{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"1.0.0","last_updated_on":"2025-09-02","out_of_network":[{"name":"Under Proprietary Laboratory Analyses","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"0449U","description":"Under Proprietary Laboratory Analyses","allowed_amounts":[{"tin":{"type":"ein","value":"811082020"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":22811.00,"providers":[{"billed_charge":94893.76,"npi":[1598314437]}]}]}]},{"name":"RESIDENTIAL TREATMENT - CHEM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"934025601"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":861.00,"providers":[{"billed_charge":11850.00,"npi":[1780452565]}]}]}]},{"name":"ROOM-BOARD/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"110","description":"ROOM AND BOARD - PRIVATE -GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1010906.61,"providers":[{"billed_charge":954581.87,"npi":[1831116441]}]}]}]},{"name":"DEB SUBQ TISSUE 20 SQ CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"11042","description":"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LE","allowed_amounts":[{"tin":{"type":"ein","value":"382947657"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":416.35,"providers":[{"billed_charge":995.00,"npi":[1326043316]}]}]}]},{"name":"MED-SUR-GY/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"111","description":"ROOM AND BOARD - PRIVATE -MEDICAL/SURGICAL/GYN","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":149241.07,"providers":[{"billed_charge":358477.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":490585.88,"providers":[{"billed_charge":265230.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":426527.22,"providers":[{"billed_charge":237450.00,"npi":[1053356352]}]}]}]},{"name":"ROOM-BOARD/SEMI","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"120","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":476167.21,"providers":[{"billed_charge":511200.00,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":6626.57,"providers":[{"billed_charge":106248.00,"npi":[1982685384]}]}]}]},{"name":"MED-SUR-GY/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"121","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -MEDICAL/SURGICAL/GYN","allowed_amounts":[{"tin":{"type":"ein","value":"382383119"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":408765.52,"providers":[{"billed_charge":204906.00,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":326338.49,"providers":[{"billed_charge":173217.00,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":139434.27,"providers":[{"billed_charge":56823.00,"npi":[1376564088]}]}]}]},{"name":"PSTAY/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"124","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"381901104"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":30017.46,"providers":[{"billed_charge":36000.00,"npi":[1972743425]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":15829.25,"providers":[{"billed_charge":39984.00,"npi":[1598746976]}]}]},{"tin":{"type":"ein","value":"382409580"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1005279.62,"providers":[{"billed_charge":1137000.00,"npi":[1053342220]}]}]},{"tin":{"type":"ein","value":"43232990"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":755198.41,"providers":[{"billed_charge":1530900.00,"npi":[1144381245]}]}]}]},{"name":"POST ICU","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"206","description":"INTENSIVE CARE - POST ICU","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":121247.68,"providers":[{"billed_charge":161570.97,"npi":[1831116441]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":0.21,"providers":[{"billed_charge":115.88,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":73.19,"providers":[{"billed_charge":118792.95,"npi":[1043625940]}]},{"allowed_amount":398.07,"providers":[{"billed_charge":13714.53,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":13592.04,"providers":[{"billed_charge":111535.10,"npi":[1790706901]}]},{"allowed_amount":186.86,"providers":[{"billed_charge":1882.30,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9.71,"providers":[{"billed_charge":2596.36,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12.51,"providers":[{"billed_charge":64.05,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":13349.40,"providers":[{"billed_charge":140982.54,"npi":[1982685384]}]},{"allowed_amount":96.54,"providers":[{"billed_charge":6761.03,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15.68,"providers":[{"billed_charge":68.39,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":248.47,"providers":[{"billed_charge":524.05,"npi":[1295803377]}]}]}]},{"name":"DRUGS/INCIDNT RAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"255","description":"PHARMACY - DRUGS INCIDENT TO RADIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2332.68,"providers":[{"billed_charge":14278.00,"npi":[1790706901]}]}]}]},{"name":"IV SOLUTIONS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"258","description":"PHARMACY - IV SOLUTIONS","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":241.20,"providers":[{"billed_charge":2680.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":60.23,"providers":[{"billed_charge":14465.46,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1744.94,"providers":[{"billed_charge":20685.16,"npi":[1982685384]}]},{"allowed_amount":93.45,"providers":[{"billed_charge":4308.30,"npi":[1982685384]}]}]}]},{"name":"IV THERAPY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"260","description":"IV THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3742.15,"providers":[{"billed_charge":8862.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90059.94,"providers":[{"billed_charge":338776.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4374.34,"providers":[{"billed_charge":6288.00,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"383369438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":271.26,"providers":[{"billed_charge":16869.00,"npi":[1588656946]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2318.45,"providers":[{"billed_charge":10115.19,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8016.16,"providers":[{"billed_charge":56192.54,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1624.00,"providers":[{"billed_charge":2900.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"382689033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4898.12,"providers":[{"billed_charge":16795.20,"npi":[1205824737]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":33305.90,"providers":[{"billed_charge":145511.90,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":43507.06,"providers":[{"billed_charge":120012.70,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":958.38,"providers":[{"billed_charge":7513.50,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3536.61,"providers":[{"billed_charge":17918.00,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2131.94,"providers":[{"billed_charge":6119.69,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6569.83,"providers":[{"billed_charge":13854.55,"npi":[1295803377]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":39634.97,"providers":[{"billed_charge":163209.00,"npi":[1790706901]}]},{"allowed_amount":11405.16,"providers":[{"billed_charge":79645.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":276.16,"providers":[{"billed_charge":684.57,"npi":[1831116441]}]},{"allowed_amount":2862.65,"providers":[{"billed_charge":34351.18,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45145.67,"providers":[{"billed_charge":175735.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1435.85,"providers":[{"billed_charge":4308.00,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"383176445"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8363.14,"providers":[{"billed_charge":14438.00,"npi":[1639111057]}]}]},{"tin":{"type":"ein","value":"383176225"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2677.26,"providers":[{"billed_charge":10000.00,"npi":[1093748642]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4745.86,"providers":[{"billed_charge":42204.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":76702.41,"providers":[{"billed_charge":122703.70,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6543.66,"providers":[{"billed_charge":18026.82,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14453.44,"providers":[{"billed_charge":42287.18,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"382377821"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11977.25,"providers":[{"billed_charge":29542.00,"npi":[1407877723]}]}]},{"tin":{"type":"ein","value":"381976271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":409.88,"providers":[{"billed_charge":858.70,"npi":[1528031226]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13749.00,"providers":[{"billed_charge":47160.00,"npi":[1992761985]}]}]}]},{"name":"MED-SUR SUPPLIES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"270","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":30.56,"providers":[{"billed_charge":1126.50,"npi":[1043625940]}]}]}]},{"name":"NON-STER SUPPLY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"271","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON-STERILE SUPPLY","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":38.80,"providers":[{"billed_charge":2793.65,"npi":[1043625940]}]}]}]},{"name":"STERILE SUPPLY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"272","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":34.02,"providers":[{"billed_charge":78303.43,"npi":[1043625940]}]},{"allowed_amount":4237.28,"providers":[{"billed_charge":18327.73,"npi":[1043625940]}]}]}]},{"name":"PROSTHETIC DEV","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"274","description":"MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC DEVICES","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":278.20,"providers":[{"billed_charge":350.27,"npi":[1831116441]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":25.78,"providers":[{"billed_charge":348.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":450.85,"providers":[{"billed_charge":5026.00,"npi":[1790706901]}]},{"allowed_amount":215.40,"providers":[{"billed_charge":2244.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":150.72,"providers":[{"billed_charge":421.57,"npi":[1831116441]}]},{"allowed_amount":1391.85,"providers":[{"billed_charge":11688.59,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2195.07,"providers":[{"billed_charge":3597.00,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":528.68,"providers":[{"billed_charge":10429.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"383369438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":267.02,"providers":[{"billed_charge":2898.00,"npi":[1588656946]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":18.18,"providers":[{"billed_charge":69.32,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":34.10,"providers":[{"billed_charge":148.78,"npi":[1962508259]}]},{"allowed_amount":528.74,"providers":[{"billed_charge":2306.78,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":49.60,"providers":[{"billed_charge":86.92,"npi":[1083644579]}]},{"allowed_amount":19.86,"providers":[{"billed_charge":6609.07,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"381358208"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":142.63,"providers":[{"billed_charge":7589.25,"npi":[1063414233]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":13.82,"providers":[{"billed_charge":90.90,"npi":[1043625940]}]},{"allowed_amount":1072.45,"providers":[{"billed_charge":14481.80,"npi":[1043625940]}]},{"allowed_amount":69.67,"providers":[{"billed_charge":15375.90,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"382377821"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15.02,"providers":[{"billed_charge":63765.75,"npi":[1407877723]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":96.32,"providers":[{"billed_charge":172.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":264.79,"providers":[{"billed_charge":976.40,"npi":[1982685384]}]},{"allowed_amount":70.61,"providers":[{"billed_charge":328.20,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19.86,"providers":[{"billed_charge":517.36,"npi":[1346275856]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":256.06,"providers":[{"billed_charge":6458.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":104.60,"providers":[{"billed_charge":708.00,"npi":[1053356352]}]},{"allowed_amount":403.76,"providers":[{"billed_charge":146252.09,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"540895648"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":377.55,"providers":[{"billed_charge":1772.00,"npi":[1225036346]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":514.62,"providers":[{"billed_charge":2934.00,"npi":[1831132133]}]},{"allowed_amount":66.64,"providers":[{"billed_charge":196.00,"npi":[1285662981]}]}]},{"tin":{"type":"ein","value":"383369438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20.09,"providers":[{"billed_charge":9138.00,"npi":[1588656946]}]}]},{"tin":{"type":"ein","value":"380593405"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":601.01,"providers":[{"billed_charge":3171.50,"npi":[1619923919]}]},{"allowed_amount":4.52,"providers":[{"billed_charge":2597.25,"npi":[1619923919]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":134.80,"providers":[{"billed_charge":588.05,"npi":[1962508259]}]},{"allowed_amount":3245.86,"providers":[{"billed_charge":14161.35,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5209.68,"providers":[{"billed_charge":9493.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":272.23,"providers":[{"billed_charge":1157.50,"npi":[1043625940]}]},{"allowed_amount":2061.85,"providers":[{"billed_charge":399535.62,"npi":[1043625940]}]},{"allowed_amount":5671.08,"providers":[{"billed_charge":155625.77,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"382689033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8.61,"providers":[{"billed_charge":15477.80,"npi":[1205824737]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":10.96,"providers":[{"billed_charge":147.61,"npi":[1902894512]}]},{"allowed_amount":472.31,"providers":[{"billed_charge":106152.70,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":498.73,"providers":[{"billed_charge":76560.85,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":874.79,"providers":[{"billed_charge":30922.90,"npi":[1982685384]}]},{"allowed_amount":6649.18,"providers":[{"billed_charge":35933.60,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":62.88,"providers":[{"billed_charge":12695.80,"npi":[1073588711]}]},{"allowed_amount":90.76,"providers":[{"billed_charge":561.00,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"872121325"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":20.10,"providers":[{"billed_charge":78.00,"npi":[1073359717]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":40.75,"providers":[{"billed_charge":834.49,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5292.86,"providers":[{"billed_charge":11161.65,"npi":[1295803377]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":19065.72,"providers":[{"billed_charge":111650.00,"npi":[1790706901]}]},{"allowed_amount":16435.18,"providers":[{"billed_charge":108750.96,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":548.06,"providers":[{"billed_charge":2856.31,"npi":[1831116441]}]},{"allowed_amount":115.75,"providers":[{"billed_charge":66048.54,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"381434090"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":829.86,"providers":[{"billed_charge":1920.70,"npi":[1134104672]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":194.02,"providers":[{"billed_charge":98809.59,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":983.92,"providers":[{"billed_charge":2397.00,"npi":[1841245594]}]},{"allowed_amount":5444.13,"providers":[{"billed_charge":11075.00,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"383176445"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5.90,"providers":[{"billed_charge":11022.59,"npi":[1639111057]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":945.95,"providers":[{"billed_charge":161157.40,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":19.63,"providers":[{"billed_charge":271.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":35.39,"providers":[{"billed_charge":57079.11,"npi":[1306227764]}]},{"allowed_amount":142.49,"providers":[{"billed_charge":2480.44,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":289.84,"providers":[{"billed_charge":36956.75,"npi":[1083644579]}]},{"allowed_amount":157.41,"providers":[{"billed_charge":607.62,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":60.27,"providers":[{"billed_charge":22439.00,"npi":[1992761985]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":56.18,"providers":[{"billed_charge":160.32,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":19.86,"providers":[{"billed_charge":100.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":51.10,"providers":[{"billed_charge":10024.89,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":75.46,"providers":[{"billed_charge":1467.28,"npi":[1790706901]}]},{"allowed_amount":42.94,"providers":[{"billed_charge":625.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":39.03,"providers":[{"billed_charge":3673.48,"npi":[1831116441]}]},{"allowed_amount":299.13,"providers":[{"billed_charge":1028.94,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":191.69,"providers":[{"billed_charge":1600.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4.27,"providers":[{"billed_charge":1283.10,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":112.25,"providers":[{"billed_charge":1715.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":70.95,"providers":[{"billed_charge":757.70,"npi":[1982685384]}]},{"allowed_amount":66.54,"providers":[{"billed_charge":258.70,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":160.00,"providers":[{"billed_charge":598.00,"npi":[1831132133]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":33.95,"providers":[{"billed_charge":1713.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2923.42,"providers":[{"billed_charge":22487.00,"npi":[1790706901]}]},{"allowed_amount":3760.71,"providers":[{"billed_charge":23111.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":56.31,"providers":[{"billed_charge":413.48,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7.77,"providers":[{"billed_charge":73.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1661.70,"providers":[{"billed_charge":2528.00,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":42.72,"providers":[{"billed_charge":676.00,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"380593405"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8.94,"providers":[{"billed_charge":97.00,"npi":[1619923919]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":740.98,"providers":[{"billed_charge":3232.82,"npi":[1962508259]}]},{"allowed_amount":11.27,"providers":[{"billed_charge":49.18,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":15.54,"providers":[{"billed_charge":300.00,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":7.77,"providers":[{"billed_charge":30.45,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":261.56,"providers":[{"billed_charge":70949.38,"npi":[1043625940]}]},{"allowed_amount":591.21,"providers":[{"billed_charge":40415.18,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":467.60,"providers":[{"billed_charge":835.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":40.91,"providers":[{"billed_charge":23143.20,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":218.49,"providers":[{"billed_charge":8413.90,"npi":[1982685384]}]},{"allowed_amount":1474.00,"providers":[{"billed_charge":8019.90,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10.47,"providers":[{"billed_charge":65.00,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2.70,"providers":[{"billed_charge":46.06,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":987.64,"providers":[{"billed_charge":2082.70,"npi":[1295803377]}]}]}]},{"name":"LAB/BACT-MIRCO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"306","description":"LABORATORY - BACTERIOLOGY & MICROBIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23","20"],"billing_class":"institutional","payments":[{"allowed_amount":105.99,"providers":[{"billed_charge":1121.00,"npi":[1871672618]}]},{"allowed_amount":159.00,"providers":[{"billed_charge":741.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4773.70,"providers":[{"billed_charge":21393.00,"npi":[1790706901]}]},{"allowed_amount":3394.13,"providers":[{"billed_charge":21747.92,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6561.06,"providers":[{"billed_charge":30138.01,"npi":[1831116441]}]},{"allowed_amount":2703.80,"providers":[{"billed_charge":5086.58,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4783.87,"providers":[{"billed_charge":22570.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":16748.39,"providers":[{"billed_charge":64954.00,"npi":[1053356352]}]},{"allowed_amount":142.63,"providers":[{"billed_charge":508.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":427.90,"providers":[{"billed_charge":1456.00,"npi":[1831132133]}]},{"allowed_amount":532.60,"providers":[{"billed_charge":1693.40,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"383176445"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":855.80,"providers":[{"billed_charge":1760.00,"npi":[1639111057]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":416.78,"providers":[{"billed_charge":883.00,"npi":[1811097223]}]},{"allowed_amount":2852.60,"providers":[{"billed_charge":28961.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7846.94,"providers":[{"billed_charge":38184.10,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1308.49,"providers":[{"billed_charge":19206.45,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":14.14,"providers":[{"billed_charge":61.69,"npi":[1962508259]}]},{"allowed_amount":2107.88,"providers":[{"billed_charge":9196.75,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3637.15,"providers":[{"billed_charge":15589.71,"npi":[1083644579]}]},{"allowed_amount":164.68,"providers":[{"billed_charge":315.25,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":155.82,"providers":[{"billed_charge":50811.42,"npi":[1043625940]}]},{"allowed_amount":8085.13,"providers":[{"billed_charge":63908.30,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4758.10,"providers":[{"billed_charge":52958.50,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7779.17,"providers":[{"billed_charge":24749.60,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":427.90,"providers":[{"billed_charge":981.00,"npi":[1992761985]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3198.33,"providers":[{"billed_charge":11156.60,"npi":[1982685384]}]},{"allowed_amount":941.78,"providers":[{"billed_charge":8567.40,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":427.89,"providers":[{"billed_charge":5611.62,"npi":[1073588711]}]},{"allowed_amount":16.16,"providers":[{"billed_charge":100.00,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2353.45,"providers":[{"billed_charge":5220.68,"npi":[1346275856]}]},{"allowed_amount":42.84,"providers":[{"billed_charge":152.94,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":249.86,"providers":[{"billed_charge":526.90,"npi":[1295803377]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2.25,"providers":[{"billed_charge":21.22,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":73.80,"providers":[{"billed_charge":188.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":56.59,"providers":[{"billed_charge":6615.45,"npi":[1043625940]}]},{"allowed_amount":227.41,"providers":[{"billed_charge":24248.80,"npi":[1043625940]}]},{"allowed_amount":39.64,"providers":[{"billed_charge":130.40,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":176.20,"providers":[{"billed_charge":1070.00,"npi":[1790706901]}]},{"allowed_amount":359.30,"providers":[{"billed_charge":3010.