein","value":"203512226"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":162.06,"providers":[{"billed_charge":3078.00,"npi":[1588680185]}]}]},{"tin":{"type":"ein","value":"232380812"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":306.12,"providers":[{"billed_charge":1662.00,"npi":[1730133059]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99285","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"223586664"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":309.08,"providers":[{"billed_charge":6419.00,"npi":[1497783419]}]}]},{"tin":{"type":"ein","value":"845095889"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":80.63,"providers":[{"billed_charge":1950.00,"npi":[1457987521]}]}]},{"tin":{"type":"ein","value":"991240790"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":954.12,"providers":[{"billed_charge":17784.00,"npi":[1790911931]}]},{"allowed_amount":80.63,"providers":[{"billed_charge":1482.00,"npi":[1033170873,1750979522]}]},{"allowed_amount":161.26,"providers":[{"billed_charge":2964.00,"npi":[1487484523]}]}]},{"tin":{"type":"ein","value":"852130594"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2620.44,"providers":[{"billed_charge":42168.00,"npi":[1912510041]}]}]},{"tin":{"type":"ein","value":"922099454"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":80.63,"providers":[{"billed_charge":984.00,"npi":[1043917180]}]}]},{"tin":{"type":"ein","value":"464852005"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":886.93,"providers":[{"billed_charge":18698.68,"npi":[1336564798]}]}]},{"tin":{"type":"ein","value":"205168942"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":456.90,"providers":[{"billed_charge":9096.00,"npi":[1669710497]}]},{"allowed_amount":3104.23,"providers":[{"billed_charge":62156.00,"npi":[1174627293]}]}]},{"tin":{"type":"ein","value":"205232173"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4138.99,"providers":[{"billed_charge":186666.00,"npi":[1205944329]}]}]},{"tin":{"type":"ein","value":"272020746"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":389.71,"providers":[{"billed_charge":5000.00,"npi":[1164749115]}]}]},{"tin":{"type":"ein","value":"341889082"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":873.49,"providers":[{"billed_charge":16297.05,"npi":[1609816024]}]},{"allowed_amount":161.26,"providers":[{"billed_charge":2963.10,"npi":[1285120337]}]}]},{"tin":{"type":"ein","value":"262945073"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":537.53,"providers":[{"billed_charge":10577.07,"npi":[1356507099]}]}]},{"tin":{"type":"ein","value":"922826272"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":29389.50,"providers":[{"billed_charge":486108.00,"npi":[1073386421]}]},{"allowed_amount":537.53,"providers":[{"billed_charge":9002.00,"npi":[1023262037]}]}]},{"tin":{"type":"ein","value":"461406790"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":161.26,"providers":[{"billed_charge":4394.00,"npi":[1780838631]}]}]},{"tin":{"type":"ein","value":"223594884"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":241.89,"providers":[{"billed_charge":4584.00,"npi":[1730376682]}]},{"allowed_amount":80.63,"providers":[{"billed_charge":1498.00,"npi":[1194012542]}]}]},{"tin":{"type":"ein","value":"474961193"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5039.35,"providers":[{"billed_charge":88465.00,"npi":[1922460542]}]},{"allowed_amount":161.26,"providers":[{"billed_charge":2722.00,"npi":[1023051497]}]}]},{"tin":{"type":"ein","value":"113066770"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":67.19,"providers":[{"billed_charge":520.00,"npi":[1902255318]}]}]},{"tin":{"type":"ein","value":"161494924"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":161.26,"providers":[{"billed_charge":1850.00,"npi":[1932595790]}]}]},{"tin":{"type":"ein","value":"263145514"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":80.63,"providers":[{"billed_charge":2197.00,"npi":[1134370547]}]}]}]},{"name":"CRITICAL CARE, FIRST HOUR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99291","description":"CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJURED PATIENT; FIRST","allowed_amounts":[{"tin":{"type":"ein","value":"922826272"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1608.98,"providers":[{"billed_charge":27088.00,"npi":[1073386421]}]}]},{"tin":{"type":"ein","value":"54585615"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":694.40,"providers":[{"billed_charge":4200.00,"npi":[1407816556]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99309","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"463162211"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":1199.39,"providers":[{"billed_charge":6200.00,"npi":[1609855725]}]},{"allowed_amount":309.52,"providers":[{"billed_charge":1600.00,"npi":[1407455884]}]}]},{"tin":{"type":"ein","value":"113095424"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":419.12,"providers":[{"billed_charge":2275.00,"npi":[1841248259]}]},{"allowed_amount":161.20,"providers":[{"billed_charge":875.00,"npi":[1821039926]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"237444829"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":369.00,"providers":[{"billed_charge":409.50,"npi":[1730179128]}]}]},{"tin":{"type":"ein","value":"113208172"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2464.60,"providers":[{"billed_charge":2466.00,"npi":[1114920774]}]}]},{"tin":{"type":"ein","value":"510190565"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2175.00,"providers":[{"billed_charge":2625.00,"npi":[1164458022]}]}]},{"tin":{"type":"ein","value":"161004252"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1472.00,"providers":[{"billed_charge":1714.42,"npi":[1053318998]}]}]},{"tin":{"type":"ein","value":"116035612"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2190.00,"providers":[{"billed_charge":2555.00,"npi":[1093284499]}]}]},{"tin":{"type":"ein","value":"61412359"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25105.48,"providers":[{"billed_charge":25105.48,"npi":[1689176646]}]}]},{"tin":{"type":"ein","value":"133354793"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":199.92,"providers":[{"billed_charge":199.92,"npi":[1437191012]}]}]},{"tin":{"type":"ein","value":"112420013"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12359.10,"providers":[{"billed_charge":12457.00,"npi":[1033343389]}]}]},{"tin":{"type":"ein","value":"146002139"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7651.00,"providers":[{"billed_charge":8292.00,"npi":[1194720300]}]}]},{"tin":{"type":"ein","value":"133062687"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30776.12,"providers":[{"billed_charge":30787.68,"npi":[1053351700]}]}]},{"tin":{"type":"ein","value":"237447904"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":741.00,"providers":[{"billed_charge":855.00,"npi":[1346227683]}]}]},{"tin":{"type":"ein","value":"160839594"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23575.00,"providers":[{"billed_charge":26145.00,"npi":[1841216439]}]}]},{"tin":{"type":"ein","value":"237049462"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10168.00,"providers":[{"billed_charge":11808.00,"npi":[1588693279]}]}]},{"tin":{"type":"ein","value":"161451102"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29185.00,"providers":[{"billed_charge":32856.18,"npi":[1255424800]}]}]},{"tin":{"type":"ein","value":"116000463"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7617.00,"providers":[{"billed_charge":7617.00,"npi":[1912009812]}]}]},{"tin":{"type":"ein","value":"150616994"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":70551.00,"providers":[{"billed_charge":72360.00,"npi":[1265430722]}]}]},{"tin":{"type":"ein","value":"111635081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9741.00,"providers":[{"billed_charge":11460.00,"npi":[1174637490]}]}]},{"tin":{"type":"ein","value":"161263979"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2973.60,"providers":[{"billed_charge":4956.00,"npi":[1114989357]}]}]},{"tin":{"type":"ein","value":"141609161"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1073.00,"providers":[{"billed_charge":1295.00,"npi":[1831172006]}]}]},{"tin":{"type":"ein","value":"202081121"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18720.87,"providers":[{"billed_charge":22385.37,"npi":[1265542765]}]}]},{"tin":{"type":"ein","value":"161020059"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10875.00,"providers":[{"billed_charge":10875.00,"npi":[1447235114]}]}]},{"tin":{"type":"ein","value":"146002267"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":90.30,"providers":[{"billed_charge":153.60,"npi":[1437936358]}]}]},{"tin":{"type":"ein","value":"161245879"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2294.00,"providers":[{"billed_charge":4787.06,"npi":[1649277617]}]}]},{"tin":{"type":"ein","value":"237076257"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10101.00,"providers":[{"billed_charge":12950.00,"npi":[1972566248]}]}]},{"tin":{"type":"ein","value":"161470051"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8502.00,"providers":[{"billed_charge":10902.00,"npi":[1588616577]}]}]},{"tin":{"type":"ein","value":"222560963"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":67411.00,"providers":[{"billed_charge":104820.00,"npi":[1306808753]}]}]},{"tin":{"type":"ein","value":"160954422"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31549.00,"providers":[{"billed_charge":35073.78,"npi":[1366419509]}]}]},{"tin":{"type":"ein","value":"160769150"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3320.00,"providers":[{"billed_charge":3746.62,"npi":[1356