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":35.47,"providers":[{"billed_charge":3087.60,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":85.31,"providers":[{"billed_charge":1542.50,"npi":[1982685384]}]},{"allowed_amount":59.16,"providers":[{"billed_charge":242.60,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":32.51,"providers":[{"billed_charge":68.55,"npi":[1295803377]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":161.43,"providers":[{"billed_charge":704.38,"npi":[1962508259]}]}]}]},{"name":"PATHOLOGY LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"310","description":"LABORATORY PATHOLOGICAL - GENERAL CLASSIFIATION","allowed_amounts":[{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4733.88,"providers":[{"billed_charge":6072.00,"npi":[1053356352]}]}]}]},{"name":"DX X-RAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"320","description":"RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":172.54,"providers":[{"billed_charge":775.77,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":272.66,"providers":[{"billed_charge":13627.61,"npi":[1043625940]}]},{"allowed_amount":2089.71,"providers":[{"billed_charge":63662.81,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1108.98,"providers":[{"billed_charge":5263.00,"npi":[1790706901]}]},{"allowed_amount":2703.86,"providers":[{"billed_charge":10837.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1034.20,"providers":[{"billed_charge":7079.13,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":85.85,"providers":[{"billed_charge":16530.20,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":78.15,"providers":[{"billed_charge":34787.00,"npi":[1053356352]}]},{"allowed_amount":93.78,"providers":[{"billed_charge":800.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":995.20,"providers":[{"billed_charge":5306.50,"npi":[1982685384]}]},{"allowed_amount":2189.14,"providers":[{"billed_charge":8112.80,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":407.96,"providers":[{"billed_charge":1490.00,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"382796005"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":136.98,"providers":[{"billed_charge":1107.00,"npi":[1972564730]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":86.27,"providers":[{"billed_charge":357.38,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2059.88,"providers":[{"billed_charge":21942.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":105.36,"providers":[{"billed_charge":459.68,"npi":[1962508259]}]},{"allowed_amount":1169.90,"providers":[{"billed_charge":5104.26,"npi":[1962508259]}]}]}]},{"name":"DX X-RAY/CHEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"324","description":"RADIOLOGY - DIAGNOSTIC - CHEST X-RAY","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4452.54,"providers":[{"billed_charge":15377.00,"npi":[1790706901]}]},{"allowed_amount":1285.24,"providers":[{"billed_charge":9992.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":13113.46,"providers":[{"billed_charge":37965.79,"npi":[1831116441]}]},{"allowed_amount":86.27,"providers":[{"billed_charge":303.69,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6490.50,"providers":[{"billed_charge":17593.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9951.64,"providers":[{"billed_charge":30605.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":277.18,"providers":[{"billed_charge":468.00,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10556.83,"providers":[{"billed_charge":19233.20,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2588.20,"providers":[{"billed_charge":8530.44,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":69.60,"providers":[{"billed_charge":303.69,"npi":[1962508259]}]},{"allowed_amount":1811.70,"providers":[{"billed_charge":7904.70,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5694.04,"providers":[{"billed_charge":15145.24,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":95.07,"providers":[{"billed_charge":39553.88,"npi":[1043625940]}]},{"allowed_amount":6020.05,"providers":[{"billed_charge":37909.56,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"382377821"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2518.64,"providers":[{"billed_charge":3933.00,"npi":[1407877723]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4970.77,"providers":[{"billed_charge":12333.80,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7104.73,"providers":[{"billed_charge":20806.00,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":345.09,"providers":[{"billed_charge":1181.99,"npi":[1346275856]}]}]}]},{"name":"CT SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"350","description":"CT SCAN - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1162.74,"providers":[{"billed_charge":6320.84,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"382377821"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5686.21,"providers":[{"billed_charge":73227.00,"npi":[1407877723]}]},{"allowed_amount":436.71,"providers":[{"billed_charge":4484.00,"npi":[1407877723]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5815.31,"providers":[{"billed_charge":39882.65,"npi":[1831116441]}]},{"allowed_amount":1165.21,"providers":[{"billed_charge":6727.11,"npi":[1831116441]}]}]}]},{"name":"CT SCAN/HEAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"351","description":"CT SCAN - HEAD SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3230.44,"providers":[{"billed_charge":34549.22,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":971.92,"providers":[{"billed_charge":92169.86,"npi":[1043625940]}]},{"allowed_amount":5292.77,"providers":[{"billed_charge":97692.26,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":9259.75,"providers":[{"billed_charge":100094.00,"npi":[1790706901]}]},{"allowed_amount":30255.10,"providers":[{"billed_charge":106044.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":8102.03,"providers":[{"billed_charge":65574.29,"npi":[1831116441]}]},{"allowed_amount":428.39,"providers":[{"billed_charge":6727.26,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6236.93,"providers":[{"billed_charge":122873.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6752.88,"providers":[{"billed_charge":120438.30,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":7290.95,"providers":[{"billed_charge":54096.10,"npi":[1316938327]}]},{"allowed_amount":104.19,"providers":[{"billed_charge":1555.50,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7773.99,"providers":[{"billed_charge":137226.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1513.10,"providers":[{"billed_charge":15630.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15022.80,"providers":[{"billed_charge":109337.70,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":261.63,"providers":[{"billed_charge":7541.25,"npi":[1306227764]}]}]}]},{"name":"CT SCAN/BODY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"CT SCAN - BODY SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":15601.82,"providers":[{"billed_charge":189946.00,"npi":[1790706901]}]},{"allowed_amount":55373.79,"providers":[{"billed_charge":356064.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":10473.46,"providers":[{"billed_charge":156157.24,"npi":[1831116441]}]},{"allowed_amount":1011.32,"providers":[{"billed_charge":13666.22,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15807.48,"providers":[{"billed_charge":290553.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":104.19,"providers":[{"billed_charge":6529.00,"npi":[1053356352]}]},{"allowed_amount":23144.50,"providers":[{"billed_charge":471140.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":6689.82,"providers":[{"billed_charge":118464.00,"npi":[1811097223]}]},{"allowed_amount":363.26,"providers":[{"billed_charge":4360.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":24582.39,"providers":[{"billed_charge":281340.80,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5614.73,"providers":[{"billed_charge":82903.25,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3015.67,"providers":[{"billed_charge":13157.38,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9904.19,"providers":[{"billed_charge":124582.96,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":12174.70,"providers":[{"billed_charge":216237.67,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"382689033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1379.76,"providers":[{"billed_charge":9473.90,"npi":[1205824737]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":106.73,"providers":[{"billed_charge":1532.10,"npi":[1902894512]}]},{"allowed_amount":17267.53,"providers":[{"billed_charge":251039.60,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13543.72,"providers":[{"billed_charge":80706.60,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2313.30,"providers":[{"billed_charge":42365.00,"npi":[1992761985]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2889.51,"providers":[{"billed_charge":32239.60,"npi":[1982685384]}]},{"allowed_amount":4066.18,"providers":[{"billed_charge":42232.00,"npi":[1982685384]}]}]}]},{"name":"OR SERVICES","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"360","description":"OPERATING ROOM SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":16694.41,"providers":[{"billed_charge":29588.40,"npi":[1831116441]}]},{"allowed_amount":10946.67,"providers":[{"billed_charge":27354.73,"npi":[1831116441]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"382311840"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":236.34,"providers":[{"billed_charge":260.00,"npi":[1255499257]}]}]},{"tin":{"type":"ein","value":"383246949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":200.00,"providers":[{"billed_charge":200.00,"npi":[1376593228]}]}]},{"tin":{"type":"ein","value":"383352287"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.63,"providers":[{"billed_charge":140.00,"npi":[1821188426]}]}]},{"tin":{"type":"ein","value":"853595065"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":299.97,"providers":[{"billed_charge":495.00,"npi":[1295227460]}]}]},{"tin":{"type":"ein","value":"383593303"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":236.40,"providers":[{"billed_charge":320.00,"npi":[1669035366]}]}]},{"tin":{"type":"ein","value":"383232366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.30,"providers":[{"billed_charge":75.00,"npi":[1164898722]}]},{"allowed_amount":46.32,"providers":[{"billed_charge":180.00,"npi":[1649520784,1144990938]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":327.24,"providers":[{"billed_charge":720.00,"npi":[1114330974]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10047.38,"providers":[{"billed_charge":14392.00,"npi":[1053314146]}]}]},{"tin":{"type":"ein","value":"382257883"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":72.72,"providers":[{"billed_charge":120.00,"npi":[1629459904]}]},{"allowed_amount":199.98,"providers":[{"billed_charge":330.00,"npi":[1346693413]}]}]},{"tin":{"type":"ein","value":"852032491"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":18.20,"providers":[{"billed_charge":120.00,"npi":[1275024606]}]}]},{"tin":{"type":"ein","value":"474895529"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.65,"providers":[{"billed_charge":50.00,"npi":[1245982909]}]},{"allowed_amount":123.68,"providers":[{"billed_charge":160.00,"npi":[1154032670]}]},{"allowed_amount":30.92,"providers":[{"billed_charge":40.00,"npi":[1629753223]}]}]}]},{"name":"ANESTHESIA","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"370","description":"ANESTHESIA - GENERAL CLASSIFICATIION","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":477.70,"providers":[{"billed_charge":3061.70,"npi":[1043625940]}]}]}]},{"name":"ULTRASOUND","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"402","description":"OTHER IMAGING SERVICES - ULTRASOUND","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1641.03,"providers":[{"billed_charge":12468.13,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1591.88,"providers":[{"billed_charge":18298.70,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1028.72,"providers":[{"billed_charge":9532.00,"npi":[1790706901]}]},{"allowed_amount":86.31,"providers":[{"billed_charge":553.00,"npi":[1790706901]}]},{"allowed_amount":4988.43,"providers":[{"billed_charge":21047.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3438.34,"providers":[{"billed_charge":24288.69,"npi":[1831116441]}]},{"allowed_amount":104.19,"providers":[{"billed_charge":2073.86,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":627.12,"providers":[{"billed_charge":5799.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1761.02,"providers":[{"billed_charge":17600.80,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1406.61,"providers":[{"billed_charge":19324.90,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3516.51,"providers":[{"billed_charge":48836.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":260.48,"providers":[{"billed_charge":1154.50,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":547.01,"providers":[{"billed_charge":2847.70,"npi":[1376564088]}]}]}]},{"name":"RESPIRATORY SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"410","description":"RESPIRATORY SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":171.30,"providers":[{"billed_charge":571.00,"npi":[1790706901]}]}]}]},{"name":"INHALATION SVC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"412","description":"RESPIRATORY SERVICES - INHALATION SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":111.74,"providers":[{"billed_charge":14698.06,"npi":[1043625940]}]}]}]},{"name":"PHYSICAL THERP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"420","description":"PHYSICAL THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":108.43,"providers":[{"billed_charge":572.20,"npi":[1831116441]}]}]}]},{"name":"PHYS THERP/VISIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"421","description":"PHYSICAL THERAPY/VISIT","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":96.28,"providers":[{"billed_charge":3347.00,"npi":[1790706901]}]},{"allowed_amount":78.30,"providers":[{"billed_charge":290.00,"npi":[1790706901]}]}]}]},{"name":"PHYS THERP/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"424","description":"PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":152.71,"providers":[{"billed_charge":334.00,"npi":[1790706901]}]},{"allowed_amount":207.16,"providers":[{"billed_charge":3744.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":94.06,"providers":[{"billed_charge":257.50,"npi":[1831116441]}]}]}]},{"name":"OCCUP THERP/VISIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"431","description":"OCCUPATIONAL THERAPY - VISIT CHARGE","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":39.15,"providers":[{"billed_charge":145.00,"npi":[1790706901]}]},{"allowed_amount":226.68,"providers":[{"billed_charge":2775.00,"npi":[1790706901]}]}]}]},{"name":"OCCUP THERP/EVAL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"434","description":"OCCUPATIONAL THERAPY - EVALUATION OR RE-EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":201.98,"providers":[{"billed_charge":700.00,"npi":[1790706901]}]},{"allowed_amount":562.44,"providers":[{"billed_charge":4165.00,"npi":[1790706901]}]}]}]},{"name":"EMERG ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31099.25,"providers":[{"billed_charge":41628.00,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":507432.78,"providers":[{"billed_charge":1027651.00,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":28472.61,"providers":[{"billed_charge":43334.00,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"383369438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15754.24,"providers":[{"billed_charge":19672.00,"npi":[1588656946]}]}]},{"tin":{"type":"ein","value":"380593405"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5023.16,"providers":[{"billed_charge":10293.00,"npi":[1619923919]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":56365.06,"providers":[{"billed_charge":245919.46,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"381358208"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8404.65,"providers":[{"billed_charge":40317.75,"npi":[1063414233]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1866.11,"providers":[{"billed_charge":448825.01,"npi":[1043625940]}]},{"allowed_amount":269854.69,"providers":[{"billed_charge":1852578.08,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6260.24,"providers":[{"billed_charge":11179.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"382689033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23466.84,"providers":[{"billed_charge":49017.00,"npi":[1205824737]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":201412.40,"providers":[{"billed_charge":536606.30,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":362024.32,"providers":[{"billed_charge":316424.30,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":13865.45,"providers":[{"billed_charge":94549.10,"npi":[1982685384]}]},{"allowed_amount":159903.90,"providers":[{"billed_charge":247284.90,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17588.02,"providers":[{"billed_charge":56031.00,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":91653.69,"providers":[{"billed_charge":200320.09,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20942.40,"providers":[{"billed_charge":44163.95,"npi":[1295803377]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":28026.79,"providers":[{"billed_charge":152546.00,"npi":[1790706901]}]},{"allowed_amount":194493.11,"providers":[{"billed_charge":541504.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":499045.10,"providers":[{"billed_charge":1013761.78,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":275350.35,"providers":[{"billed_charge":542418.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5642.00,"providers":[{"billed_charge":12698.00,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"383176445"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":54419.11,"providers":[{"billed_charge":98697.00,"npi":[1639111057]}]}]},{"tin":{"type":"ein","value":"383176225"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11842.07,"providers":[{"billed_charge":28527.00,"npi":[1093748642]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":527992.96,"providers":[{"billed_charge":750581.70,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":105074.73,"providers":[{"billed_charge":298356.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":103690.52,"providers":[{"billed_charge":306630.82,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":320458.81,"providers":[{"billed_charge":587306.50,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"382377821"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":113334.90,"providers":[{"billed_charge":242672.00,"npi":[1407877723]}]},{"allowed_amount":939.00,"providers":[{"billed_charge":66966.00,"npi":[1407877723]}]}]},{"tin":{"type":"ein","value":"471161992"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13963.03,"providers":[{"billed_charge":32617.00,"npi":[1083010953]}]}]},{"tin":{"type":"ein","value":"386108110"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5952.75,"providers":[{"billed_charge":13837.00,"npi":[1063471639]}]}]},{"tin":{"type":"ein","value":"381976271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6170.79,"providers":[{"billed_charge":11951.30,"npi":[1528031226]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":55206.48,"providers":[{"billed_charge":129775.00,"npi":[1992761985]}]}]},{"tin":{"type":"ein","value":"382796005"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10575.86,"providers":[{"billed_charge":31191.00,"npi":[1972564730]}]}]},{"tin":{"type":"ein","value":"381362830"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7021.08,"providers":[{"billed_charge":8689.00,"npi":[1952307852]}]}]}]},{"name":"URGENT CARE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"456","description":"EMERGENCY ROOM - URGENT CARE","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":757.65,"providers":[{"billed_charge":1847.00,"npi":[1871672618]}]}]}]},{"name":"ECHOCARDIOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"483","description":"CARDIOLOGY - ECHOCARDIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":195.58,"providers":[{"billed_charge":5086.90,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1649.62,"providers":[{"billed_charge":7580.00,"npi":[1790706901]}]}]}]},{"name":"CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"510","description":"CLINIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"382589966"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1239.82,"providers":[{"billed_charge":1457.00,"npi":[1831132133]}]}]}]},{"name":"AMBULANCE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"540","description":"AMBULANCE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"381738615"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5406.20,"providers":[{"billed_charge":13539.90,"npi":[1497750608]}]}]}]},{"name":"SKILLED NURSE/VISIT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"551","description":"SKILLED NURSING - VISIT CHARGE","allowed_amounts":[{"tin":{"type":"ein","value":"832473075"},"service_code":["12"],"billing_class":"institutional","payments":[{"allowed_amount":930.00,"providers":[{"billed_charge":8250.00,"npi":[1811461734]}]}]}]},{"name":"DRUG/DETAIL CODE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"DRUGS REQ SPEC IDENTIFICATION - DRUGS REQ DETAILED CODING*","allowed_amounts":[{"tin":{"type":"ein","value":"382800065"},"service_code":["23","20"],"billing_class":"institutional","payments":[{"allowed_amount":1.00,"providers":[{"billed_charge":42.30,"npi":[1871672618]}]},{"allowed_amount":10.42,"providers":[{"billed_charge":3920.35,"npi":[1871672618]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6609.14,"providers":[{"billed_charge":47424.65,"npi":[1053356352]}]}]},{"tin":{"type":"ein","value":"382589966"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":992.64,"providers":[{"billed_charge":4718.35,"npi":[1831132133]}]},{"allowed_amount":102.90,"providers":[{"billed_charge":898.65,"npi":[1831132133]}]}]},{"tin":{"type":"ein","value":"383369438"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8.63,"providers":[{"billed_charge":2252.09,"npi":[1588656946]}]}]},{"tin":{"type":"ein","value":"380593405"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1.15,"providers":[{"billed_charge":382.00,"npi":[1619923919]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2223.74,"providers":[{"billed_charge":9702.32,"npi":[1962508259]}]},{"allowed_amount":22.38,"providers":[{"billed_charge":97.63,"npi":[1962508259]}]}]},{"tin":{"type":"ein","value":"382007629"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":206.07,"providers":[{"billed_charge":646.64,"npi":[1942254529]}]}]},{"tin":{"type":"ein","value":"381358208"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1.45,"providers":[{"billed_charge":1130.26,"npi":[1063414233]}]}]},{"tin":{"type":"ein","value":"464719451"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":397.60,"providers":[{"billed_charge":284643.27,"npi":[1043625940]}]},{"allowed_amount":1147.83,"providers":[{"billed_charge":6414.49,"npi":[1043625940]}]},{"allowed_amount":5371.32,"providers":[{"billed_charge":98507.76,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381738615"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":301.84,"providers":[{"billed_charge":539.00,"npi":[1497750608]}]}]},{"tin":{"type":"ein","value":"382689033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":23.83,"providers":[{"billed_charge":3363.57,"npi":[1205824737]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":142.21,"providers":[{"billed_charge":12730.26,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3897.90,"providers":[{"billed_charge":34380.44,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1641.04,"providers":[{"billed_charge":23073.25,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381360584"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.35,"providers":[{"billed_charge":3824.41,"npi":[1073588711]}]}]},{"tin":{"type":"ein","value":"381676780"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1017.98,"providers":[{"billed_charge":9409.85,"npi":[1346275856]}]}]},{"tin":{"type":"ein","value":"381359180"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2754.06,"providers":[{"billed_charge":5808.05,"npi":[1295803377]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3227.84,"providers":[{"billed_charge":17730.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":28406.68,"providers":[{"billed_charge":166351.03,"npi":[1831116441]}]},{"allowed_amount":2811.49,"providers":[{"billed_charge":63102.88,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"381434090"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":51.38,"providers":[{"billed_charge":171.28,"npi":[1134104672]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17965.31,"providers":[{"billed_charge":48178.15,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"350868157"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":160.47,"providers":[{"billed_charge":753.80,"npi":[1841245594]}]}]},{"tin":{"type":"ein","value":"383176225"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13.59,"providers":[{"billed_charge":1252.12,"npi":[1093748642]}]}]},{"tin":{"type":"ein","value":"383176445"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":39.68,"providers":[{"billed_charge":2055.35,"npi":[1639111057]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":11312.61,"providers":[{"billed_charge":53108.42,"npi":[1376564088]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1.00,"providers":[{"billed_charge":195.00,"npi":[1811097223]}]},{"allowed_amount":4378.79,"providers":[{"billed_charge":13966.00,"npi":[1811097223]}]}]},{"tin":{"type":"ein","value":"472361878"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":119.35,"providers":[{"billed_charge":34690.22,"npi":[1306227764]}]}]},{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":204.97,"providers":[{"billed_charge":28547.74,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"471161992"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2.85,"providers":[{"billed_charge":384.90,"npi":[1083010953]}]}]},{"tin":{"type":"ein","value":"386108110"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3.50,"providers":[{"billed_charge":233.00,"npi":[1063471639]}]}]},{"tin":{"type":"ein","value":"381976271"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4125.41,"providers":[{"billed_charge":11148.62,"npi":[1528031226]}]}]},{"tin":{"type":"ein","value":"824757260"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9243.07,"providers":[{"billed_charge":37170.30,"npi":[1992761985]}]}]},{"tin":{"type":"ein","value":"382796005"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13.88,"providers":[{"billed_charge":554.00,"npi":[1972564730]}]}]}]},{"name":"HOSPICE/RTN HOME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"651","description":"HOSPICE SERVICES - ROUTINE HOME CARE","allowed_amounts":[{"tin":{"type":"ein","value":"341788398"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":6981.00,"providers":[{"billed_charge":6981.00,"npi":[1114627890]}]}]}]},{"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":"381859770"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":79.38,"providers":[{"billed_charge":230.00,"npi":[1104260603,1326422528]}]},{"allowed_amount":938.61,"providers":[{"billed_charge":2875.00,"npi":[1104260603]}]},{"allowed_amount":220.26,"providers":[{"billed_charge":690.00,"npi":[1104260603]}]}]}]},{"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":"381859770"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":306.86,"providers":[{"billed_charge":954.00,"npi":[1104260603]}]},{"allowed_amount":107.67,"providers":[{"billed_charge":318.00,"npi":[1104260603]}]}]}]},{"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":"934891173"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":77.70,"providers":[{"billed_charge":150.00,"npi":[1265457485]}]},{"allowed_amount":12.95,"providers":[{"billed_charge":25.00,"npi":[1487090213]}]},{"allowed_amount":219.03,"providers":[{"billed_charge":425.00,"npi":[1265457485]}]},{"allowed_amount":38.29,"providers":[{"billed_charge":75.00,"npi":[1386904704]}]},{"allowed_amount":25.90,"providers":[{"billed_charge":50.00,"npi":[1386904704,1306188081]}]}]},{"tin":{"type":"ein","value":"381850302"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":17.26,"providers":[{"billed_charge":66.00,"npi":[1396769378]}]},{"allowed_amount":25.89,"providers":[{"billed_charge":99.00,"npi":[1396769378]}]}]},{"tin":{"type":"ein","value":"386005601"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":33.04,"providers":[{"billed_charge":84.00,"npi":[1659687408]}]},{"allowed_amount":156.94,"providers":[{"billed_charge":399.00,"npi":[1518157478]}]},{"allowed_amount":90.86,"providers":[{"billed_charge":231.00,"npi":[1659687408]}]},{"allowed_amount":16.52,"providers":[{"billed_charge":42.00,"npi":[1518157478]}]},{"allowed_amount":140.42,"providers":[{"billed_charge":357.00,"npi":[1518157478,1659687408]}]}]},{"tin":{"type":"ein","value":"382492131"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":24.78,"providers":[{"billed_charge":54.00,"npi":[1336137264]}]},{"allowed_amount":12.39,"providers":[{"billed_charge":27.00,"npi":[1336137264]}]}]},{"tin":{"type":"ein","value":"381693395"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":8.63,"providers":[{"billed_charge":29.00,"npi":[1255384590]}]}]}]},{"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":"934891173"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":14.78,"providers":[{"billed_charge":30.00,"npi":[1265457485]}]}]},{"tin":{"type":"ein","value":"381894009"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":92.16,"providers":[{"billed_charge":234.00,"npi":[1942648662]}]},{"allowed_amount":20.48,"providers":[{"billed_charge":52.00,"npi":[1942648662]}]},{"allowed_amount":10.24,"providers":[{"billed_charge":26.00,"npi":[1942648662]}]}]},{"tin":{"type":"ein","value":"381357020"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":41.46,"providers":[{"billed_charge":120.00,"npi":[1881981652]}]}]},{"tin":{"type":"ein","value":"386005601"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":39.40,"providers":[{"billed_charge":84.00,"npi":[1659687408]}]},{"allowed_amount":19.70,"providers":[{"billed_charge":42.00,"npi":[1659687408]}]},{"allowed_amount":29.55,"providers":[{"billed_charge":63.00,"npi":[1659687408]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":32.81,"providers":[{"billed_charge":90.00,"npi":[1114330974]}]}]},{"tin":{"type":"ein","value":"383612247"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":15.36,"providers":[{"billed_charge":28.00,"npi":[1013171941,1619289501]}]},{"allowed_amount":30.72,"providers":[{"billed_charge":56.00,"npi":[1619289501]}]}]}]},{"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":"381859770"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":186.65,"providers":[{"billed_charge":636.00,"npi":[1104260603]}]},{"allowed_amount":58.76,"providers":[{"billed_charge":212.00,"npi":[1104260603]}]}]}]},{"name":"EKG/ECG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"730","description":"EKG/ECG - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":172.28,"providers":[{"billed_charge":37761.60,"npi":[1043625940]}]},{"allowed_amount":857.60,"providers":[{"billed_charge":44448.55,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1826.88,"providers":[{"billed_charge":10527.00,"npi":[1790706901]}]},{"allowed_amount":5158.06,"providers":[{"billed_charge":27051.00,"npi":[1790706901]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":274.29,"providers":[{"billed_charge":10412.00,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":58.20,"providers":[{"billed_charge":213.80,"npi":[1316938327]}]}]},{"tin":{"type":"ein","value":"381369611"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":591.60,"providers":[{"billed_charge":1356.00,"npi":[1982685384]}]},{"allowed_amount":111.18,"providers":[{"billed_charge":3616.00,"npi":[1982685384]}]}]},{"tin":{"type":"ein","value":"381359218"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1519.81,"providers":[{"billed_charge":6739.40,"npi":[1962508259]}]}]}]},{"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":"386005601"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":164.22,"providers":[{"billed_charge":344.00,"npi":[1659687408]}]}]},{"tin":{"type":"ein","value":"381693395"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":599.55,"providers":[{"billed_charge":2093.00,"npi":[1457734162]}]},{"allowed_amount":171.30,"providers":[{"billed_charge":598.00,"npi":[1578981080]}]},{"allowed_amount":85.65,"providers":[{"billed_charge":299.00,"npi":[1457734162,1578981080]}]}]}]},{"name":"TREATMENT ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"761","description":"TREATMENT OR OBSERVATION ROOM - TREATMENT ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"382776791"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":309.65,"providers":[{"billed_charge":4154.16,"npi":[1083644579]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2574.87,"providers":[{"billed_charge":3563.70,"npi":[1831116441]}]},{"allowed_amount":9280.99,"providers":[{"billed_charge":29258.39,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"382796005"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1710.68,"providers":[{"billed_charge":1604.00,"npi":[1972564730]}]}]},{"tin":{"type":"ein","value":"381984289"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13678.34,"providers":[{"billed_charge":50298.00,"npi":[1811097223]}]}]}]},{"name":"OBSERVATION ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"762","description":"TREATMENT OR OBSERVATION ROOM - OBSERVATION ROOM","allowed_amounts":[{"tin":{"type":"ein","value":"383521763"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":860.54,"providers":[{"billed_charge":11132.00,"npi":[1790706901]}]},{"allowed_amount":10693.20,"providers":[{"billed_charge":73154.00,"npi":[1790706901]}]}]}]},{"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":"383545312"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.36,"providers":[{"billed_charge":426.00,"npi":[1467912477]}]}]}]},{"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":"381951356"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1003.44,"providers":[{"billed_charge":1848.00,"npi":[1831545953]}]}]},{"tin":{"type":"ein","value":"382286062"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":54.06,"providers":[{"billed_charge":96.00,"npi":[1033110549]}]}]},{"tin":{"type":"ein","value":"880602985"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":385.18,"providers":[{"billed_charge":1650.00,"npi":[1548279763]}]},{"allowed_amount":378.42,"providers":[{"billed_charge":1540.00,"npi":[1548279763]}]}]},{"tin":{"type":"ein","value":"381850302"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":647.45,"providers":[{"billed_charge":805.00,"npi":[1396769378]}]}]},{"tin":{"type":"ein","value":"383612247"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":717.91,"providers":[{"billed_charge":1581.00,"npi":[1982774469]}]}]}]},{"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":"381951356"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1273.95,"providers":[{"billed_charge":1752.00,"npi":[1831545953]}]}]},{"tin":{"type":"ein","value":"382286062"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":68.70,"providers":[{"billed_charge":148.00,"npi":[1033110549]}]}]},{"tin":{"type":"ein","value":"880602985"},"service_code":["22","19"],"billing_class":"professional","payments":[{"allowed_amount":480.90,"providers":[{"billed_charge":1904.00,"npi":[1548279763]}]},{"allowed_amount":515.25,"providers":[{"billed_charge":2040.00,"npi":[1548279763]}]}]},{"tin":{"type":"ein","value":"381850302"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":823.63,"providers":[{"billed_charge":2875.00,"npi":[1396769378]}]}]},{"tin":{"type":"ein","value":"383612247"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":913.24,"providers":[{"billed_charge":1785.00,"npi":[1982774469]}]}]}]},{"name":"HT MUSCLE IMAGE SPECT MULT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"78452","description":"MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT) (INCL ATTENUATION CORRECTION, QUALITATIVE OR QUANT","allowed_amounts":[{"tin":{"type":"ein","value":"381859770"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":428.22,"providers":[{"billed_charge":1350.00,"npi":[1952716862]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":698.98,"providers":[{"billed_charge":2511.60,"npi":[1053314146]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80053","description":"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17610.56,"providers":[{"billed_charge":65232.56,"npi":[1053314146]}]}]}]},{"name":"LIPID PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80061","description":"LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DI","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21892.74,"providers":[{"billed_charge":76758.19,"npi":[1053314146]}]}]}]},{"name":"RENAL FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80069","description":"RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":85.02,"providers":[{"billed_charge":416.00,"npi":[1053314146]}]}]}]},{"name":"ACUTE HEPATITIS PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80074","description":"ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6967.74,"providers":[{"billed_charge":25038.00,"npi":[1053314146]}]}]}]},{"name":"HEPATIC FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80076","description":"HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.94,"providers":[{"billed_charge":923.80,"npi":[1053314146]}]}]}]},{"name":"DRUG TEST PRSMV DIR OPT OBS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80305","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE","allowed_amounts":[{"tin":{"type":"ein","value":"813667937"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12.60,"providers":[{"billed_charge":25.00,"npi":[1538422548]}]}]},{"tin":{"type":"ein","value":"382374946"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":289.80,"providers":[{"billed_charge":460.00,"npi":[1265503031]}]}]}]},{"name":"DRUG TEST PRSMV CHEM ANLYZR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80307","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR","allowed_amounts":[{"tin":{"type":"ein","value":"474715923"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":466.05,"providers":[{"billed_charge":1500.00,"npi":[1144606542]}]},{"allowed_amount":15907.84,"providers":[{"billed_charge":51200.00,"npi":[1144606542]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":22027.81,"providers":[{"billed_charge":46260.00,"npi":[1053314146]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1274.62,"providers":[{"billed_charge":7920.00,"npi":[1053314146]}]}]}]},{"name":"URINALYSIS NONAUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81002","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"383589415"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.04,"providers":[{"billed_charge":253.00,"npi":[1558354159]}]}]},{"tin":{"type":"ein","value":"853275263"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":8.88,"providers":[{"billed_charge":30.00,"npi":[1043656135]}]}]},{"tin":{"type":"ein","value":"475372624"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":32.56,"providers":[{"billed_charge":110.00,"npi":[1245936012]}]},{"allowed_amount":2.96,"providers":[{"billed_charge":10.00,"npi":[1245936012]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":247.50,"providers":[{"billed_charge":4620.00,"npi":[1114330974]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":723.24,"providers":[{"billed_charge":3528.00,"npi":[1114330974]}]}]}]},{"name":"FETAL CHRMOML ANEUPLOIDY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81420","description":"FETAL CHROMOSOMAL ANEUPLOIDY (EG, TRISOMY 21, MONOSOMY X) GENOMIC SEQUENCE ANALYSIS PANEL, CIRCULATI","allowed_amounts":[{"tin":{"type":"ein","value":"811082020"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18217.22,"providers":[{"billed_charge":78941.20,"npi":[1598314437]}]}]}]},{"name":"HEMO/OP OR HOME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"820","description":"HEMODIALYSIS - OUTPT OR HOME - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"381359087"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5141.80,"providers":[{"billed_charge":4845.00,"npi":[1831116441]}]}]}]},{"name":"ASSAY OF SERUM ALBUMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82040","description":"ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":533.20,"providers":[{"billed_charge":1974.00,"npi":[1053314146]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1790.97,"providers":[{"billed_charge":7362.00,"npi":[1053314146]}]}]}]},{"name":"HEMO/COMPOSITE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"821","description":"HEMODIALYSIS - OUTPT OR HOME - HEMODIALYSIS/COMPOSITE RATE","allowed_amounts":[{"tin":{"type":"ein","value":"42516906"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":922.00,"providers":[{"billed_charge":8832.00,"npi":[1760645139]}]},{"allowed_amount":296.09,"providers":[{"billed_charge":8832.00,"npi":[1699275487]}]},{"allowed_amount":1483.47,"providers":[{"billed_charge":44160.00,"npi":[1871608612]}]}]},{"tin":{"type":"ein","value":"900754081"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":2968.58,"providers":[{"billed_charge":70656.00,"npi":[1417055542]}]}]},{"tin":{"type":"ein","value":"364525442"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":5866.94,"providers":[{"billed_charge":176640.00,"npi":[1407897465]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":170.30,"providers":[{"billed_charge":612.00,"npi":[1053314146]}]}]}]},{"name":"BILIRUBIN, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82247","description":"BILIRUBIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":550.70,"providers":[{"billed_charge":2002.00,"npi":[1053314146]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":436.12,"providers":[{"billed_charge":1624.00,"npi":[1053314146]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25535.92,"providers":[{"billed_charge":90173.60,"npi":[1053314146]}]}]}]},{"name":"CARCINOEMBRYONIC ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82378","description":"CARCINOEMBRYONIC ANTIGEN (CEA)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":109.98,"providers":[{"billed_charge":432.00,"npi":[1053314146]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":392.83,"providers":[{"billed_charge":1472.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF CK (CPK)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82550","description":"CREATINE KINASE (CK), (CPK); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":326.31,"providers":[{"billed_charge":1254.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF URINE CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82570","description":"CREATININE; OTHER SOURCE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1050.60,"providers":[{"billed_charge":1722.50,"npi":[1053314146]}]}]}]},{"name":"VITAMIN B-12","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82607","description":"CYANOCOBALAMIN (VITAMIN B-12);","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10065.82,"providers":[{"billed_charge":39147.08,"npi":[1053314146]}]}]}]},{"name":"DEHYDROEPIANDROSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82627","description":"DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1026.84,"providers":[{"billed_charge":3780.00,"npi":[1053314146]}]}]}]},{"name":"VIT D 1 25-DIHYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82652","description":"VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4924.15,"providers":[{"billed_charge":15744.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF ESTRADIOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82670","description":"ESTRADIOL","allowed_amounts":[{"tin":{"type":"ein","value":"383352287"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":139.70,"providers":[{"billed_charge":165.00,"npi":[1821188426]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2559.09,"providers":[{"billed_charge":9282.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3312.50,"providers":[{"billed_charge":12015.60,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF FOLIC ACID SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82746","description":"FOLIC ACID; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2191.77,"providers":[{"billed_charge":8173.20,"npi":[1053314146]}]}]}]},{"name":"ASSAY IGA/IGD/IGG/IGM EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82784","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":170.19,"providers":[{"billed_charge":720.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY, GLUCOSE, BLOOD QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82947","description":"GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":159.03,"providers":[{"billed_charge":594.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF GGT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82977","description":"GLUTAMYLTRANSFERASE, GAMMA (GGT)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":223.92,"providers":[{"billed_charge":800.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (FSH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83001","description":"GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1942.98,"providers":[{"billed_charge":7051.20,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF GONADOTROPIN (LH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83002","description":"GONADOTROPIN; LUTEINIZING HORMONE (LH)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1717.24,"providers":[{"billed_charge":6219.20,"npi":[1053314146]}]}]}]},{"name":"H PYLORI (C-13), BREATH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83013","description":"HELICOBACTER PYLORI; BREATH TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (EG, C-13)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":249.24,"providers":[{"billed_charge":920.00,"npi":[1053314146]}]}]}]},{"name":"HEMOGLOBIN ELECTROPHORESIS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83020","description":"HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (EG, A2, S, C, AND/OR F)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":227.90,"providers":[{"billed_charge":1200.00,"npi":[1053314146]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13952.76,"providers":[{"billed_charge":59824.11,"npi":[1053314146]}]}]}]},{"name":"IG LIGHT CHAINS FREE EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83521","description":"IMMUNOGLOBULIN LIGHT CHAINS FREE EACH","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":55.26,"providers":[{"billed_charge":128.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF INSULIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83525","description":"INSULIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":297.08,"providers":[{"billed_charge":1700.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2461.30,"providers":[{"billed_charge":11915.27,"npi":[1053314146]}]}]}]},{"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":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1965.10,"providers":[{"billed_charge":6988.80,"npi":[1053314146]}]}]}]},{"name":"LACTATE (LD) (LDH) ENZYME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83615","description":"LACTATE DEHYDROGENASE (LD), (LDH);","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":108.68,"providers":[{"billed_charge":401.20,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF LIPASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83690","description":"LIPASE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":276.22,"providers":[{"billed_charge":1092.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1987.22,"providers":[{"billed_charge":7806.70,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF NATRIURETIC PEPTIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83880","description":"NATRIURETIC PEPTIDE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":459.37,"providers":[{"billed_charge":1500.