436422]}]}]},{"tin":{"type":"ein","value":"562588289"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5771.77,"providers":[{"billed_charge":5790.00,"npi":[1306891882]}]}]},{"tin":{"type":"ein","value":"920296304"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":161.20,"providers":[{"billed_charge":166.40,"npi":[1093545188]}]}]},{"tin":{"type":"ein","value":"116076987"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":210.00,"providers":[{"billed_charge":245.00,"npi":[1942942461]}]}]},{"tin":{"type":"ein","value":"813213894"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1825.00,"providers":[{"billed_charge":2127.27,"npi":[1790228062]}]}]},{"tin":{"type":"ein","value":"136210595"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13563.04,"providers":[{"billed_charge":22876.56,"npi":[1205878774]}]}]},{"tin":{"type":"ein","value":"156000418"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":897.60,"providers":[{"billed_charge":1215.50,"npi":[1013984756]}]}]},{"tin":{"type":"ein","value":"161397606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9216.00,"providers":[{"billed_charge":9216.00,"npi":[1316934144]}]}]},{"tin":{"type":"ein","value":"146002472"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":496.00,"providers":[{"billed_charge":656.00,"npi":[1164410510]}]}]},{"tin":{"type":"ein","value":"161134413"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":744.00,"providers":[{"billed_charge":1390.50,"npi":[1053428789]}]}]},{"tin":{"type":"ein","value":"160924141"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":21422.00,"providers":[{"billed_charge":22836.00,"npi":[1609960210]}]}]},{"tin":{"type":"ein","value":"161025659"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":21204.00,"providers":[{"billed_charge":28728.00,"npi":[1831285410]}]}]},{"tin":{"type":"ein","value":"813286384"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5205.00,"providers":[{"billed_charge":5205.00,"npi":[1407390537]}]}]},{"tin":{"type":"ein","value":"237356692"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5977.00,"providers":[{"billed_charge":5977.00,"npi":[1568446375]}]}]},{"tin":{"type":"ein","value":"161198651"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9626.40,"providers":[{"billed_charge":11250.40,"npi":[1144257635]}]}]},{"tin":{"type":"ein","value":"112404466"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1680.00,"providers":[{"billed_charge":1960.00,"npi":[1003460890]}]}]},{"tin":{"type":"ein","value":"112125662"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2338.10,"providers":[{"billed_charge":4035.00,"npi":[1649356791]}]}]},{"tin":{"type":"ein","value":"160873040"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1306.00,"providers":[{"billed_charge":1306.00,"npi":[1649251067]}]}]},{"tin":{"type":"ein","value":"811485302"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":238.00,"providers":[{"billed_charge":290.40,"npi":[1982148003]}]}]},{"tin":{"type":"ein","value":"116080443"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":114.00,"providers":[{"billed_charge":120.00,"npi":[1700481173]}]}]},{"tin":{"type":"ein","value":"821661717"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":655.50,"providers":[{"billed_charge":655.50,"npi":[1811400401]}]}]},{"tin":{"type":"ein","value":"141597784"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":44458.00,"providers":[{"billed_charge":48630.00,"npi":[1770562910]}]}]},{"tin":{"type":"ein","value":"141785232"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3739.15,"providers":[{"billed_charge":4145.53,"npi":[1538150495]}]}]},{"tin":{"type":"ein","value":"132646815"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":96379.50,"providers":[{"billed_charge":145022.50,"npi":[1003878596]}]}]},{"tin":{"type":"ein","value":"132655001"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":43348.90,"providers":[{"billed_charge":49500.00,"npi":[1083715460]}]}]}]},{"name":"AMB SVC ALS NON ER TRSPRT L1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0426","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NONEMERGENCY TRANSPORT, LEVEL 1 (ALS 