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PARATHORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83970","description":"PARATHORMONE (PARATHYROID HORMONE)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1576.72,"providers":[{"billed_charge":5800.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY ALKALINE PHOSPHATASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84075","description":"PHOSPHATASE, ALKALINE;","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":573.46,"providers":[{"billed_charge":2044.00,"npi":[1053314146]}]}]}]},{"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":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":792.62,"providers":[{"billed_charge":2640.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PROGESTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84144","description":"PROGESTERONE","allowed_amounts":[{"tin":{"type":"ein","value":"383352287"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":83.44,"providers":[{"billed_charge":88.00,"npi":[1821188426]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":638.38,"providers":[{"billed_charge":2496.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1730.21,"providers":[{"billed_charge":7130.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PSA, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84153","description":"PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6226.32,"providers":[{"billed_charge":17680.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PSA, FREE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84154","description":"PROSTATE SPECIFIC ANTIGEN (PSA); FREE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":448.68,"providers":[{"billed_charge":1600.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PROTEIN SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84155","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":417.90,"providers":[{"billed_charge":1650.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF PROTEIN, URINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84156","description":"PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":182.68,"providers":[{"billed_charge":804.00,"npi":[1053314146]}]}]}]},{"name":"PROTEIN E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84165","description":"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":205.09,"providers":[{"billed_charge":1625.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF SEX HORMONE GLOBUL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84270","description":"SEX HORMONE BINDING GLOBULIN (SHBG)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3213.33,"providers":[{"billed_charge":9730.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF TOTAL TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84403","description":"TESTOSTERONE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6355.18,"providers":[{"billed_charge":23155.20,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF TOTAL THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84436","description":"THYROXINE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":310.76,"providers":[{"billed_charge":1146.87,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7255.76,"providers":[{"billed_charge":42224.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY THYROID STIM HORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84443","description":"THYROID STIMULATING HORMONE (TSH)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":26176.08,"providers":[{"billed_charge":97284.00,"npi":[1053314146]}]}]}]},{"name":"TRANSFERASE (AST) (SGOT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84450","description":"TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":762.86,"providers":[{"billed_charge":2710.40,"npi":[1053314146]}]}]}]},{"name":"ALANINE AMINO (ALT) (SGPT)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84460","description":"TRANSFERASE; ALANINE AMINO (ALT) (SGPT)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":784.93,"providers":[{"billed_charge":2696.40,"npi":[1053314146]}]}]}]},{"name":"ASSAY OF TRANSFERRIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84466","description":"TRANSFERRIN","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":81.68,"providers":[{"billed_charge":272.00,"npi":[1053314146]}]}]}]},{"name":"ASSAY, TRIIODOTHYRONINE (T3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84480","description":"TRIIODOTHYRONINE T3; TOTAL (TT-3)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2594.10,"providers":[{"billed_charge":9600.00,"npi":[1053314146]}]}]}]},{"name":"FREE ASSAY (FT-3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84481","description":"TRIIODOTHYRONINE T3; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2583.00,"providers":[{"billed_charge":9600.00,"npi":[1053314146]}]}]}]},{"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":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1950.14,"providers":[{"billed_charge":7826.00,"npi":[1053314146]}]}]}]},{"name":"CHORIONIC GONADOTROPIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84702","description":"GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1846.75,"providers":[{"billed_charge":4050.00,"npi":[1053314146]}]}]}]},{"name":"COMPLETE CBC W/AUTO DIFF WBC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85025","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11545.65,"providers":[{"billed_charge":48427.77,"npi":[1053314146]}]}]}]},{"name":"COMPLETE CBC, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85027","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1148.76,"providers":[{"billed_charge":3068.00,"npi":[1053314146]}]}]}]},{"name":"AUTOMATED RETICULOCYTE COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85045","description":"BLOOD COUNT; RETICULOCYTE, AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":46.66,"providers":[{"billed_charge":241.40,"npi":[1053314146]}]}]}]},{"name":"PROTHROMBIN TIME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85610","description":"PROTHROMBIN TIME;","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":135.10,"providers":[{"billed_charge":672.00,"npi":[1053314146]}]}]}]},{"name":"RBC SED RATE, AUTOMATED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85652","description":"SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":361.80,"providers":[{"billed_charge":1920.60,"npi":[1053314146]}]}]}]},{"name":"THROMBOPLASTIN TIME, PARTIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85730","description":"THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":54.12,"providers":[{"billed_charge":264.00,"npi":[1053314146]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86038","description":"ANTINUCLEAR ANTIBODIES (ANA);","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":506.51,"providers":[{"billed_charge":2457.00,"npi":[1053314146]}]}]}]},{"name":"C-REACTIVE PROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86140","description":"C-REACTIVE PROTEIN;","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":211.16,"providers":[{"billed_charge":810.00,"npi":[1053314146]}]}]}]},{"name":"C-REACTIVE PROTEIN, HS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86141","description":"C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":411.84,"providers":[{"billed_charge":1554.00,"npi":[1053314146]}]}]}]},{"name":"CCP ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86200","description":"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":79.00,"providers":[{"billed_charge":400.00,"npi":[1053314146]}]}]}]},{"name":"DNA ANTIBODY NATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86225","description":"DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":504.17,"providers":[{"billed_charge":1598.00,"npi":[1053314146]}]}]}]},{"name":"NUCLEAR ANTIGEN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86235","description":"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5477.54,"providers":[{"billed_charge":16464.00,"npi":[1053314146]}]}]}]},{"name":"IMMUNOFIX E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86334","description":"IMMUNOFIXATION ELECTROPHORESIS; SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":58.08,"providers":[{"billed_charge":400.00,"npi":[1053314146]}]}]}]},{"name":"T CELL, ABSOLUTE COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86361","description":"T CELLS; ABSOLUTE CD4 COUNT","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":254.37,"providers":[{"billed_charge":650.00,"npi":[1053314146]}]}]}]},{"name":"MICROSOMAL ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86376","description":"MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":561.64,"providers":[{"billed_charge":1960.00,"npi":[1053314146]}]}]}]},{"name":"RHEUMATOID FACTOR, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86431","description":"RHEUMATOID FACTOR; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":135.64,"providers":[{"billed_charge":496.00,"npi":[1053314146]}]}]}]},{"name":"TB AG RESPONSE T-CELL SUSP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86481","description":"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; ENUMERATION OF GAMMA INTERFE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":800.00,"providers":[{"billed_charge":2000.00,"npi":[1053314146]}]}]}]},{"name":"SYPHILIS TEST NON-TREP QUAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86592","description":"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":37.20,"providers":[{"billed_charge":432.00,"npi":[1053314146]}]}]}]},{"name":"HERPES SIMPLEX TYPE 1 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86695","description":"ANTIBODY; HERPES SIMPLEX, TYPE 1","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1089.40,"providers":[{"billed_charge":4070.00,"npi":[1053314146]}]}]}]},{"name":"HERPES SIMPLEX TYPE 2 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86696","description":"ANTIBODY; HERPES SIMPLEX, TYPE 2","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1639.04,"providers":[{"billed_charge":6215.00,"npi":[1053314146]}]}]}]},{"name":"HEP B CORE ANTIBODY, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86704","description":"HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":884.54,"providers":[{"billed_charge":3880.00,"npi":[1053314146]}]}]}]},{"name":"HEP B SURFACE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86706","description":"HEPATITIS B SURFACE ANTIBODY (HBSAB)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":949.22,"providers":[{"billed_charge":4720.00,"npi":[1053314146]}]}]}]},{"name":"HEPATITIS A ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86708","description":"HEPATITIS A ANTIBODY (HAAB)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":779.28,"providers":[{"billed_charge":2890.00,"npi":[1053314146]}]}]}]},{"name":"RUBELLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86762","description":"ANTIBODY; RUBELLA","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":274.82,"providers":[{"billed_charge":1000.00,"npi":[1053314146]}]}]}]},{"name":"TREPONEMA PALLIDUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86780","description":"ANTIBODY; TREPONEMA PALLIDUM","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3248.54,"providers":[{"billed_charge":9720.00,"npi":[1053314146]}]}]}]},{"name":"VARICELLA-ZOSTER ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86787","description":"ANTIBODY; VARICELLA-ZOSTER","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":365.66,"providers":[{"billed_charge":1406.00,"npi":[1053314146]}]}]}]},{"name":"THYROGLOBULIN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86800","description":"THYROGLOBULIN ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":434.43,"providers":[{"billed_charge":1800.00,"npi":[1053314146]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3176.28,"providers":[{"billed_charge":11680.00,"npi":[1053314146]}]}]}]},{"name":"RBC ANTIBODY SCREEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86850","description":"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":238.52,"providers":[{"billed_charge":960.00,"npi":[1053314146]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86900","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":51.41,"providers":[{"billed_charge":230.00,"npi":[1053314146]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC RH(D)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86901","description":"BLOOD TYPING, SEROLOGIC; RH (D)","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":56.19,"providers":[{"billed_charge":250.00,"npi":[1053314146]}]}]}]},{"name":"CULTURE OTHR SPECIMN AEROBIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87070","description":"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESU","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":77.62,"providers":[{"billed_charge":360.00,"npi":[1053314146]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":691.40,"providers":[{"billed_charge":3480.00,"npi":[1053314146]}]}]}]},{"name":"CULTURE SCREEN ONLY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87081","description":"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.60,"providers":[{"billed_charge":28.00,"npi":[1053314146]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2316.04,"providers":[{"billed_charge":11340.00,"npi":[1053314146]}]}]}]},{"name":"URINE BACTERIA CULTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87088","description":"CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF EACH ISOLATE, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1380.73,"providers":[{"billed_charge":6750.00,"npi":[1053314146]}]}]}]},{"name":"MICROBE SUSCEPTIBLE MIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87186","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONC","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":558.89,"providers":[{"billed_charge":2670.00,"npi":[1053314146]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":560.73,"providers":[{"billed_charge":2160.00,"npi":[1053314146]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6471.48,"providers":[{"billed_charge":18408.00,"npi":[1053314146]}]}]}]},{"name":"CANDIDA, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87481","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":316.44,"providers":[{"billed_charge":3510.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3649.14,"providers":[{"billed_charge":7100.00,"npi":[1053314146]}]}]}]},{"name":"CHYLMD TRACH, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87491","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1242.32,"providers":[{"billed_charge":13780.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7470.46,"providers":[{"billed_charge":28600.00,"npi":[1053314146]}]}]}]},{"name":"GARDNER VAG, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87511","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GARDNERELLA VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":58.60,"providers":[{"billed_charge":650.00,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS C REVRS TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87522","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION, INCLUDES REVER","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":861.04,"providers":[{"billed_charge":2862.00,"npi":[1053314146]}]}]}]},{"name":"HIV-1 QUANT&REVRSE TRNSCRPJ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87536","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION, INCLUDES REVERSE TRA","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2246.64,"providers":[{"billed_charge":6300.00,"npi":[1053314146]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":832.12,"providers":[{"billed_charge":9230.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":136.86,"providers":[{"billed_charge":480.00,"npi":[1053314146]}]}]}]},{"name":"N.GONORRHOEAE, DNA, AMP PROB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87591","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1242.32,"providers":[{"billed_charge":13780.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7442.39,"providers":[{"billed_charge":28500.00,"npi":[1053314146]}]}]}]},{"name":"HPV HIGH-RISK TYPES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87624","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":105.48,"providers":[{"billed_charge":1530.00,"npi":[1234567893]}]}]}]},{"name":"Infectious Agent Antigen Detection","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87626","description":"the detection of human papillomavirus (HPV) by nucleic acid (DNA or RNA) tests, specifically reporting separately the high-risk types (16, 18, 31, 45, 51, and 52) and any high-risk pooled results.","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6640.92,"providers":[{"billed_charge":12200.00,"npi":[1053314146]}]}]}]},{"name":"SARSCOV2&INF A&B&RSV AMP PRB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","allowed_amounts":[{"tin":{"type":"ein","value":"474715923"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":3494.68,"providers":[{"billed_charge":12250.00,"npi":[1144606542]}]},{"allowed_amount":213.96,"providers":[{"billed_charge":750.00,"npi":[1144606542]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":185.42,"providers":[{"billed_charge":700.00,"npi":[1053314146]}]}]}]},{"name":"TRICHOMONAS VAGINALIS AMPLIF","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87661","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":82.04,"providers":[{"billed_charge":910.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5147.58,"providers":[{"billed_charge":19800.00,"npi":[1053314146]}]}]}]},{"name":"DETECT AGENT NOS, DNA, AMP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87798","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE TE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1066.38,"providers":[{"billed_charge":12380.80,"npi":[1234567893]}]}]}]},{"name":"DETECT AGNT MULT, DNA, AMPLI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87801","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECH","allowed_amounts":[{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1958.58,"providers":[{"billed_charge":3900.00,"npi":[1053314146]}]}]}]},{"name":"INFLUENZA ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87804","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":215.15,"providers":[{"billed_charge":780.00,"npi":[1114330974]}]}]}]},{"name":"STREP A ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87880","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GR","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":49.59,"providers":[{"billed_charge":180.00,"npi":[1114330974]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":124.46,"providers":[{"billed_charge":1050.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4162.27,"providers":[{"billed_charge":15022.00,"npi":[1053314146]}]}]}]},{"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":"261926383"},"service_code":["22","23"],"billing_class":"professional","payments":[{"allowed_amount":35.09,"providers":[{"billed_charge":370.00,"npi":[1790191278]}]},{"allowed_amount":35.10,"providers":[{"billed_charge":370.00,"npi":[1003868969]}]},{"allowed_amount":17.55,"providers":[{"billed_charge":185.00,"npi":[1790191278]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":489.78,"providers":[{"billed_charge":4396.00,"npi":[1234567893]}]},{"allowed_amount":121.82,"providers":[{"billed_charge":1064.00,"npi":[1234567893]}]},{"allowed_amount":52.64,"providers":[{"billed_charge":160.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":772.95,"providers":[{"billed_charge":2196.00,"npi":[1659574127]}]}]},{"tin":{"type":"ein","value":"383111008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":711.30,"providers":[{"billed_charge":2160.00,"npi":[1053314146]}]}]},{"tin":{"type":"ein","value":"381857764"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":102.22,"providers":[{"billed_charge":300.00,"npi":[1336366293,1902914062]}]},{"allowed_amount":51.11,"providers":[{"billed_charge":150.00,"npi":[1336366293]}]},{"allowed_amount":255.54,"providers":[{"billed_charge":750.00,"npi":[1902914062]}]}]},{"tin":{"type":"ein","value":"382147744"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":34.07,"providers":[{"billed_charge":195.00,"npi":[1205042207]}]}]},{"tin":{"type":"ein","value":"391351587"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":347.75,"providers":[{"billed_charge":6607.08,"npi":[1326393307]}]}]}]},{"name":"IMMUNIZATION ADMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90471","description":"IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJE","allowed_amounts":[{"tin":{"type":"ein","value":"383844634"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":241.20,"providers":[{"billed_charge":546.00,"npi":[1396368734]}]}]}]},{"name":"PSYCH DIAG EVAL W/MED SRVCS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90792","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"381357020"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":837.30,"providers":[{"billed_charge":1650.00,"npi":[1174182976]}]},{"allowed_amount":334.92,"providers":[{"billed_charge":660.00,"npi":[1174182976]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":375.86,"providers":[{"billed_charge":776.00,"npi":[1679117063]}]}]},{"tin":{"type":"ein","value":"831910484"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":765.52,"providers":[{"billed_charge":800.00,"npi":[1629416169]}]},{"allowed_amount":167.46,"providers":[{"billed_charge":200.00,"npi":[1629416169]}]}]}]},{"name":"PSYTX W PT 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90832","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":315.72,"providers":[{"billed_charge":596.00,"npi":[1831338441]}]}]},{"tin":{"type":"ein","value":"382406558"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1047.60,"providers":[{"billed_charge":1530.00,"npi":[1215541545]}]},{"allowed_amount":256.70,"providers":[{"billed_charge":425.00,"npi":[1215541545]}]}]}]},{"name":"PSYTX W PT W E/M 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90833","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"851404855"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1286.16,"providers":[{"billed_charge":4150.00,"npi":[1043507833]}]},{"allowed_amount":1845.36,"providers":[{"billed_charge":5350.00,"npi":[1043507833]}]}]},{"tin":{"type":"ein","value":"382776209"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":108.58,"providers":[{"billed_charge":230.00,"npi":[1992321830]}]}]},{"tin":{"type":"ein","value":"824961447"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3157.92,"providers":[{"billed_charge":7200.00,"npi":[1447323829]}]},{"allowed_amount":148.16,"providers":[{"billed_charge":300.00,"npi":[1447323829]}]}]}]},{"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":"273742440"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2054.44,"providers":[{"billed_charge":2054.44,"npi":[1033203161]}]},{"allowed_amount":1474.40,"providers":[{"billed_charge":1599.52,"npi":[1033203161]}]}]},{"tin":{"type":"ein","value":"381402860"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":414.66,"providers":[{"billed_charge":992.28,"npi":[1396268447]}]}]},{"tin":{"type":"ein","value":"383502573"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":67.71,"providers":[{"billed_charge":110.00,"npi":[1144743378]}]},{"allowed_amount":230.31,"providers":[{"billed_charge":330.00,"npi":[1144743378]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":2187.36,"providers":[{"billed_charge":5460.00,"npi":[1417605833]}]},{"allowed_amount":208.32,"providers":[{"billed_charge":520.00,"npi":[1669538211]}]},{"allowed_amount":3645.60,"providers":[{"billed_charge":9100.00,"npi":[1831338441]}]},{"allowed_amount":104.16,"providers":[{"billed_charge":260.00,"npi":[1770904252,1275092348]}]},{"allowed_amount":729.12,"providers":[{"billed_charge":1820.00,"npi":[1033515317]}]},{"allowed_amount":1458.24,"providers":[{"billed_charge":3640.00,"npi":[1497889927]}]},{"allowed_amount":833.28,"providers":[{"billed_charge":2080.00,"npi":[1912103268]}]},{"allowed_amount":1354.08,"providers":[{"billed_charge":3380.00,"npi":[1467802744]}]}]},{"tin":{"type":"ein","value":"831910484"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":841.84,"providers":[{"billed_charge":1343.04,"npi":[1629416169]}]}]}]},{"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":"382796478"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":6991.73,"providers":[{"billed_charge":9800.00,"npi":[1255372058]}]}]}]},{"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":"474714944"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1502.27,"providers":[{"billed_charge":2200.00,"npi":[1811331481]}]}]},{"tin":{"type":"ein","value":"825510340"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1872.20,"providers":[{"billed_charge":4400.00,"npi":[1114403136]}]},{"allowed_amount":573.58,"providers":[{"billed_charge":1540.00,"npi":[1114403136]}]}]},{"tin":{"type":"ein","value":"990632329"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":400.26,"providers":[{"billed_charge":420.00,"npi":[1174221741]}]}]},{"tin":{"type":"ein","value":"933817534"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1365.70,"providers":[{"billed_charge":1820.00,"npi":[1164450995]}]}]},{"tin":{"type":"ein","value":"382776209"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":102.43,"providers":[{"billed_charge":245.00,"npi":[1740458538]}]},{"allowed_amount":1053.18,"providers":[{"billed_charge":2205.00,"npi":[1740458538]}]},{"allowed_amount":802.24,"providers":[{"billed_charge":1960.00,"npi":[1295511020]}]}]},{"tin":{"type":"ein","value":"852229929"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":585.10,"providers":[{"billed_charge":1000.00,"npi":[1407536006]}]},{"allowed_amount":102.43,"providers":[{"billed_charge":200.00,"npi":[1407536006]}]}]},{"tin":{"type":"ein","value":"821510432"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":117.02,"providers":[{"billed_charge":175.00,"npi":[1992169460]}]},{"allowed_amount":102.43,"providers":[{"billed_charge":175.00,"npi":[1992169460]}]},{"allowed_amount":204.86,"providers":[{"billed_charge":350.00,"npi":[1992169460]}]}]},{"tin":{"type":"ein","value":"822225208"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":227.54,"providers":[{"billed_charge":410.00,"npi":[1396054920]}]}]},{"tin":{"type":"ein","value":"833919424"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":240.69,"providers":[{"billed_charge":555.00,"npi":[1720771900]}]}]},{"tin":{"type":"ein","value":"472970145"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1092.56,"providers":[{"billed_charge":2000.00,"npi":[1396913497]}]},{"allowed_amount":4524.58,"providers":[{"billed_charge":7250.00,"npi":[1396913497]}]}]},{"tin":{"type":"ein","value":"853424902"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3367.37,"providers":[{"billed_charge":5550.00,"npi":[1508241787]}]},{"allowed_amount":4459.49,"providers":[{"billed_charge":7350.00,"npi":[1154652865]}]},{"allowed_amount":80.23,"providers":[{"billed_charge":150.00,"npi":[1508241787]}]}]},{"tin":{"type":"ein","value":"845134076"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":717.01,"providers":[{"billed_charge":1575.00,"npi":[1952730624]}]}]},{"tin":{"type":"ein","value":"386122756"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":91.01,"providers":[{"billed_charge":150.00,"npi":[1336339787]}]}]},{"tin":{"type":"ein","value":"453029406"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":409.72,"providers":[{"billed_charge":700.00,"npi":[1457514366]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":2005.77,"providers":[{"billed_charge":4377.00,"npi":[1497889927]},{"billed_charge":4501.00,"npi":[1669538211]}]}]},{"tin":{"type":"ein","value":"460642468"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1287.22,"providers":[{"billed_charge":1925.00,"npi":[1326455320]}]}]},{"tin":{"type":"ein","value":"831910484"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":682.85,"providers":[{"billed_charge":1253.90,"npi":[1629416169]}]},{"allowed_amount":2496.32,"providers":[{"billed_charge":4012.48,"npi":[1629416169]}]}]},{"tin":{"type":"ein","value":"382363235"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":624.08,"providers":[{"billed_charge":858.00,"npi":[1750393690]}]},{"allowed_amount":136.57,"providers":[{"billed_charge":214.50,"npi":[1750393690]}]}]},{"tin":{"type":"ein","value":"814957518"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1203.36,"providers":[{"billed_charge":2160.00,"npi":[1205058344]}]}]},{"tin":{"type":"ein","value":"20779408"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":234.04,"providers":[{"billed_charge":380.00,"npi":[1639760663]}]}]},{"tin":{"type":"ein","value":"830723766"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":200.58,"providers":[{"billed_charge":320.00,"npi":[1275070377]}]}]},{"tin":{"type":"ein","value":"863656058"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1203.45,"providers":[{"billed_charge":3000.00,"npi":[1003278631]}]},{"allowed_amount":401.15,"providers":[{"billed_charge":1000.00,"npi":[1437765336]}]},{"allowed_amount":1001.11,"providers":[{"billed_charge":2200.00,"npi":[1437765336]}]},{"allowed_amount":819.09,"providers":[{"billed_charge":1800.00,"npi":[1427423359]}]},{"allowed_amount":80.23,"providers":[{"billed_charge":200.00,"npi":[1427423359]}]},{"allowed_amount":91.01,"providers":[{"billed_charge":200.00,"npi":[1003278631]}]}]},{"tin":{"type":"ein","value":"474144586"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":187.22,"providers":[{"billed_charge":400.00,"npi":[1588826556]}]},{"allowed_amount":655.52,"providers":[{"billed_charge":1600.00,"npi":[1588826556]}]}]},{"tin":{"type":"ein","value":"383000735"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1820.32,"providers":[{"billed_charge":2400.00,"npi":[1609419118]}]}]},{"tin":{"type":"ein","value":"383579022"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1946.17,"providers":[{"billed_charge":4750.00,"npi":[1215502265]}]},{"allowed_amount":351.06,"providers":[{"billed_charge":750.00,"npi":[1215502265]}]}]},{"tin":{"type":"ein","value":"454675306"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":5080.98,"providers":[{"billed_charge":9500.00,"npi":[1487021978]}]},{"allowed_amount":300.84,"providers":[{"billed_charge":750.00,"npi":[1093049561]}]}]},{"tin":{"type":"ein","value":"824961447"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":409.71,"providers":[{"billed_charge":894.00,"npi":[1447323829]}]},{"allowed_amount":156.02,"providers":[{"billed_charge":298.00,"npi":[1447323829]}]}]},{"tin":{"type":"ein","value":"471173250"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":585.10,"providers":[{"billed_charge":975.00,"npi":[1558916270]}]}]},{"tin":{"type":"ein","value":"381958763"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":117.02,"providers":[{"billed_charge":192.00,"npi":[1639830821]}]}]},{"tin":{"type":"ein","value":"460974303"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":701.96,"providers":[{"billed_charge":1400.00,"npi":[1366672370]}]}]}]},{"name":"GROUP PSYCHOTHERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90853","description":"GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","allowed_amounts":[{"tin":{"type":"ein","value":"386088382"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":228.36,"providers":[{"billed_charge":990.00,"npi":[1972037844]}]}]},{"tin":{"type":"ein","value":"386122756"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":215.93,"providers":[{"billed_charge":520.00,"npi":[1336339787]}]}]},{"tin":{"type":"ein","value":"383381605"},"service_code":["57"],"billing_class":"professional","payments":[{"allowed_amount":155.70,"providers":[{"billed_charge":1055.00,"npi":[1902227911]}]}]}]},{"name":"DIALYSIS PROCEDURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90999","description":"UNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"852368872"},"service_code":["65"],"billing_class":"professional","payments":[{"allowed_amount":26680.50,"providers":[{"billed_charge":66701.25,"npi":[1437413168]}]}]}]},{"name":"PSYCHIATRIC CARE INTENSIVE 4","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"913","description":"PSYCHIATRIC CARE INTENSIVE 4-6 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"384149930"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4129.84,"providers":[{"billed_charge":38000.00,"npi":[1679248496]}]}]}]},{"name":"PERI VASCUL LAB","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"921","description":"OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB","allowed_amounts":[{"tin":{"type":"ein","value":"464719451"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1106.37,"providers":[{"billed_charge":7259.80,"npi":[1043625940]}]}]},{"tin":{"type":"ein","value":"381359087"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3452.92,"providers":[{"billed_charge":20173.40,"npi":[1831116441]}]},{"allowed_amount":104.19,"providers":[{"billed_charge":756.35,"npi":[1831116441]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":213.46,"providers":[{"billed_charge":1178.00,"npi":[1902894512]}]}]},{"tin":{"type":"ein","value":"383175878"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":233.77,"providers":[{"billed_charge":1774.00,"npi":[1780658443]}]},{"allowed_amount":2294.94,"providers":[{"billed_charge":13793.00,"npi":[1780658443]}]}]},{"tin":{"type":"ein","value":"383176536"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1889.87,"providers":[{"billed_charge":14765.00,"npi":[1053356352]}]}]}]},{"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":"382027689"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":22.95,"providers":[{"billed_charge":81.00,"npi":[1255332490]}]},{"allowed_amount":30.60,"providers":[{"billed_charge":108.00,"npi":[1770549099]}]},{"allowed_amount":45.90,"providers":[{"billed_charge":162.00,"npi":[1770549099]}]},{"allowed_amount":38.25,"providers":[{"billed_charge":135.00,"npi":[1255332490,1134625502]}]},{"allowed_amount":7.65,"providers":[{"billed_charge":27.00,"npi":[1770549099,1134625502]}]}]},{"tin":{"type":"ein","value":"465322251"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":79.80,"providers":[{"billed_charge":300.00,"npi":[1982834826]}]},{"allowed_amount":175.56,"providers":[{"billed_charge":660.00,"npi":[1982834826]}]}]},{"tin":{"type":"ein","value":"270391924"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":35.91,"providers":[{"billed_charge":60.00,"npi":[1831267376]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":15.00,"npi":[1831267376]}]}]},{"tin":{"type":"ein","value":"381359063"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":179.64,"providers":[{"billed_charge":2290.00,"npi":[1992990089]}]},{"allowed_amount":209.58,"providers":[{"billed_charge":1344.00,"npi":[1992990089]}]},{"allowed_amount":29.94,"providers":[{"billed_charge":192.00,"npi":[1992990089]}]}]},{"tin":{"type":"ein","value":"383322109"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":99.80,"providers":[{"billed_charge":590.00,"npi":[1619310885]}]},{"allowed_amount":35.91,"providers":[{"billed_charge":177.00,"npi":[1386680494]}]},{"allowed_amount":149.70,"providers":[{"billed_charge":885.00,"npi":[1477599587]}]},{"allowed_amount":179.64,"providers":[{"billed_charge":1062.00,"npi":[1477599587]}]},{"allowed_amount":49.90,"providers":[{"billed_charge":295.00,"npi":[1174525729,1346774981]}]},{"allowed_amount":39.92,"providers":[{"billed_charge":236.00,"npi":[1174525729]}]},{"allowed_amount":159.68,"providers":[{"billed_charge":944.00,"npi":[1619310885]}]},{"allowed_amount":115.71,"providers":[{"billed_charge":826.00,"npi":[1386680494]}]},{"allowed_amount":129.74,"providers":[{"billed_charge":767.00,"npi":[1124077953]}]},{"allowed_amount":19.96,"providers":[{"billed_charge":118.00,"npi":[1346774981]}]},{"allowed_amount":269.46,"providers":[{"billed_charge":1593.00,"npi":[1124077953]}]}]},{"tin":{"type":"ein","value":"382791823"},"service_code":["22","19","21"],"billing_class":"professional","payments":[{"allowed_amount":79.80,"providers":[{"billed_charge":270.00,"npi":[1164816476]}]},{"allowed_amount":15.96,"providers":[{"billed_charge":54.00,"npi":[1164816476]}]},{"allowed_amount":95.76,"providers":[{"billed_charge":324.00,"npi":[1164816476]}]}]},{"tin":{"type":"ein","value":"381218516"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":251.37,"providers":[{"billed_charge":690.90,"npi":[1962889402]}]},{"allowed_amount":35.91,"providers":[{"billed_charge":98.70,"npi":[1962889402]}]},{"allowed_amount":79.80,"providers":[{"billed_charge":329.00,"npi":[1275915092]}]},{"allowed_amount":347.13,"providers":[{"billed_charge":954.10,"npi":[1275915092]}]},{"allowed_amount":107.73,"providers":[{"billed_charge":329.00,"npi":[1275915092]}]},{"allowed_amount":47.88,"providers":[{"billed_charge":131.60,"npi":[1366882656]}]}]},{"tin":{"type":"ein","value":"383316559"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":23.94,"providers":[{"billed_charge":84.00,"npi":[1265694426]}]},{"allowed_amount":39.57,"providers":[{"billed_charge":140.00,"npi":[1720221542]}]},{"allowed_amount":71.16,"providers":[{"billed_charge":252.00,"npi":[1356318398]}]},{"allowed_amount":39.90,"providers":[{"billed_charge":140.00,"npi":[1003883539,1356318398]}]},{"allowed_amount":15.96,"providers":[{"billed_charge":56.00,"npi":[1003883539,1356318398,1265694426,1720221542]}]},{"allowed_amount":15.30,"providers":[{"billed_charge":56.00,"npi":[1073924189]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":28.00,"npi":[1073924189]}]},{"allowed_amount":55.86,"providers":[{"billed_charge":196.00,"npi":[1720221542]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":279.44,"providers":[{"billed_charge":742.00,"npi":[1234567893]}]},{"allowed_amount":47.22,"providers":[{"billed_charge":138.00,"npi":[1234567893]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":28.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"381428164"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":71.82,"providers":[{"billed_charge":197.40,"npi":[1104266881]}]},{"allowed_amount":59.85,"providers":[{"billed_charge":164.50,"npi":[1588657076]}]},{"allowed_amount":347.13,"providers":[{"billed_charge":954.10,"npi":[1588657076]}]},{"allowed_amount":311.22,"providers":[{"billed_charge":855.40,"npi":[1104266881]}]},{"allowed_amount":19.95,"providers":[{"billed_charge":65.80,"npi":[1588657076]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":32.90,"npi":[1104266881]}]}]},{"tin":{"type":"ein","value":"386006309"},"service_code":["22","23","19","21"],"billing_class":"professional","payments":[{"allowed_amount":23.94,"providers":[{"billed_charge":225.00,"npi":[1073698809]}]},{"allowed_amount":39.90,"providers":[{"billed_charge":375.00,"npi":[1073698809]}]},{"allowed_amount":103.74,"providers":[{"billed_charge":975.00,"npi":[1073698809]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":75.00,"npi":[1073698809]}]}]}]},{"name":"TTE W/DOPPLER COMPLETE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93306","description":"ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W IMG DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN","allowed_amounts":[{"tin":{"type":"ein","value":"270391924"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1489.05,"providers":[{"billed_charge":2250.00,"npi":[1831267376]}]},{"allowed_amount":168.75,"providers":[{"billed_charge":450.00,"npi":[1831267376]}]}]}]},{"name":"IMMUNOTHERAPY INJECTIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95117","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; 2 O","allowed_amounts":[{"tin":{"type":"ein","value":"382319009"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":192.64,"providers":[{"billed_charge":384.00,"npi":[1215955422]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"382719621"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":310.20,"providers":[{"billed_charge":792.00,"npi":[1578727335]}]}]},{"tin":{"type":"ein","value":"383232366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":48.70,"providers":[{"billed_charge":96.00,"npi":[1649520784]}]},{"allowed_amount":32.00,"providers":[{"billed_charge":64.00,"npi":[1144990938]}]},{"allowed_amount":56.00,"providers":[{"billed_charge":112.00,"npi":[1164898722]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96372","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"475372624"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":35.79,"providers":[{"billed_charge":84.24,"npi":[1245936012]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2260.44,"providers":[{"billed_charge":5580.00,"npi":[1114330974]}]}]},{"tin":{"type":"ein","value":"833394221"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":131.23,"providers":[{"billed_charge":622.08,"npi":[1457065930]}]}]}]},{"name":"ELECTRIC STIMULATION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97014","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED)","allowed_amounts":[{"tin":{"type":"ein","value":"760376595"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":12.46,"providers":[{"billed_charge":38.00,"npi":[1275599979]}]},{"allowed_amount":161.98,"providers":[{"billed_charge":494.00,"npi":[1063844769]}]}]},{"tin":{"type":"ein","value":"813717226"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":311.50,"providers":[{"billed_charge":1925.00,"npi":[1174969877]}]}]},{"tin":{"type":"ein","value":"830404137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":62.30,"providers":[{"billed_charge":600.00,"npi":[1609450956]}]},{"allowed_amount":971.88,"providers":[{"billed_charge":9360.00,"npi":[1326274168]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1455.62,"providers":[{"billed_charge":4380.00,"npi":[1942704572]}]},{"allowed_amount":209.37,"providers":[{"billed_charge":630.00,"npi":[1861792186]}]}]}]},{"name":"ELECTRICAL STIMULATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97032","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"270069350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":259.40,"providers":[{"billed_charge":1700.00,"npi":[1477969533]}]}]}]},{"name":"ULTRASOUND THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97035","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ULTRASOUND, EACH 15 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"383456889"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":139.26,"providers":[{"billed_charge":605.00,"npi":[1164642302]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":162.08,"providers":[{"billed_charge":480.00,"npi":[1942704572]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"364877508"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1406.72,"providers":[{"billed_charge":6600.00,"npi":[1295004141]}]}]},{"tin":{"type":"ein","value":"270069350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":571.64,"providers":[{"billed_charge":2520.00,"npi":[1477969533]}]}]},{"tin":{"type":"ein","value":"462721176"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":52.46,"providers":[{"billed_charge":130.00,"npi":[1518520865]}]}]},{"tin":{"type":"ein","value":"813717226"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":684.15,"providers":[{"billed_charge":2470.00,"npi":[1174969877]}]}]},{"tin":{"type":"ein","value":"412064132"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":25.98,"providers":[{"billed_charge":115.00,"npi":[1821803362]}]},{"allowed_amount":441.72,"providers":[{"billed_charge":1955.00,"npi":[1316772411]}]}]},{"tin":{"type":"ein","value":"812090175"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":259.85,"providers":[{"billed_charge":650.00,"npi":[1538993217]}]}]},{"tin":{"type":"ein","value":"830404137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":259.85,"providers":[{"billed_charge":1200.00,"npi":[1609450956]}]},{"allowed_amount":3871.76,"providers":[{"billed_charge":17880.00,"npi":[1326274168]}]}]},{"tin":{"type":"ein","value":"760424739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2078.69,"providers":[{"billed_charge":6640.00,"npi":[1962062273]}]},{"allowed_amount":421.49,"providers":[{"billed_charge":1328.00,"npi":[1376271007]}]},{"allowed_amount":415.72,"providers":[{"billed_charge":1328.00,"npi":[1376352732]}]},{"allowed_amount":727.51,"providers":[{"billed_charge":2324.00,"npi":[1609678499]}]},{"allowed_amount":181.88,"providers":[{"billed_charge":581.00,"npi":[1427644707]}]}]},{"tin":{"type":"ein","value":"383456889"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":603.35,"providers":[{"billed_charge":1210.00,"npi":[1164642302]}]}]},{"tin":{"type":"ein","value":"760376595"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1157.70,"providers":[{"billed_charge":3652.00,"npi":[1184811747]}]},{"allowed_amount":259.83,"providers":[{"billed_charge":830.00,"npi":[1275599979]}]},{"allowed_amount":1550.38,"providers":[{"billed_charge":4897.00,"npi":[1760062905]}]},{"allowed_amount":577.37,"providers":[{"billed_charge":1743.00,"npi":[1457690786]}]},{"allowed_amount":421.50,"providers":[{"billed_charge":1328.00,"npi":[1063844769]}]}]},{"tin":{"type":"ein","value":"342050384"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":270.21,"providers":[{"billed_charge":975.00,"npi":[1730895509]}]}]},{"tin":{"type":"ein","value":"383558997"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":245.38,"providers":[{"billed_charge":900.00,"npi":[1205582673]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":524.31,"providers":[{"billed_charge":1625.00,"npi":[1861792186]}]},{"allowed_amount":3936.24,"providers":[{"billed_charge":12285.00,"npi":[1942704572]}]}]},{"tin":{"type":"ein","value":"200955956"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1194.10,"providers":[{"billed_charge":5700.00,"npi":[1205863651]}]}]},{"tin":{"type":"ein","value":"134220942"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1429.01,"providers":[{"billed_charge":6600.00,"npi":[1730566621]}]}]},{"tin":{"type":"ein","value":"383595753"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":534.09,"providers":[{"billed_charge":2560.00,"npi":[1740582410]}]}]}]},{"name":"NEUROMUSCULAR REEDUCATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97112","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALA","allowed_amounts":[{"tin":{"type":"ein","value":"760376595"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":510.22,"providers":[{"billed_charge":1632.00,"npi":[1184811747]}]},{"allowed_amount":298.43,"providers":[{"billed_charge":960.00,"npi":[1760062905]}]},{"allowed_amount":699.55,"providers":[{"billed_charge":2208.00,"npi":[1063844769]}]},{"allowed_amount":60.97,"providers":[{"billed_charge":192.00,"npi":[1457690786]}]}]},{"tin":{"type":"ein","value":"342050384"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":161.70,"providers":[{"billed_charge":525.00,"npi":[1730895509]}]}]},{"tin":{"type":"ein","value":"412064132"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":28.88,"providers":[{"billed_charge":120.00,"npi":[1821803362]}]}]},{"tin":{"type":"ein","value":"200955956"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":667.41,"providers":[{"billed_charge":2700.00,"npi":[1205863651]}]}]},{"tin":{"type":"ein","value":"830404137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":240.67,"providers":[{"billed_charge":960.00,"npi":[1609450956]}]},{"allowed_amount":2775.69,"providers":[{"billed_charge":11520.00,"npi":[1326274168]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4304.31,"providers":[{"billed_charge":12090.00,"npi":[1942704572]}]}]},{"tin":{"type":"ein","value":"812090175"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":96.27,"providers":[{"billed_charge":195.00,"npi":[1538993217]}]}]},{"tin":{"type":"ein","value":"760424739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1270.73,"providers":[{"billed_charge":4128.00,"npi":[1962062273]}]},{"allowed_amount":811.85,"providers":[{"billed_charge":2688.00,"npi":[1376352732]}]},{"allowed_amount":888.87,"providers":[{"billed_charge":2880.00,"npi":[1609678499]}]}]},{"tin":{"type":"ein","value":"134220942"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2146.75,"providers":[{"billed_charge":9250.00,"npi":[1730566621]}]}]},{"tin":{"type":"ein","value":"263541523"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":233.32,"providers":[{"billed_charge":520.00,"npi":[1124569223]}]}]}]},{"name":"MASSAGE THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97124","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; MASSAGE, INCLUDING EFFLEURAGE, PETRISSAGE