1)","allowed_amounts":[{"tin":{"type":"ein","value":"132646815"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19586.00,"providers":[{"billed_charge":36975.00,"npi":[1003878596]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"160839594"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34856.00,"providers":[{"billed_charge":40000.00,"npi":[1841216439]}]}]},{"tin":{"type":"ein","value":"237076257"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":25545.00,"providers":[{"billed_charge":26000.00,"npi":[1972566248]}]}]},{"tin":{"type":"ein","value":"161451102"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":135131.00,"providers":[{"billed_charge":137785.85,"npi":[1255424800]}]}]},{"tin":{"type":"ein","value":"161470051"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19650.00,"providers":[{"billed_charge":28650.00,"npi":[1588616577]}]}]},{"tin":{"type":"ein","value":"222560963"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":42859.00,"providers":[{"billed_charge":91000.00,"npi":[1306808753]}]}]},{"tin":{"type":"ein","value":"161198651"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2900.00,"providers":[{"billed_charge":3800.00,"npi":[1144257635]}]}]},{"tin":{"type":"ein","value":"61412359"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19800.00,"providers":[{"billed_charge":19800.00,"npi":[1689176646]}]}]},{"tin":{"type":"ein","value":"160769150"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7360.00,"providers":[{"billed_charge":11443.92,"npi":[1356436422]}]}]},{"tin":{"type":"ein","value":"160954422"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":175747.50,"providers":[{"billed_charge":246044.28,"npi":[1366419509]}]}]},{"tin":{"type":"ein","value":"562588289"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12905.29,"providers":[{"billed_charge":14400.00,"npi":[1306891882]}]}]},{"tin":{"type":"ein","value":"112420013"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":68902.00,"providers":[{"billed_charge":71400.00,"npi":[1033343389]}]}]},{"tin":{"type":"ein","value":"150616994"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":100700.00,"providers":[{"billed_charge":100700.00,"npi":[1265430722]}]}]},{"tin":{"type":"ein","value":"116000463"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":59854.28,"providers":[{"billed_charge":59854.28,"npi":[1912009812]}]}]},{"tin":{"type":"ein","value":"146002139"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37207.00,"providers":[{"billed_charge":39900.00,"npi":[1194720300]}]}]},{"tin":{"type":"ein","value":"111635081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":60480.00,"providers":[{"billed_charge":60480.00,"npi":[1174637490]}]}]},{"tin":{"type":"ein","value":"133062687"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8911.80,"providers":[{"billed_charge":8911.80,"npi":[1053351700]}]}]},{"tin":{"type":"ein","value":"202081121"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2893.71,"providers":[{"billed_charge":3315.42,"npi":[1265542765]}]}]},{"tin":{"type":"ein","value":"141597784"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":154085.00,"providers":[{"billed_charge":187353.00,"npi":[1770562910]}]}]},{"tin":{"type":"ein","value":"141785232"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5788.00,"providers":[{"billed_charge":5820.00,"npi":[1538150495]}]}]},{"tin":{"type":"ein","value":"132646815"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":115308.00,"providers":[{"billed_charge":150075.00,"npi":[1003878596]}]}]},{"tin":{"type":"ein","value":"132655001"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":396861.00,"providers":[{"billed_charge":424284.00,"npi":[1083715460]}]}]},{"tin":{"type":"ein","value":"161025659"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4653.00,"providers":[{"billed_charge":8398.41,"npi":[1831285410]}]}]},{"tin":{"type":"ein","value":"160924141"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31020.00,"providers":[{"billed_charge":31500.00,"npi":[1609960210]}]}]}]},{"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":"113208172"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29681.00,"providers":[{"billed_charge":51100.00,"npi":[1114920774]}]}]},{"tin":{"type":"ein","value":"510190565"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1214.00,"providers":[{"billed_charge":1500.00,"npi":[1164458022]}]}]},{"tin":{"type":"ein","value":"116035612"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1500.00,"providers":[{"billed_charge":1500.00,"npi":[1093284499]}]}]},{"tin":{"type":"ein","value":"222560963"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34946.00,"providers":[{"billed_charge":80475.00,"npi":[1306808753]}]}]},{"tin":{"type":"ein","value":"61412359"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3996.00,"providers":[{"billed_charge":3996.00,"npi":[1689176646]}]}]},{"tin":{"type":"ein","value":"160954422"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":47325.00,"providers":[{"billed_charge":66721.55,"npi":[1366419509]}]}]},{"tin":{"type":"ein","value":"112420013"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":175964.00,"providers":[{"billed_charge":179000.00,"npi":[1033343389]}]}]},{"tin":{"type":"ein","value":"136210595"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":67860.00,"providers":[{"billed_charge":120640.00,"npi":[1205878774]}]}]},{"tin":{"type":"ein","value":"156000418"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":10813.00,"providers":[{"billed_charge":13013.00,