A","allowed_amounts":[{"tin":{"type":"ein","value":"270069350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":503.08,"providers":[{"billed_charge":1710.00,"npi":[1477969533]}]}]}]},{"name":"MANUAL THERAPY 1/> REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97140","description":"MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTIO","allowed_amounts":[{"tin":{"type":"ein","value":"364877508"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":431.86,"providers":[{"billed_charge":2200.00,"npi":[1295004141]}]}]},{"tin":{"type":"ein","value":"813717226"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":820.48,"providers":[{"billed_charge":2640.00,"npi":[1174969877]}]}]},{"tin":{"type":"ein","value":"412064132"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.65,"providers":[{"billed_charge":525.00,"npi":[1316772411]}]}]},{"tin":{"type":"ein","value":"812090175"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.65,"providers":[{"billed_charge":325.00,"npi":[1538993217]}]}]},{"tin":{"type":"ein","value":"830404137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":122.65,"providers":[{"billed_charge":600.00,"npi":[1609450956]}]},{"allowed_amount":1986.99,"providers":[{"billed_charge":9720.00,"npi":[1326274168]}]}]},{"tin":{"type":"ein","value":"760424739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":49.06,"providers":[{"billed_charge":152.00,"npi":[1962062273]}]},{"allowed_amount":122.66,"providers":[{"billed_charge":380.00,"npi":[1376352732]}]}]},{"tin":{"type":"ein","value":"383456889"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":269.83,"providers":[{"billed_charge":605.00,"npi":[1164642302]}]}]},{"tin":{"type":"ein","value":"381958736"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":223.01,"providers":[{"billed_charge":583.00,"npi":[1619608015]}]}]},{"tin":{"type":"ein","value":"760376595"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":566.93,"providers":[{"billed_charge":1748.00,"npi":[1063844769]}]},{"allowed_amount":24.53,"providers":[{"billed_charge":76.00,"npi":[1275599979]}]},{"allowed_amount":258.17,"providers":[{"billed_charge":836.00,"npi":[1508339961]}]},{"allowed_amount":738.63,"providers":[{"billed_charge":2280.00,"npi":[1457690786]}]},{"allowed_amount":73.60,"providers":[{"billed_charge":228.00,"npi":[1184811747]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":414.41,"providers":[{"billed_charge":1260.00,"npi":[1861792186]}]},{"allowed_amount":3284.75,"providers":[{"billed_charge":10020.00,"npi":[1942704572]}]}]},{"tin":{"type":"ein","value":"383558997"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":147.20,"providers":[{"billed_charge":600.00,"npi":[1619673209]}]},{"allowed_amount":490.69,"providers":[{"billed_charge":2000.00,"npi":[1205582673]}]}]},{"tin":{"type":"ein","value":"200955956"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":372.97,"providers":[{"billed_charge":1900.00,"npi":[1205863651]}]}]},{"tin":{"type":"ein","value":"134220942"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":196.24,"providers":[{"billed_charge":880.00,"npi":[1730566621]}]}]},{"tin":{"type":"ein","value":"383595753"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":318.91,"providers":[{"billed_charge":1534.00,"npi":[1740582410]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"461228277"},"service_code":["11","99","12"],"billing_class":"professional","payments":[{"allowed_amount":295.90,"providers":[{"billed_charge":295.90,"npi":[1891278487]}]},{"allowed_amount":28647.39,"providers":[{"billed_charge":28705.12,"npi":[1770133456]}]},{"allowed_amount":29471.74,"providers":[{"billed_charge":29471.74,"npi":[1902506306]}]},{"allowed_amount":294.00,"providers":[{"billed_charge":294.00,"npi":[1770133456]}]},{"allowed_amount":30989.84,"providers":[{"billed_charge":30989.84,"npi":[1043750904]}]},{"allowed_amount":18599.24,"providers":[{"billed_charge":18599.24,"npi":[1891278487]}]},{"allowed_amount":23382.66,"providers":[{"billed_charge":23629.92,"npi":[1902506306]}]}]}]},{"name":"ADAPT BEHAVIOR TX PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97155","description":"ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"461228277"},"service_code":["11","12","02"],"billing_class":"professional","payments":[{"allowed_amount":6262.00,"providers":[{"billed_charge":8190.49,"npi":[1770133456]}]},{"allowed_amount":1169.81,"providers":[{"billed_charge":1472.68,"npi":[1902506306]}]},{"allowed_amount":1555.58,"providers":[{"billed_charge":1957.80,"npi":[1902506306]}]},{"allowed_amount":7804.24,"providers":[{"billed_charge":9989.37,"npi":[1902506306]}]},{"allowed_amount":3617.44,"providers":[{"billed_charge":4557.15,"npi":[1891278487]}]},{"allowed_amount":5785.31,"providers":[{"billed_charge":7560.65,"npi":[1043750904]}]}]}]},{"name":"PT EVAL MOD COMPLEX 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97162","description":"PHYSICAL THERAPY EVALUATION: MODERATE COMPLEXITY, REQUIRING THESE COMPONENTS: A HISTORY OF PRESENT P","allowed_amounts":[{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":157.48,"providers":[{"billed_charge":460.00,"npi":[1942704572]}]}]}]},{"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":"381958736"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":105.18,"providers":[{"billed_charge":244.00,"npi":[1619608015]}]}]},{"tin":{"type":"ein","value":"342050384"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":193.76,"providers":[{"billed_charge":525.00,"npi":[1730895509]}]}]},{"tin":{"type":"ein","value":"813717226"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1228.30,"providers":[{"billed_charge":3330.00,"npi":[1174969877]}]}]},{"tin":{"type":"ein","value":"760376595"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":346.00,"providers":[{"billed_charge":1050.00,"npi":[1760062905]}]},{"allowed_amount":69.20,"providers":[{"billed_charge":210.00,"npi":[1184811747]}]}]},{"tin":{"type":"ein","value":"412064132"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":138.40,"providers":[{"billed_charge":500.00,"npi":[1316772411]}]}]},{"tin":{"type":"ein","value":"830404137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2691.88,"providers":[{"billed_charge":9480.00,"npi":[1326274168]}]}]},{"tin":{"type":"ein","value":"844612992"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":495.47,"providers":[{"billed_charge":1350.00,"npi":[1861792186]}]},{"allowed_amount":5178.89,"providers":[{"billed_charge":14175.00,"npi":[1942704572]}]}]},{"tin":{"type":"ein","value":"760424739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1356.32,"providers":[{"billed_charge":4305.00,"npi":[1962062273]}]},{"allowed_amount":1186.78,"providers":[{"billed_charge":3780.00,"npi":[1376352732]}]},{"allowed_amount":266.42,"providers":[{"billed_charge":840.00,"npi":[1609678499]}]}]},{"tin":{"type":"ein","value":"134220942"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2671.12,"providers":[{"billed_charge":10125.00,"npi":[1730566621]}]}]}]},{"name":"SELF CARE MNGMENT TRAINING","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97535","description":"SELF-CARE/HOME MANAGEMENT TRAINING (EG, ACTIVITIES OF DAILY LIVING (ADL) AND COMPENSATORY TRAINING,","allowed_amounts":[{"tin":{"type":"ein","value":"760424739"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":144.25,"providers":[{"billed_charge":460.00,"npi":[1376352732]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98941","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"462479137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":524.62,"providers":[{"billed_charge":850.00,"npi":[1710321005]}]}]},{"tin":{"type":"ein","value":"382133559"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":501.54,"providers":[{"billed_charge":913.25,"npi":[1851451637]}]}]}]},{"name":"CHIROPRACTIC MANJ 5 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98942","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"611507069"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":49.88,"providers":[{"billed_charge":59.00,"npi":[1992845598]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99203","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"383246949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":336.45,"providers":[{"billed_charge":510.00,"npi":[1376593228]}]}]},{"tin":{"type":"ein","value":"853275263"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":95.33,"providers":[{"billed_charge":275.00,"npi":[1043656135]}]}]},{"tin":{"type":"ein","value":"383584702"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":105.27,"providers":[{"billed_charge":150.00,"npi":[1215021472]}]}]},{"tin":{"type":"ein","value":"842071867"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":95.33,"providers":[{"billed_charge":407.00,"npi":[1780347377]}]}]},{"tin":{"type":"ein","value":"842580415"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":571.98,"providers":[{"billed_charge":1170.00,"npi":[1275863102]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":8523.40,"providers":[{"billed_charge":19000.00,"npi":[1114330974]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":14631.66,"providers":[{"billed_charge":21750.00,"npi":[1114330974]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99211","description":"OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, THAT M","allowed_amounts":[{"tin":{"type":"ein","value":"853595065"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":113.30,"providers":[{"billed_charge":250.00,"npi":[1295227460]}]}]}]},{"name":"OFFICE OR OTH OUTPATIENT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99212","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"853595065"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":334.74,"providers":[{"billed_charge":600.00,"npi":[1295227460]}]},{"allowed_amount":385.66,"providers":[{"billed_charge":1100.00,"npi":[1295227460]}]}]},{"tin":{"type":"ein","value":"382406558"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":141.85,"providers":[{"billed_charge":275.00,"npi":[1427489293]}]},{"allowed_amount":283.70,"providers":[{"billed_charge":550.00,"npi":[1427092147]}]},{"allowed_amount":56.74,"providers":[{"billed_charge":110.00,"npi":[1427092147]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"382311840"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1361.85,"providers":[{"billed_charge":1525.00,"npi":[1255499257]}]}]},{"tin":{"type":"ein","value":"821804736"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":185.22,"providers":[{"billed_charge":792.00,"npi":[1285231662]}]}]},{"tin":{"type":"ein","value":"472621929"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":540.19,"providers":[{"billed_charge":1848.00,"npi":[1851094940]}]}]},{"tin":{"type":"ein","value":"842580415"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1389.06,"providers":[{"billed_charge":3330.00,"npi":[1275863102]}]}]},{"tin":{"type":"ein","value":"386005601"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":436.74,"providers":[{"billed_charge":846.00,"npi":[1407475494]}]}]},{"tin":{"type":"ein","value":"383232366"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":77.17,"providers":[{"billed_charge":147.00,"npi":[1649520784]}]},{"allowed_amount":231.51,"providers":[{"billed_charge":441.00,"npi":[1164898722]}]}]},{"tin":{"type":"ein","value":"383844634"},"service_code":["50","10"],"billing_class":"professional","payments":[{"allowed_amount":907.90,"providers":[{"billed_charge":2346.90,"npi":[1558554998]}]},{"allowed_amount":1452.64,"providers":[{"billed_charge":3755.04,"npi":[1538212485]}]},{"allowed_amount":3903.97,"providers":[{"billed_charge":10091.67,"npi":[1396368734]}]},{"allowed_amount":263.64,"providers":[{"billed_charge":938.76,"npi":[1538212485]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":14526.40,"providers":[{"billed_charge":24000.00,"npi":[1114330974]}]}]},{"tin":{"type":"ein","value":"823482082"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":231.51,"providers":[{"billed_charge":660.00,"npi":[1295497279]}]}]},{"tin":{"type":"ein","value":"833394221"},"service_code":["11","02","20"],"billing_class":"professional","payments":[{"allowed_amount":168.06,"providers":[{"billed_charge":1088.88,"npi":[1457065930]}]},{"allowed_amount":1080.38,"providers":[{"billed_charge":5094.96,"npi":[1457065930]}]},{"allowed_amount":154.34,"providers":[{"billed_charge":726.96,"npi":[1457065930]}]}]},{"tin":{"type":"ein","value":"853275263"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2006.42,"providers":[{"billed_charge":6370.00,"npi":[1043656135]}]}]},{"tin":{"type":"ein","value":"261358156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":655.11,"providers":[{"billed_charge":1125.00,"npi":[1003656281]}]}]},{"tin":{"type":"ein","value":"842071867"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":77.17,"providers":[{"billed_charge":274.00,"npi":[1013167162]}]}]},{"tin":{"type":"ein","value":"842847032"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":873.48,"providers":[{"billed_charge":1200.00,"npi":[1770303083]}]}]},{"tin":{"type":"ein","value":"382374946"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":726.32,"providers":[{"billed_charge":867.60,"npi":[1265503031]}]}]},{"tin":{"type":"ein","value":"464805855"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":817.11,"providers":[{"billed_charge":963.00,"npi":[1780137927]}]}]},{"tin":{"type":"ein","value":"382406558"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":53.25,"providers":[{"billed_charge":75.00,"npi":[1427092147]}]},{"allowed_amount":1601.16,"providers":[{"billed_charge":1650.00,"npi":[1427092147]}]}]},{"tin":{"type":"ein","value":"382719621"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.79,"providers":[{"billed_charge":120.00,"npi":[1578727335]}]}]},{"tin":{"type":"ein","value":"933109432"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":90.79,"providers":[{"billed_charge":272.37,"npi":[1932761467]}]}]},{"tin":{"type":"ein","value":"381357020"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":65.91,"providers":[{"billed_charge":99.00,"npi":[1275718793]}]}]},{"tin":{"type":"ein","value":"383251354"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1969.49,"providers":[{"billed_charge":2415.00,"npi":[1093339145]}]}]},{"tin":{"type":"ein","value":"475372624"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1311.89,"providers":[{"billed_charge":3086.86,"npi":[1245936012]}]}]},{"tin":{"type":"ein","value":"386004868"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":272.37,"providers":[{"billed_charge":1304.19,"npi":[1538106059]}]}]},{"tin":{"type":"ein","value":"474895529"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1389.06,"providers":[{"billed_charge":3350.16,"npi":[1154032670]}]},{"allowed_amount":771.70,"providers":[{"billed_charge":1861.20,"npi":[1629753223]}]},{"allowed_amount":2623.78,"providers":[{"billed_charge":6328.08,"npi":[1245982909]}]}]},{"tin":{"type":"ein","value":"383246949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1634.22,"providers":[{"billed_charge":2070.00,"npi":[1376593228]}]}]},{"tin":{"type":"ein","value":"853595065"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":659.10,"providers":[{"billed_charge":1500.00,"npi":[1295227460]}]},{"allowed_amount":6355.30,"providers":[{"billed_charge":10500.00,"npi":[1295227460]}]}]},{"tin":{"type":"ein","value":"824961447"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":272.37,"providers":[{"billed_charge":480.00,"npi":[1447323829]}]},{"allowed_amount":2702.31,"providers":[{"billed_charge":6560.00,"npi":[1447323829]}]}]},{"tin":{"type":"ein","value":"863366964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":363.95,"providers":[{"billed_charge":975.00,"npi":[1699199125]}]}]},{"tin":{"type":"ein","value":"383584702"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1455.71,"providers":[{"billed_charge":2040.00,"npi":[1215021472]}]}]},{"tin":{"type":"ein","value":"382257883"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":907.90,"providers":[{"billed_charge":1200.00,"npi":[1346693413]}]}]}]},{"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":"382311840"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2304.72,"providers":[{"billed_charge":2520.00,"npi":[1255499257]}]}]},{"tin":{"type":"ein","value":"821804736"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1480.19,"providers":[{"billed_charge":6358.00,"npi":[1285231662]}]},{"allowed_amount":1741.40,"providers":[{"billed_charge":7480.00,"npi":[1952016941]}]}]},{"tin":{"type":"ein","value":"472621929"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3373.73,"providers":[{"billed_charge":11594.00,"npi":[1851094940]}]}]},{"tin":{"type":"ein","value":"813667937"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1456.50,"providers":[{"billed_charge":2850.00,"npi":[1538422548]}]},{"allowed_amount":11523.60,"providers":[{"billed_charge":17100.00,"npi":[1538422548]}]}]},{"tin":{"type":"ein","value":"465695978"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2650.34,"providers":[{"billed_charge":8976.00,"npi":[1770312514]}]}]},{"tin":{"type":"ein","value":"383844634"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":2176.68,"providers":[{"billed_charge":3913.06,"npi":[1558554998]}]},{"allowed_amount":5121.60,"providers":[{"billed_charge":9207.20,"npi":[1396368734]}]}]},{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":15492.84,"providers":[{"billed_charge":24250.00,"npi":[1114330974]}]}]},{"tin":{"type":"ein","value":"823482082"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":544.15,"providers":[{"billed_charge":1635.00,"npi":[1871195727]}]}]},{"tin":{"type":"ein","value":"821784717"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":348.28,"providers":[{"billed_charge":1496.00,"npi":[1891478889]}]}]},{"tin":{"type":"ein","value":"833394221"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3264.90,"providers":[{"billed_charge":15387.12,"npi":[1457065930]}]},{"allowed_amount":1523.62,"providers":[{"billed_charge":7208.32,"npi":[1669243135]}]}]},{"tin":{"type":"ein","value":"382027689"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":92.25,"providers":[{"billed_charge":224.00,"npi":[1689682551]}]}]},{"tin":{"type":"ein","value":"853275263"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":108.83,"providers":[{"billed_charge":315.00,"npi":[1043656135]}]}]},{"tin":{"type":"ein","value":"851404855"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":2806.36,"providers":[{"billed_charge":7050.00,"npi":[1043507833]}]},{"allowed_amount":2228.58,"providers":[{"billed_charge":5800.00,"npi":[1043507833]}]}]},{"tin":{"type":"ein","value":"61772985"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.83,"providers":[{"billed_charge":260.00,"npi":[1114382637]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":1502.16,"providers":[{"billed_charge":3424.00,"npi":[1942891353]}]},{"allowed_amount":1752.52,"providers":[{"billed_charge":3948.00,"npi":[1679117063]}]},{"allowed_amount":2253.24,"providers":[{"billed_charge":5116.00,"npi":[1629640479]}]}]},{"tin":{"type":"ein","value":"383593303"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":166.45,"providers":[{"billed_charge":333.00,"npi":[1669035366]}]}]},{"tin":{"type":"ein","value":"821936174"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":761.81,"providers":[{"billed_charge":1225.00,"npi":[1194231597]}]}]},{"tin":{"type":"ein","value":"382719621"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4097.28,"providers":[{"billed_charge":5696.00,"npi":[1578727335]}]}]},{"tin":{"type":"ein","value":"320415553"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":652.98,"providers":[{"billed_charge":1175.00,"npi":[1366994816]}]}]},{"tin":{"type":"ein","value":"381358212"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":121.38,"providers":[{"billed_charge":177.00,"npi":[1194797035]}]},{"allowed_amount":1120.35,"providers":[{"billed_charge":1722.00,"npi":[1194797035]}]}]},{"tin":{"type":"ein","value":"382692114"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2944.92,"providers":[{"billed_charge":4025.00,"npi":[1083807176]}]}]},{"tin":{"type":"ein","value":"475372624"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1414.79,"providers":[{"billed_charge":3329.04,"npi":[1245936012]}]}]},{"tin":{"type":"ein","value":"852032491"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2688.84,"providers":[{"billed_charge":6090.00,"npi":[1275024606]}]}]},{"tin":{"type":"ein","value":"474895529"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2829.58,"providers":[{"billed_charge":6867.12,"npi":[1629753223]}]},{"allowed_amount":870.64,"providers":[{"billed_charge":2112.96,"npi":[1154032670]}]},{"allowed_amount":2176.60,"providers":[{"billed_charge":5282.40,"npi":[1245982909]}]}]},{"tin":{"type":"ein","value":"832004627"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1024.32,"providers":[{"billed_charge":1400.00,"npi":[1255772604]}]}]},{"tin":{"type":"ein","value":"383246949"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":13700.28,"providers":[{"billed_charge":17655.00,"npi":[1376593228]}]}]},{"tin":{"type":"ein","value":"853595065"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5249.64,"providers":[{"billed_charge":8200.00,"npi":[1295227460]}]}]},{"tin":{"type":"ein","value":"382833497"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":326.49,"providers":[{"billed_charge":413.43,"npi":[1679390645]}]}]},{"tin":{"type":"ein","value":"382257883"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2816.88,"providers":[{"billed_charge":3300.00,"npi":[1346693413]}]},{"allowed_amount":97.10,"providers":[{"billed_charge":150.00,"npi":[1346693413]}]},{"allowed_amount":3201.00,"providers":[{"billed_charge":3750.00,"npi":[1629459904]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99215","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"462781294"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1099.71,"providers":[{"billed_charge":1800.00,"npi":[1093423824]}]},{"allowed_amount":97.47,"providers":[{"billed_charge":200.00,"npi":[1093423824]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99222","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"382081222"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":2347.08,"providers":[{"billed_charge":2424.00,"npi":[1972584191]}]},{"allowed_amount":782.36,"providers":[{"billed_charge":808.00,"npi":[1972584191]}]}]},{"tin":{"type":"ein","value":"463857474"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":260.78,"providers":[{"billed_charge":400.00,"npi":[1730464561]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99223","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"810667403"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":250.00,"providers":[{"billed_charge":250.00,"npi":[1245281435]}]}]},{"tin":{"type":"ein","value":"811672122"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":867.20,"providers":[{"billed_charge":1250.00,"npi":[1881258820]}]}]}]},{"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":"220966774"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":294.08,"providers":[{"billed_charge":340.00,"npi":[1669576906]}]}]},{"tin":{"type":"ein","value":"853978891"},"service_code":["51","21"],"billing_class":"professional","payments":[{"allowed_amount":4680.00,"providers":[{"billed_charge":4680.00,"npi":[1417156332]}]},{"allowed_amount":1820.00,"providers":[{"billed_charge":1820.00,"npi":[1417156332]}]}]},{"tin":{"type":"ein","value":"843331851"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2132.08,"providers":[{"billed_charge":2175.00,"npi":[1871611251]}]}]},{"tin":{"type":"ein","value":"364827394"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":694.08,"providers":[{"billed_charge":1280.00,"npi":[1841955846]}]}]},{"tin":{"type":"ein","value":"382407635"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":808.72,"providers":[{"billed_charge":1045.00,"npi":[1902970619]}]}]}]},{"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":"263366822"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1203.52,"providers":[{"billed_charge":8000.00,"npi":[1235624719]}]}]},{"tin":{"type":"ein","value":"814061406"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":237.66,"providers":[{"billed_charge":280.00,"npi":[1508120627]}]}]},{"tin":{"type":"ein","value":"382789107"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1279.46,"providers":[{"billed_charge":2394.00,"npi":[1508521105]}]}]},{"tin":{"type":"ein","value":"451068969"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":400.00,"providers":[{"billed_charge":400.00,"npi":[1265559488]}]}]},{"tin":{"type":"ein","value":"382262467"},"service_code":["51","21"],"billing_class":"professional","payments":[{"allowed_amount":3683.73,"providers":[{"billed_charge":3875.00,"npi":[1386657427]}]},{"allowed_amount":950.64,"providers":[{"billed_charge":1000.00,"npi":[1386657427]}]}]},{"tin":{"type":"ein","value":"680655441"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":946.88,"providers":[{"billed_charge":990.00,"npi":[1003921891]}]}]},{"tin":{"type":"ein","value":"833394001"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1544.79,"providers":[{"billed_charge":4264.00,"npi":[1447554654]}]}]},{"tin":{"type":"ein","value":"382027689"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":225.66,"providers":[{"billed_charge":684.00,"npi":[1548421167]}]}]},{"tin":{"type":"ein","value":"200760613"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":831.81,"providers":[{"billed_charge":840.00,"npi":[1316938061]}]}]},{"tin":{"type":"ein","value":"383536668"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":10450.00,"providers":[{"billed_charge":10450.00,"npi":[1184661670]}]}]},{"tin":{"type":"ein","value":"853978891"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":950.00,"providers":[{"billed_charge":950.00,"npi":[1417156332]}]}]},{"tin":{"type":"ein","value":"382383119"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3046.41,"providers":[{"billed_charge":6426.00,"npi":[1275927295,1992199194]}]},{"allowed_amount":451.32,"providers":[{"billed_charge":952.00,"npi":[1689949315]}]}]},{"tin":{"type":"ein","value":"383481310"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1600.00,"providers":[{"billed_charge":1600.00,"npi":[1841272259]}]}]},{"tin":{"type":"ein","value":"870805677"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":15010.00,"providers":[{"billed_charge":15010.00,"npi":[1750393690]}]}]},{"tin":{"type":"ein","value":"262719426"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":633.76,"providers":[{"billed_charge":960.00,"npi":[1043237951]}]},{"allowed_amount":79.22,"providers":[{"billed_charge":120.00,"npi":[1043237951]}]}]},{"tin":{"type":"ein","value":"382796478"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":6575.26,"providers":[{"billed_charge":8400.00,"npi":[1255372058]}]}]},{"tin":{"type":"ein","value":"611922162"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":600.26,"providers":[{"billed_charge":2765.70,"npi":[1699833897]}]}]},{"tin":{"type":"ein","value":"382550047"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":237.66,"providers":[{"billed_charge":375.00,"npi":[1447875976]}]},{"allowed_amount":633.76,"providers":[{"billed_charge":1000.00,"npi":[1922673342]}]}]},{"tin":{"type":"ein","value":"383614942"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1307.13,"providers":[{"billed_charge":1320.00,"npi":[1770568198]}]}]},{"tin":{"type":"ein","value":"752398395"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5466.18,"providers":[{"billed_charge":5750.00,"npi":[1124029335]}]}]},{"tin":{"type":"ein","value":"933895859"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":338.49,"providers":[{"billed_charge":1665.00,"npi":[1013142827]}]}]},{"tin":{"type":"ein","value":"381359063"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":396.12,"providers":[{"billed_charge":400.00,"npi":[1740568377]}]}]},{"tin":{"type":"ein","value":"383276498"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":158.44,"providers":[{"billed_charge":220.00,"npi":[1871949925]}]}]},{"tin":{"type":"ein","value":"822784244"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":3501.66,"providers":[{"billed_charge":5406.00,"npi":[1679764997]}]}]},{"tin":{"type":"ein","value":"990777079"},"service_code":["02","51"],"billing_class":"professional","payments":[{"allowed_amount":319.70,"providers":[{"billed_charge":1975.50,"npi":[1336859198]}]},{"allowed_amount":992.94,"providers":[{"billed_charge":3951.00,"npi":[1386756740]}]}]},{"tin":{"type":"ein","value":"814043627"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1425.96,"providers":[{"billed_charge":2100.00,"npi":[1821239302]}]},{"allowed_amount":118.83,"providers":[{"billed_charge":175.00,"npi":[1821239302]}]}]},{"tin":{"type":"ein","value":"375088693"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":8470.00,"providers":[{"billed_charge":8470.00,"npi":[1417064502]}]}]},{"tin":{"type":"ein","value":"80660230"},"service_code":["22","51","21"],"billing_class":"professional","payments":[{"allowed_amount":237.66,"providers":[{"billed_charge":250.00,"npi":[1972585248]}]},{"allowed_amount":118.83,"providers":[{"billed_charge":125.00,"npi":[1972585248]}]},{"allowed_amount":2851.92,"providers":[{"billed_charge":3000.00,"npi":[1972585248]}]}]},{"tin":{"type":"ein","value":"823744003"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1166.10,"providers":[{"billed_charge":1320.00,"npi":[1740661982]}]}]},{"tin":{"type":"ein","value":"834605197"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1109.08,"providers":[{"billed_charge":1260.00,"npi":[1730854605]}]}]},{"tin":{"type":"ein","value":"161768956"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":450.00,"providers":[{"billed_charge":450.00,"npi":[1205834470]}]},{"allowed_amount":270.00,"providers":[{"billed_charge":270.00,"npi":[1205834470]}]}]},{"tin":{"type":"ein","value":"383447980"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":554.54,"providers":[{"billed_charge":679.00,"npi":[1396725305]}]}]},{"tin":{"type":"ein","value":"851540000"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":431.69,"providers":[{"billed_charge":1092.00,"npi":[1033745310]}]}]},{"tin":{"type":"ein","value":"811672122"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1505.18,"providers":[{"billed_charge":5700.00,"npi":[1881258820]}]}]},{"tin":{"type":"ein","value":"382407635"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":5440.00,"providers":[{"billed_charge":5440.00,"npi":[1902970619]}]}]}]},{"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":"263366822"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":224.16,"providers":[{"billed_charge":1436.00,"npi":[1760010474]}]}]},{"tin":{"type":"ein","value":"383276498"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":4233.96,"providers":[{"billed_charge":5805.00,"npi":[1871949925]}]}]},{"tin":{"type":"ein","value":"431992138"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1008.72,"providers":[{"billed_charge":1485.00,"npi":[1669033700]}]}]},{"tin":{"type":"ein","value":"382597466"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":336.24,"providers":[{"billed_charge":375.00,"npi":[1225426893]}]}]},{"tin":{"type":"ein","value":"205326061"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1400.00,"providers":[{"billed_charge":1400.00,"npi":[1912941477]}]}]},{"tin":{"type":"ein","value":"900977152"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":99.97,"providers":[{"billed_charge":400.00,"npi":[1780226613]}]}]},{"tin":{"type":"ein","value":"834368857"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":6016.00,"providers":[{"billed_charge":6016.00,"npi":[1689962136]}]},{"allowed_amount":176.00,"providers":[{"billed_charge":176.00,"npi":[1689962136]}]}]},{"tin":{"type":"ein","value":"992089266"},"service_code":["02","21"],"billing_class":"professional","payments":[{"allowed_amount":224.16,"providers":[{"billed_charge":352.00,"npi":[1639481344]}]},{"allowed_amount":1646.54,"providers":[{"billed_charge":2464.00,"npi":[1639481344]}]}]},{"tin":{"type":"ein","value":"382550047"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2705.03,"providers":[{"billed_charge":4255.00,"npi":[1922673342]}]}]},{"tin":{"type":"ein","value":"991552518"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":761.60,"providers":[{"billed_charge":1757.55,"npi":[1306191853]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99283","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"383345124"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":107.94,"providers":[{"billed_charge":576.00,"npi":[1619910106]}]}]},{"tin":{"type":"ein","value":"382537427"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1079.40,"providers":[{"billed_charge":4935.00,"npi":[1972562171]}]}]}]},{"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":"611442402"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":739.16,"providers":[{"billed_charge":3988.00,"npi":[1598189334]}]},{"allowed_amount":184.79,"providers":[{"billed_charge":997.00,"npi":[1952977357]}]},{"allowed_amount":923.95,"providers":[{"billed_charge":4985.00,"npi":[1225234354]}]}]},{"tin":{"type":"ein","value":"381914446"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":116.43,"providers":[{"billed_charge":717.00,"npi":[1801091970]}]},{"allowed_amount":582.15,"providers":[{"billed_charge":3585.00,"npi":[1063733038]}]}]},{"tin":{"type":"ein","value":"383345124"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":369.58,"providers":[{"billed_charge":1938.00,"npi":[1033670724,1790700292]}]},{"allowed_amount":6087.93,"providers":[{"billed_charge":31977.00,"npi":[1124642095]}]},{"allowed_amount":184.79,"providers":[{"billed_charge":969.00,"npi":[1558318741,1578050340]}]},{"allowed_amount":554.37,"providers":[{"billed_charge":2907.00,"npi":[1992325542,1952325961,1073896346,1568774008,1679198972,1396235685]}]},{"allowed_amount":923.95,"providers":[{"billed_charge":4845.00,"npi":[1982991824,1346251816,1194216101]}]},{"allowed_amount":1108.74,"providers":[{"billed_charge":5814.00,"npi":[1699902239,1740544915]}]},{"allowed_amount":3695.80,"providers":[{"billed_charge":19380.00,"npi":[1669748091]}]},{"allowed_amount":739.16,"providers":[{"billed_charge":3876.00,"npi":[1184201048,1801245618]}]},{"allowed_amount":16631.10,"providers":[{"billed_charge":87210.00,"npi":[1619910106]}]},{"allowed_amount":1766.78,"providers":[{"billed_charge":9690.00,"npi":[1811334386]}]},{"allowed_amount":2217.48,"providers":[{"billed_charge":11628.00,"npi":[1215135553]}]},{"allowed_amount":5543.70,"providers":[{"billed_charge":29070.00,"npi":[1306056106]}]},{"allowed_amount":13489.67,"providers":[{"billed_charge":70737.00,"npi":[1255373130]}]},{"allowed_amount":2587.06,"providers":[{"billed_charge":13566.00,"npi":[1407029564,1700824968]}]},{"allowed_amount":1478.32,"providers":[{"billed_charge":7752.00,"npi":[1144516352,1245404896,1275196669,1447660212]}]},{"allowed_amount":1256.56,"providers":[{"billed_charge":7752.00,"npi":[1386096964]}]},{"allowed_amount":1663.11,"providers":[{"billed_charge":8721.00,"npi":[1619916178]}]},{"allowed_amount":4434.96,"providers":[{"billed_charge":23256.00,"npi":[1245646868]}]},{"allowed_amount":4715.55,"providers":[{"billed_charge":26163.00,"npi":[1326088030]}]},{"allowed_amount":1293.53,"providers":[{"billed_charge":6783.00,"npi":[1942865894,1518913557,1164862561]}]},{"allowed_amount":1468.18,"providers":[{"billed_charge":7752.00,"npi":[1710079074]}]},{"allowed_amount":3326.22,"providers":[{"billed_charge":17442.00,"npi":[1497800767]}]},{"allowed_amount":3511.01,"providers":[{"billed_charge":18411.00,"npi":[1417306184]}]},{"allowed_amount":2956.64,"providers":[{"billed_charge":15504.00,"npi":[1487886685]}]},{"allowed_amount":359.44,"providers":[{"billed_charge":1938.00,"npi":[1124327366]}]},{"allowed_amount":1847.90,"providers":[{"billed_charge":9690.00,"npi":[1740696400,1588874374]}]}]},{"tin":{"type":"ein","value":"454019145"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":369.58,"providers":[{"billed_charge":2052.00,"npi":[1780621425]}]},{"allowed_amount":554.37,"providers":[{"billed_charge":3078.00,"npi":[1407351018]}]}]},{"tin":{"type":"ein","value":"381357020"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":166.31,"providers":[{"billed_charge":401.00,"npi":[1841400389]}]},{"allowed_amount":1256.52,"providers":[{"billed_charge":4812.00,"npi":[1619419553]}]}]},{"tin":{"type":"ein","value":"382537427"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":369.57,"providers":[{"billed_charge":1881.00,"npi":[1427444843]}]},{"allowed_amount":2833.37,"providers":[{"billed_charge":14421.00,"npi":[1245686831,1598040677]}]},{"allowed_amount":1724.66,"providers":[{"billed_charge":8778.00,"npi":[1528379997]}]},{"allowed_amount":7514.59,"providers":[{"billed_charge":38247.00,"npi":[1972562171]}]},{"allowed_amount":3942.08,"providers":[{"billed_charge":20064.00,"npi":[1588985923]}]},{"allowed_amount":862.33,"providers":[{"billed_charge":4389.00,"npi":[1083827612,1790359792]}]},{"allowed_amount":4681.22,"providers":[{"billed_charge":23826.00,"npi":[1063767457]}]},{"allowed_amount":6098.07,"providers":[{"billed_charge":20691.00,"npi":[1679829667]}]},{"allowed_amount":554.37,"providers":[{"billed_charge":1881.00,"npi":[1104863349]}]},{"allowed_amount":923.95,"providers":[{"billed_charge":3135.00,"npi":[1003853201]}]},{"allowed_amount":1108.71,"providers":[{"billed_charge":5643.00,"npi":[1386140366,1356900054]}]},{"allowed_amount":3880.59,"providers":[{"billed_charge":13167.00,"npi":[1003875287]}]},{"allowed_amount":1570.65,"providers":[{"billed_charge":9405.00,"npi":[1629455993]}]},{"allowed_amount":123.19,"providers":[{"billed_charge":627.00,"npi":[1619997160,1720510209]}]},{"allowed_amount":523.55,"providers":[{"billed_charge":3135.00,"npi":[1467949446]}]},{"allowed_amount":3326.13,"providers":[{"billed_charge":16929.00,"npi":[1922462183,1083633887,1922628676]}]},{"allowed_amount":3695.70,"providers":[{"billed_charge":18810.00,"npi":[1508204587]}]},{"allowed_amount":1847.85,"providers":[{"billed_charge":9405.00,"npi":[1306883541]}]},{"allowed_amount":492.76,"providers":[{"billed_charge":2508.00,"npi":[1558894378]}]},{"allowed_amount":246.38,"providers":[{"billed_charge":1254.00,"npi":[1346694478]}]},{"allowed_amount":3202.94,"providers":[{"billed_charge":16302.00,"npi":[1689849002,1154553964]}]},{"allowed_amount":4927.60,"providers":[{"billed_charge":25080.00,"npi":[1245209410]}]},{"allowed_amount":985.52,"providers":[{"billed_charge":5016.00,"npi":[1720547045]}]},{"allowed_amount":5666.74,"providers":[{"billed_charge":28842.00,"npi":[1427255835]}]},{"allowed_amount":1355.09,"providers":[{"billed_charge":6897.00,"npi":[1700827490,1497714265]}]},{"allowed_amount":2710.18,"providers":[{"billed_charge":13794.00,"npi":[1023373503]}]},{"allowed_amount":314.13,"providers":[{"billed_charge":1881.00,"npi":[1184661928]}]},{"allowed_amount":2094.23,"providers":[{"billed_charge":10659.00,"npi":[1063783181]}]},{"allowed_amount":1293.53,"providers":[{"billed_charge":4389.00,"npi":[1366688442]}]},{"allowed_amount":4311.65,"providers":[{"billed_charge":21945.00,"npi":[1093378507]}]},{"allowed_amount":2586.99,"providers":[{"billed_charge":13167.00,"npi":[1740592294]}]},{"allowed_amount":1231.90,"providers":[{"billed_charge":6270.00,"npi":[1811330467]}]}]},{"tin":{"type":"ein","value":"811230538"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":554.37,"providers":[{"billed_charge":2448.00,"npi":[1407066095]}]}]},{"tin":{"type":"ein","value":"462593177"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5063.74,"providers":[{"billed_charge":12540.00,"npi":[1396819900]}]},{"allowed_amount":9206.80,"providers":[{"billed_charge":22800.00,"npi":[1104137025]}]},{"allowed_amount":3682.72,"providers":[{"billed_charge":9120.00,"npi":[1114330974]}]},{"allowed_amount":6444.76,"providers":[{"billed_charge":15960.00,"npi":[1598028003]}]}]},{"tin":{"type":"ein","value":"843515632"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":873.25,"providers":[{"billed_charge":7670.00,"npi":[1518587591]}]},{"allowed_amount":1222.55,"providers":[{"billed_charge":10738.00,"npi":[1134185051]}]},{"allowed_amount":1921.15,"providers":[{"billed_charge":16874.00,"npi":[1700883204]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":9310.42,"providers":[{"billed_charge":42998.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"382988086"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":8315.55,"providers":[{"billed_charge":20070.00,"npi":[1487183984]}]},{"allowed_amount":2587.06,"providers":[{"billed_charge":6244.00,"npi":[1497923221]}]},{"allowed_amount":11826.56,"providers":[{"billed_charge":28544.00,"npi":[1730292343]}]},{"allowed_amount":8500.34,"providers":[{"billed_charge":20516.00,"npi":[1861873390]}]},{"allowed_amount":349.30,"providers":[{"billed_charge":892.00,"npi":[1407080286]}]},{"allowed_amount":2771.85,"providers":[{"billed_charge":6690.00,"npi":[1356733489]}]},{"allowed_amount":523.95,"providers":[{"billed_charge":1338.00,"npi":[1144649203]}]},{"allowed_amount":7391.60,"providers":[{"billed_charge":17840.00,"npi":[1588289003,1861832552]}]}]},{"tin":{"type":"ein","value":"873710985"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3326.22,"providers":[{"billed_charge":22392.00,"npi":[1114986734]}]},{"allowed_amount":729.02,"providers":[{"billed_charge":4976.00,"npi":[1609823921]}]},{"allowed_amount":1478.32,"providers":[{"billed_charge":9952.00,"npi":[1336458249]}]},{"allowed_amount":554.37,"providers":[{"billed_charge":3732.00,"npi":[1245218734]}]},{"allowed_amount":1663.11,"providers":[{"billed_charge":11196.00,"npi":[1508313313]}]},{"allowed_amount":4199.47,"providers":[{"billed_charge":28612.00,"npi":[1467554949]}]},{"allowed_amount":923.95,"providers":[{"billed_charge":6220.00,"npi":[1619048329]}]},{"allowed_amount":1108.74,"providers":[{"billed_charge":7464.00,"npi":[1821451642]}]}]}]},{"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":"381914446"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":337.96,"providers":[{"billed_charge":2078.00,"npi":[1154905719,1801091970]}]}]},{"tin":{"type":"ein","value":"383345124"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":506.94,"providers":[{"billed_charge":2818.00,"npi":[1588015879,1811334386,1487866976]}]},{"allowed_amount":804.93,"providers":[{"billed_charge":4227.00,"npi":[1659505378]}]},{"allowed_amount":1341.55,"providers":[{"billed_charge":7045.00,"npi":[1922362185]}]},{"allowed_amount":4292.96,"providers":[{"billed_charge":22544.00,"npi":[1700824968,1801245618]}]},{"allowed_amount":1609.86,"providers":[{"billed_charge":8454.00,"npi":[1790342996,1841811072]}]},{"allowed_amount":536.62,"providers":[{"billed_charge":2818.00,"npi":[1558318741,1578845459,1255540894,1184201048]}]},{"allowed_amount":1878.17,"providers":[{"billed_charge":9863.00,"npi":[1144516352,1194216101,1740544915,1235579467]}]},{"allowed_amount":1073.24,"providers":[{"billed_charge":5636.00,"npi":[1447660212,1699902239]}]},{"allowed_amount":2951.41,"providers":[{"billed_charge":15499.00,"npi":[1982991824,1255373130,1669748091]}]},{"allowed_amount":3756.34,"providers":[{"billed_charge":19726.00,"npi":[1144631292,1245646868]}]},{"allowed_amount":5097.89,"providers":[{"billed_charge":26771.00,"npi":[1578121703]}]},{"allowed_amount":1774.29,"providers":[{"billed_charge":9863.00,"npi":[1669791760]}]},{"allowed_amount":2146.48,"providers":[{"billed_charge":11272.00,"npi":[1407029564,1568774008,1245404896,1346538766,1396235685,1790700292]}]},{"allowed_amount":4814.74,"providers":[{"billed_charge":25362.00,"npi":[1124642095]}]},{"allowed_amount":2668.26,"providers":[{"billed_charge":14090.00,"npi":[1710079074]}]},{"allowed_amount":8854.23,"providers":[{"billed_charge":46497.00,"npi":[1073896346]}]},{"allowed_amount":3219.72,"providers":[{"billed_charge":16908.00,"npi":[1275196669,1215135553]}]},{"allowed_amount":4055.52,"providers":[{"billed_charge":22544.00,"npi":[1598250946]}]},{"allowed_amount":5351.36,"providers":[{"billed_charge":28180.00,"npi":[1487886685]}]},{"allowed_amount":2683.10,"providers":[{"billed_charge":14090.00,"npi":[1184245383,1346251816,1679198972,1154618254,1619916178]}]},{"allowed_amount":5902.82,"providers":[{"billed_charge":30998.00,"npi":[1497800767]}]},{"allowed_amount":4024.65,"providers":[{"billed_charge":21135.00,"npi":[1346816774,1588874374,1417306184]}]},{"allowed_amount":6707.75,"providers":[{"billed_charge":35225.00,"npi":[1992325542]}]},{"allowed_amount":3548.58,"providers":[{"billed_charge":19726.00,"npi":[1407177884]}]},{"allowed_amount":684.18,"providers":[{"billed_charge":4227.00,"npi":[1386096964]}]},{"allowed_amount":4561.27,"providers":[{"billed_charge":23953.00,"npi":[1215977343,1619910106]}]},{"allowed_amount":253.47,"providers":[{"billed_charge":1409.00,"npi":[1962468090,1396907150,1801232434,1043621931]}]},{"allowed_amount":3994.97,"providers":[{"billed_charge":21135.00,"npi":[1033670724]}]},{"allowed_amount":268.31,"providers":[{"billed_charge":1409.00,"npi":[1730529223,1265926018,1952325961,1033796297,1942865894,1487146825]}]},{"allowed_amount":3891.09,"providers":[{"billed_charge":21135.00,"npi":[1124327366]}]},{"allowed_amount":5634.51,"providers":[{"billed_charge":29589.00,"npi":[1740696400]}]},{"allowed_amount":6439.44,"providers":[{"billed_charge":33816.00,"npi":[1306056106]}]}]},{"tin":{"type":"ein","value":"454019145"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1609.86,"providers":[{"billed_charge":9096.00,"npi":[1033438130]}]}]},{"tin":{"type":"ein","value":"844478409"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":357.44,"providers":[{"billed_charge":1688.00,"npi":[1346623568]}]},{"allowed_amount":1267.35,"providers":[{"billed_charge":4220.00,"npi":[1104127760]}]},{"allowed_amount":587.85,"providers":[{"billed_charge":2532.00,"npi":[1316443054]}]}]},{"tin":{"type":"ein","value":"382537427"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3935.14,"providers":[{"billed_charge":20284.00,"npi":[1972562171]}]},{"allowed_amount":3577.40,"providers":[{"billed_charge":18440.00,"npi":[1427444843]}]},{"allowed_amount":178.87,"providers":[{"billed_charge":922.00,"npi":[1528379997]}]},{"allowed_amount":1609.86,"providers":[{"billed_charge":5532.00,"npi":[1366688442]}]},{"allowed_amount":536.61,"providers":[{"billed_charge":2766.00,"npi":[1588985923]}]},{"allowed_amount":1609.83,"providers":[{"billed_charge":8298.00,"npi":[1063767457,1083633887]}]},{"allowed_amount":3040.79,"providers":[{"billed_charge":15674.00,"npi":[1083827612,1740592294]}]},{"allowed_amount":3398.53,"providers":[{"billed_charge":17518.00,"npi":[1093378507]}]},{"allowed_amount":1967.57,"providers":[{"billed_charge":10142.00,"npi":[1063783181,1508204587]}]},{"allowed_amount":2861.92,"providers":[{"billed_charge":14752.00,"npi":[1245686831]}]},{"allowed_amount":2325.31,"providers":[{"billed_charge":11986.00,"npi":[1790359792,1922628676]}]},{"allowed_amount":1788.70,"providers":[{"billed_charge":9220.00,"npi":[1154553964]}]},{"allowed_amount":715.48,"providers":[{"billed_charge":3688.00,"npi":[1922462183,1689849002,1619997160,1720547045]}]},{"allowed_amount":3756.27,"providers":[{"billed_charge":19362.00,"npi":[1023373503,1811330467]}]},{"allowed_amount":6975.93,"providers":[{"billed_charge":35958.00,"npi":[1700827490]}]},{"allowed_amount":2951.41,"providers":[{"billed_charge":10142.00,"npi":[1679829667]}]},{"allowed_amount":894.35,"providers":[{"billed_charge":4610.00,"npi":[1558894378,1346287513]}]},{"allowed_amount":1430.96,"providers":[{"billed_charge":7376.00,"npi":[1427255835]}]},{"allowed_amount":5544.97,"providers":[{"billed_charge":28582.00,"npi":[1598040677]}]},{"allowed_amount":2683.05,"providers":[{"billed_charge":13830.00,"npi":[1720510209]}]}]},{"tin":{"type":"ein","value":"811230538"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":3756.34,"providers":[{"billed_charge":16828.00,"npi":[1407066095]}]}]},{"tin":{"type":"ein","value":"462593177"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":20909.50,"providers":[{"billed_charge":51832.00,"npi":[1104137025]}]},{"allowed_amount":13490.00,"providers":[{"billed_charge":33440.00,"npi":[1396819900]}]},{"allowed_amount":5396.00,"providers":[{"billed_charge":13376.00,"npi":[1710349543]}]},{"allowed_amount":10792.00,"providers":[{"billed_charge":26752.00,"npi":[1750901443]}]},{"allowed_amount":26305.50,"providers":[{"billed_charge":65208.00,"npi":[1114330974]}]},{"allowed_amount":18211.50,"providers":[{"billed_charge":45144.00,"npi":[1598028003]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":12447.33,"providers":[{"billed_charge":62555.