"npi":[1013984756]}]}]},{"tin":{"type":"ein","value":"133062687"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":61480.00,"providers":[{"billed_charge":61480.00,"npi":[1053351700]}]}]},{"tin":{"type":"ein","value":"161397606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2800.00,"providers":[{"billed_charge":2800.00,"npi":[1316934144]}]}]},{"tin":{"type":"ein","value":"160924141"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":24930.00,"providers":[{"billed_charge":25650.00,"npi":[1609960210]}]}]},{"tin":{"type":"ein","value":"160839594"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":45227.00,"providers":[{"billed_charge":65625.00,"npi":[1841216439]}]}]},{"tin":{"type":"ein","value":"237049462"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19650.00,"providers":[{"billed_charge":22500.00,"npi":[1588693279]}]}]},{"tin":{"type":"ein","value":"161451102"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1377.86,"providers":[{"billed_charge":1377.86,"npi":[1255424800]}]}]},{"tin":{"type":"ein","value":"161198651"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5898.00,"providers":[{"billed_charge":7200.00,"npi":[1144257635]}]}]},{"tin":{"type":"ein","value":"112404466"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":21000.00,"providers":[{"billed_charge":21000.00,"npi":[1003460890]}]}]},{"tin":{"type":"ein","value":"116000463"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":80432.49,"providers":[{"billed_charge":80475.62,"npi":[1912009812]}]}]},{"tin":{"type":"ein","value":"112125662"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37491.00,"providers":[{"billed_charge":49950.00,"npi":[1649356791]}]}]},{"tin":{"type":"ein","value":"150616994"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":21000.00,"providers":[{"billed_charge":21000.00,"npi":[1265430722]}]}]},{"tin":{"type":"ein","value":"111635081"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":257610.00,"providers":[{"billed_charge":257610.00,"npi":[1174637490]}]}]},{"tin":{"type":"ein","value":"821661717"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29178.00,"providers":[{"billed_charge":33000.00,"npi":[1811400401]}]}]},{"tin":{"type":"ein","value":"202081121"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":174197.18,"providers":[{"billed_charge":179991.48,"npi":[1265542765]}]}]},{"tin":{"type":"ein","value":"141597784"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":169421.90,"providers":[{"billed_charge":212196.35,"npi":[1770562910]}]}]},{"tin":{"type":"ein","value":"132646815"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":269071.00,"providers":[{"billed_charge":378300.00,"npi":[1003878596]}]}]},{"tin":{"type":"ein","value":"132655001"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1223554.00,"providers":[{"billed_charge":1356444.00,"npi":[1083715460]}]}]}]},{"name":"AMB SVC AIR TRNSPRT 1 WY ROT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0431","description":"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)","allowed_amounts":[{"tin":{"type":"ein","value":"870533822"},"service_code":["42"],"billing_class":"professional","payments":[{"allowed_amount":669696.00,"providers":[{"billed_charge":704373.13,"npi":[1407855240]}]}]}]},{"name":"ROTARY WING AIR MILEAGE-STAT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0436","description":"ROTARY WING AIR MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"870533822"},"service_code":["42"],"billing_class":"professional","payments":[{"allowed_amount":320177.34,"providers":[{"billed_charge":348348.25,"npi":[1407855240]}]}]}]},{"name":"AMB RSPN&TREATMENT NO TRNSPT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0998","description":"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"132646815"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3422.00,"providers":[{"billed_charge":4000.00,"npi":[1003878596]}]}]}]},{"name":"INJECTION, PROPOFOL, 10 MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J2704","description":"INJECTION, PROPOFOL, 10 MG","allowed_amounts":[{"tin":{"type":"ein","value":"472961712"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.58,"providers":[{"billed_charge":842.40,"npi":[1043247539]}]}]},{"tin":{"type":"ein","value":"474331924"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":280.43,"providers":[{"billed_charge":1600.00,"npi":[1528233079]}]}]},{"tin":{"type":"ein","value":"473696105"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.37,"providers":[{"billed_charge":20750.00,"npi":[1811383300]}]}]},{"tin":{"type":"ein","value":"813269041"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":13350.00,"npi":[1033168067]}]}]},{"tin":{"type":"ein","value":"261722227"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":593.06,"providers":[{"billed_charge":4450.00,"npi":[1598784753]}]}]}]}]}