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"382988086"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":253.47,"providers":[{"billed_charge":684.00,"npi":[1215421904]}]},{"allowed_amount":1609.86,"providers":[{"billed_charge":4104.00,"npi":[1487183984]}]},{"allowed_amount":1013.88,"providers":[{"billed_charge":2736.00,"npi":[1407080286]}]},{"allowed_amount":2146.48,"providers":[{"billed_charge":5472.00,"npi":[1730292343]}]}]},{"tin":{"type":"ein","value":"873710985"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2590.80,"providers":[{"billed_charge":18020.00,"npi":[1114986734]}]},{"allowed_amount":1341.55,"providers":[{"billed_charge":9010.00,"npi":[1336458249]}]},{"allowed_amount":253.47,"providers":[{"billed_charge":1802.00,"npi":[1255521423]}]},{"allowed_amount":775.25,"providers":[{"billed_charge":5406.00,"npi":[1114960630]}]},{"allowed_amount":536.62,"providers":[{"billed_charge":3604.00,"npi":[1467554949]}]},{"allowed_amount":4737.28,"providers":[{"billed_charge":32436.00,"npi":[1821451642]}]},{"allowed_amount":2713.66,"providers":[{"billed_charge":19822.00,"npi":[1245218734]}]},{"allowed_amount":1595.02,"providers":[{"billed_charge":10812.00,"npi":[1609823921]}]},{"allowed_amount":1520.82,"providers":[{"billed_charge":10812.00,"npi":[1437500949]}]}]}]},{"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":"814182282"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":1833.80,"providers":[{"billed_charge":3700.00,"npi":[1376050096,1679134563]}]},{"allowed_amount":183.38,"providers":[{"billed_charge":370.00,"npi":[1376050096]}]}]},{"tin":{"type":"ein","value":"383433632"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":6472.20,"providers":[{"billed_charge":13500.00,"npi":[1053517540]}]},{"allowed_amount":1510.18,"providers":[{"billed_charge":3150.00,"npi":[1134575798]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99308","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"272480925"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":2275.71,"providers":[{"billed_charge":4030.00,"npi":[1790940526]}]}]},{"tin":{"type":"ein","value":"932550241"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":1615.02,"providers":[{"billed_charge":6996.00,"npi":[1437413721]}]}]},{"tin":{"type":"ein","value":"874406123"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":1372.80,"providers":[{"billed_charge":2750.00,"npi":[1851855845]}]},{"allowed_amount":748.80,"providers":[{"billed_charge":1500.00,"npi":[1548705783]}]}]},{"tin":{"type":"ein","value":"834368857"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":1560.00,"providers":[{"billed_charge":3090.00,"npi":[1033803127]}]},{"allowed_amount":249.60,"providers":[{"billed_charge":520.00,"npi":[1033803127]}]}]}]},{"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":"208305340"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":272.43,"providers":[{"billed_charge":1574.31,"npi":[1932525524]}]}]},{"tin":{"type":"ein","value":"205326061"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":1175.13,"providers":[{"billed_charge":1595.00,"npi":[1912941477]}]}]},{"tin":{"type":"ein","value":"815220142"},"service_code":["31","32"],"billing_class":"professional","payments":[{"allowed_amount":90.81,"providers":[{"billed_charge":352.00,"npi":[1568218832]}]}]}]},{"name":"Under Other Evaluation and Management Services","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99459","description":"Under Other Evaluation and Management Services","allowed_amounts":[{"tin":{"type":"ein","value":"383589415"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":857.22,"providers":[{"billed_charge":2100.00,"npi":[1558354159]}]},{"allowed_amount":81.64,"providers":[{"billed_charge":200.00,"npi":[1982697454]}]}]},{"tin":{"type":"ein","value":"381914289"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":67.65,"providers":[{"billed_charge":132.00,"npi":[1275252322]}]}]}]},{"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":"20753921"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5322.36,"providers":[{"billed_charge":6932.30,"npi":[1215982749]}]}]},{"tin":{"type":"ein","value":"386004619"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":105.79,"providers":[{"billed_charge":176.00,"npi":[1689610693]}]}]},{"tin":{"type":"ein","value":"382142110"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":200.25,"providers":[{"billed_charge":709.76,"npi":[1881627503]}]}]},{"tin":{"type":"ein","value":"382666933"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":130403.06,"providers":[{"billed_charge":199346.00,"npi":[1124056296]}]}]},{"tin":{"type":"ein","value":"382415274"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1102.14,"providers":[{"billed_charge":3384.30,"npi":[1528071115]}]}]},{"tin":{"type":"ein","value":"386005820"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":271.08,"providers":[{"billed_charge":384.00,"npi":[1134164585]}]}]},{"tin":{"type":"ein","value":"386004611"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3463.83,"providers":[{"billed_charge":4256.00,"npi":[1154172435]}]}]},{"tin":{"type":"ein","value":"386007226"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3308.81,"providers":[{"billed_charge":3868.00,"npi":[1386634863]}]}]},{"tin":{"type":"ein","value":"386004676"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1815.04,"providers":[{"billed_charge":2077.50,"npi":[1487722682]}]}]},{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":126221.56,"providers":[{"billed_charge":343162.45,"npi":[1720046188]}]}]},{"tin":{"type":"ein","value":"386008155"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2051.62,"providers":[{"billed_charge":2743.60,"npi":[1669416947]}]}]},{"tin":{"type":"ein","value":"382947312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23912.24,"providers":[{"billed_charge":45260.80,"npi":[1578510764]}]}]},{"tin":{"type":"ein","value":"382483662"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4676.55,"providers":[{"billed_charge":9750.00,"npi":[1689730939]}]}]},{"tin":{"type":"ein","value":"386007202"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1259.70,"providers":[{"billed_charge":4277.60,"npi":[1477589596]}]}]},{"tin":{"type":"ein","value":"386006334"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":247.05,"providers":[{"billed_charge":272.25,"npi":[1538568902]}]}]},{"tin":{"type":"ein","value":"382200909"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29795.54,"providers":[{"billed_charge":42697.90,"npi":[1689600975]}]}]},{"tin":{"type":"ein","value":"382783846"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":370.64,"providers":[{"billed_charge":572.55,"npi":[1629016274]}]}]},{"tin":{"type":"ein","value":"382485700"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18955.54,"providers":[{"billed_charge":22037.42,"npi":[1598877268]}]}]},{"tin":{"type":"ein","value":"990643623"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34536.01,"providers":[{"billed_charge":109326.00,"npi":[1457112534]}]}]},{"tin":{"type":"ein","value":"386031668"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1206.54,"providers":[{"billed_charge":1318.40,"npi":[1730119504]}]}]},{"tin":{"type":"ein","value":"381712300"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":737.36,"providers":[{"billed_charge":866.25,"npi":[1811010416]}]}]},{"tin":{"type":"ein","value":"386004606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":56237.70,"providers":[{"billed_charge":126797.85,"npi":[1477599900]}]}]},{"tin":{"type":"ein","value":"382196204"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":94.20,"providers":[{"billed_charge":298.50,"npi":[1063423473]}]}]},{"tin":{"type":"ein","value":"386004605"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2862.57,"providers":[{"billed_charge":3806.25,"npi":[1346282183]}]}]},{"tin":{"type":"ein","value":"386006926"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":193.80,"providers":[{"billed_charge":644.30,"npi":[1790724656]}]}]},{"tin":{"type":"ein","value":"381810301"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2348.01,"providers":[{"billed_charge":2814.82,"npi":[1114036464]}]}]},{"tin":{"type":"ein","value":"383316836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19079.25,"providers":[{"billed_charge":26045.90,"npi":[1871521542]}]}]},{"tin":{"type":"ein","value":"382138484"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13003.48,"providers":[{"billed_charge":22998.96,"npi":[1619932415]}]}]},{"tin":{"type":"ein","value":"822925189"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5181.77,"providers":[{"billed_charge":10665.20,"npi":[1205346319]}]}]},{"tin":{"type":"ein","value":"841657548"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12212.47,"providers":[{"billed_charge":12698.10,"npi":[1871898452]}]}]},{"tin":{"type":"ein","value":"382285796"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4979.41,"providers":[{"billed_charge":10167.50,"npi":[1689621047]}]}]},{"tin":{"type":"ein","value":"382094795"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1057.67,"providers":[{"billed_charge":1552.32,"npi":[1780688721]}]}]},{"tin":{"type":"ein","value":"386006902"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":448.52,"providers":[{"billed_charge":689.70,"npi":[1740221688]}]}]},{"tin":{"type":"ein","value":"382441192"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11946.88,"providers":[{"billed_charge":16452.90,"npi":[1457469462]}]}]},{"tin":{"type":"ein","value":"386006306"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1884.52,"providers":[{"billed_charge":2831.00,"npi":[1982644241]}]}]},{"tin":{"type":"ein","value":"383198397"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26880.53,"providers":[{"billed_charge":46626.80,"npi":[1306887260]}]}]},{"tin":{"type":"ein","value":"386007299"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":422.29,"providers":[{"billed_charge":572.90,"npi":[1649210154]}]}]},{"tin":{"type":"ein","value":"381869375"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1294.05,"providers":[{"billed_charge":1579.20,"npi":[1669618989]}]}]},{"tin":{"type":"ein","value":"113687518"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16086.52,"providers":[{"billed_charge":21954.60,"npi":[1699863704]}]}]}]},{"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":"382666933"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17003.60,"providers":[{"billed_charge":43200.00,"npi":[1124056296]}]}]},{"tin":{"type":"ein","value":"382485700"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1440.90,"providers":[{"billed_charge":2325.00,"npi":[1598877268]}]}]}]},{"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":"386004606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":55598.48,"providers":[{"billed_charge":164200.00,"npi":[1477599900]}]}]},{"tin":{"type":"ein","value":"386004605"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1606.08,"providers":[{"billed_charge":1700.00,"npi":[1346282183]}]}]},{"tin":{"type":"ein","value":"20753921"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8207.76,"providers":[{"billed_charge":10620.00,"npi":[1215982749]}]}]},{"tin":{"type":"ein","value":"382666933"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":302514.41,"providers":[{"billed_charge":597000.00,"npi":[1124056296]}]}]},{"tin":{"type":"ein","value":"381810301"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13254.11,"providers":[{"billed_charge":14938.43,"npi":[1114036464]}]}]},{"tin":{"type":"ein","value":"383316836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":62965.89,"providers":[{"billed_charge":92914.00,"npi":[1871521542]}]}]},{"tin":{"type":"ein","value":"382138484"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16020.34,"providers":[{"billed_charge":22307.12,"npi":[1619932415]}]}]},{"tin":{"type":"ein","value":"822925189"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2814.59,"providers":[{"billed_charge":11280.80,"npi":[1205346319]}]}]},{"tin":{"type":"ein","value":"841657548"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":18805.47,"providers":[{"billed_charge":19200.00,"npi":[1871898452]}]}]},{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":73775.92,"providers":[{"billed_charge":171200.00,"npi":[1720046188]}]}]},{"tin":{"type":"ein","value":"382441192"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30215.21,"providers":[{"billed_charge":48461.00,"npi":[1457469462]}]}]},{"tin":{"type":"ein","value":"386008155"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3203.04,"providers":[{"billed_charge":3350.00,"npi":[1669416947]}]}]},{"tin":{"type":"ein","value":"383198397"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":49510.36,"providers":[{"billed_charge":57984.00,"npi":[1306887260]}]}]},{"tin":{"type":"ein","value":"382947312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":213376.97,"providers":[{"billed_charge":289301.00,"npi":[1578510764]}]}]},{"tin":{"type":"ein","value":"382483662"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":12848.64,"providers":[{"billed_charge":32800.00,"npi":[1689730939]}]}]},{"tin":{"type":"ein","value":"386007202"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1376.20,"providers":[{"billed_charge":3700.00,"npi":[1477589596]}]}]},{"tin":{"type":"ein","value":"382200909"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":45836.48,"providers":[{"billed_charge":69030.00,"npi":[1689600975]}]}]},{"tin":{"type":"ein","value":"382485700"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":85729.52,"providers":[{"billed_charge":94540.00,"npi":[1598877268]}]}]},{"tin":{"type":"ein","value":"990643623"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":128152.03,"providers":[{"billed_charge":387717.00,"npi":[1457112534]}]}]},{"tin":{"type":"ein","value":"386031668"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1600.00,"providers":[{"billed_charge":1600.00,"npi":[1730119504]}]}]},{"tin":{"type":"ein","value":"381869375"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6255.47,"providers":[{"billed_charge":6575.00,"npi":[1669618989]}]}]},{"tin":{"type":"ein","value":"113687518"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":27716.73,"providers":[{"billed_charge":36000.00,"npi":[1699863704]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0428","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NONEMERGENCY TRANSPORT, (BLS)","allowed_amounts":[{"tin":{"type":"ein","value":"382666933"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":149076.66,"providers":[{"billed_charge":261800.00,"npi":[1124056296]}]}]},{"tin":{"type":"ein","value":"382200909"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5076.06,"providers":[{"billed_charge":11076.00,"npi":[1689600975]}]}]},{"tin":{"type":"ein","value":"990643623"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1690.64,"providers":[{"billed_charge":4852.00,"npi":[1457112534]}]}]},{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":142609.02,"providers":[{"billed_charge":619220.00,"npi":[1720046188]}]}]},{"tin":{"type":"ein","value":"113687518"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6134.78,"providers":[{"billed_charge":13600.00,"npi":[1699863704]}]}]}]},{"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":"382196204"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":441.42,"providers":[{"billed_charge":1000.00,"npi":[1063423473]}]}]},{"tin":{"type":"ein","value":"386004606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":603172.00,"providers":[{"billed_charge":1146134.38,"npi":[1477599900]}]}]},{"tin":{"type":"ein","value":"386004605"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":28080.95,"providers":[{"billed_charge":33000.00,"npi":[1346282183]}]}]},{"tin":{"type":"ein","value":"386006926"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":955.52,"providers":[{"billed_charge":2940.00,"npi":[1790724656]}]}]},{"tin":{"type":"ein","value":"382666933"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31204.32,"providers":[{"billed_charge":45075.00,"npi":[1124056296]}]}]},{"tin":{"type":"ein","value":"381810301"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8456.44,"providers":[{"billed_charge":9527.08,"npi":[1114036464]}]}]},{"tin":{"type":"ein","value":"383316836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4183.84,"providers":[{"billed_charge":6468.00,"npi":[1871521542]}]}]},{"tin":{"type":"ein","value":"382138484"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":47816.00,"providers":[{"billed_charge":73965.43,"npi":[1619932415]}]}]},{"tin":{"type":"ein","value":"822925189"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2645.38,"providers":[{"billed_charge":9514.40,"npi":[1205346319]}]}]},{"tin":{"type":"ein","value":"841657548"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":106278.80,"providers":[{"billed_charge":108450.00,"npi":[1871898452]}]}]},{"tin":{"type":"ein","value":"386004611"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37457.20,"providers":[{"billed_charge":38500.00,"npi":[1154172435]}]}]},{"tin":{"type":"ein","value":"386004676"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17207.20,"providers":[{"billed_charge":18000.00,"npi":[1487722682]}]}]},{"tin":{"type":"ein","value":"386007226"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":39164.40,"providers":[{"billed_charge":41250.00,"npi":[1386634863]}]}]},{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":190807.53,"providers":[{"billed_charge":252130.00,"npi":[1720046188]}]}]},{"tin":{"type":"ein","value":"382441192"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4183.84,"providers":[{"billed_charge":6965.00,"npi":[1457469462]}]}]},{"tin":{"type":"ein","value":"386006306"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13196.82,"providers":[{"billed_charge":15750.00,"npi":[1982644241]}]}]},{"tin":{"type":"ein","value":"383198397"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":85103.05,"providers":[{"billed_charge":95575.00,"npi":[1306887260]}]}]},{"tin":{"type":"ein","value":"382483662"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31462.20,"providers":[{"billed_charge":76950.00,"npi":[1689730939]}]}]},{"tin":{"type":"ein","value":"382200909"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":17254.32,"providers":[{"billed_charge":24948.00,"npi":[1689600975]}]}]},{"tin":{"type":"ein","value":"386007202"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6449.76,"providers":[{"billed_charge":15790.00,"npi":[1477589596]}]}]},{"tin":{"type":"ein","value":"990643623"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":231725.02,"providers":[{"billed_charge":705351.00,"npi":[1457112534]}]}]},{"tin":{"type":"ein","value":"386031668"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4881.44,"providers":[{"billed_charge":5200.00,"npi":[1730119504]}]}]},{"tin":{"type":"ein","value":"381712300"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4550.00,"providers":[{"billed_charge":4550.00,"npi":[1811010416]}]}]},{"tin":{"type":"ein","value":"113687518"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":48729.78,"providers":[{"billed_charge":66300.00,"npi":[1699863704]}]}]}]},{"name":"SPECIALTY CARE TRANSPORT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0434","description":"SPECIALTY CARE TRANSPORT (SCT)","allowed_amounts":[{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":32721.66,"providers":[{"billed_charge":191225.00,"npi":[1720046188]}]}]}]},{"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":"386004606"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":54810.00,"providers":[{"billed_charge":136350.00,"npi":[1477599900]}]}]},{"tin":{"type":"ein","value":"383198397"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1203.60,"providers":[{"billed_charge":3009.00,"npi":[1306887260]}]}]},{"tin":{"type":"ein","value":"382947312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1610.80,"providers":[{"billed_charge":4027.00,"npi":[1578510764]}]}]},{"tin":{"type":"ein","value":"383316836"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1397.60,"providers":[{"billed_charge":3494.00,"npi":[1871521542]}]}]},{"tin":{"type":"ein","value":"841657548"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1944.00,"providers":[{"billed_charge":4860.00,"npi":[1871898452]}]}]},{"tin":{"type":"ein","value":"383716596"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7688.00,"providers":[{"billed_charge":19220.00,"npi":[1720046188]}]}]}]},{"name":"Disposable collection and storage bag for breast milk, any size, any type, each","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4287","description":"Disposable collection and storage bag for breast milk, any size, any type, each","allowed_amounts":[{"tin":{"type":"ein","value":"464408166"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":2185.92,"providers":[{"billed_charge":7286.40,"npi":[1003462581]}]}]}]},{"name":"GLOVES NON-STERILE PER 100","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4927","description":"GLOVES, NONSTERILE, PER 100","allowed_amounts":[{"tin":{"type":"ein","value":"813717226"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2.55,"providers":[{"billed_charge":5.00,"npi":[1174969877]}]}]}]},{"name":"OFF-BSD TX OUD;AL 60 M SUBSE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2087","description":"OFF-BASED TX OUD; AL 60 MIN SUBSEQ CALENDAR MO","allowed_amounts":[{"tin":{"type":"ein","value":"824763691"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2586.69,"providers":[{"billed_charge":4725.00,"npi":[1730792664]}]}]}]},{"name":"VISIT CPLX INHERENT E&M ASSO","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2211","description":"VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC","allowed_amounts":[{"tin":{"type":"ein","value":"382027689"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":45.78,"providers":[{"billed_charge":75.00,"npi":[1689682551]}]}]},{"tin":{"type":"ein","value":"381357020"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":63.84,"providers":[{"billed_charge":100.00,"npi":[1588732010]}]}]}]},{"name":"PROLNG OF/OP E&M BYND RT;EA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G2212","description":"PROLONG OFC/OP E&M BYND REQ TIME; EA ADD 15 M","allowed_amounts":[{"tin":{"type":"ein","value":"462781294"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":780.93,"providers":[{"billed_charge":1800.00,"npi":[1093423824]}]}]}]},{"name":"COORD CARE FEE PHYS OVRSIGHT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G9008","description":"COORDINATED CARE FEE, PHYSICIAN COORDINATED CARE OVERSIGHT SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"382374946"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1214.40,"providers":[{"billed_charge":3036.00,"npi":[1265503031]}]}]}]},{"name":"INJ CEFTRIAXONE SODM PER 250","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J0696","description":"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":6.74,"providers":[{"billed_charge":420.00,"npi":[1114330974]}]}]}]},{"name":"INJ DEXMETH SODM PHOSHA 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1100","description":"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":3.17,"providers":[{"billed_charge":930.00,"npi":[1114330974]}]}]}]},{"name":"INJ KETOROLAC TROMETHAMINE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1885","description":"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG","allowed_amounts":[{"tin":{"type":"ein","value":"830645679"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":54.85,"providers":[{"billed_charge":5960.00,"npi":[1114330974]}]}]}]},{"name":"WRST HND ORTHOS CNTRL COCK-U","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"L3908","description":"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":107.72,"providers":[{"billed_charge":141.88,"npi":[1234567893]}]}]}]},{"name":"WALKING BOOT, PNEUMATIC AND/","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"L4361","description":"WALKING BOOT, PNEUMATIC AND/OR VACUUM, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, P","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":4180.00,"providers":[{"billed_charge":6700.80,"npi":[1234567893]}]}]}]}]}