{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"1.0.0","last_updated_on":"2025-12-02","out_of_network":[{"name":"Proprietary Laboratory Analysis (PLA) code for the Guardant Shield  test,","billing_code_type":"CPT","billing_code_type_version":"2025","billing_code":"0537U","description":"Proprietary Laboratory Analysis (PLA) code for the Guardant Shield  test,","allowed_amounts":[{"tin":{"type":"ein","value":"883933025"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":51486.35,"providers":[{"billed_charge":114080.00,"npi":[1538857099]}]}]}]},{"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":"921915185"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1752.00,"providers":[{"billed_charge":15375.00,"npi":[1578261202]}]}]},{"tin":{"type":"ein","value":"931384444"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":103932.00,"providers":[{"billed_charge":742500.00,"npi":[1003507278]}]}]},{"tin":{"type":"ein","value":"833203254"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":2560.00,"providers":[{"billed_charge":44480.00,"npi":[1710443940]}]}]},{"tin":{"type":"ein","value":"825128901"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":18125.00,"providers":[{"billed_charge":141955.00,"npi":[1740771195]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["22","56"],"billing_class":"institutional","payments":[{"allowed_amount":11550.00,"providers":[{"billed_charge":11550.00,"npi":[1447099056]}]},{"allowed_amount":110220.00,"providers":[{"billed_charge":110220.00,"npi":[1447099056]}]}]},{"tin":{"type":"ein","value":"271595826"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":20735.00,"providers":[{"billed_charge":72500.00,"npi":[1447573670]}]}]},{"tin":{"type":"ein","value":"993979121"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":27584.00,"providers":[{"billed_charge":299300.00,"npi":[1720815129]}]}]},{"tin":{"type":"ein","value":"611895106"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":6424.00,"providers":[{"billed_charge":59958.36,"npi":[1609352186]}]}]}]},{"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":"620479367"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":38855.48,"providers":[{"billed_charge":51313.00,"npi":[1558365890]}]}]}]},{"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":"471765618"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1653.60,"providers":[{"billed_charge":6604.00,"npi":[1134304512]}]}]},{"tin":{"type":"ein","value":"852133258"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1306.50,"providers":[{"billed_charge":2745.30,"npi":[1811098403]}]}]},{"tin":{"type":"ein","value":"863723348"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":585.30,"providers":[{"billed_charge":1080.00,"npi":[1457716029]}]}]}]},{"name":"OB/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"112","description":"ROOM AND BOARD - PRIVATE -OB","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":61189.83,"providers":[{"billed_charge":28924.48,"npi":[1811912009]}]}]}]},{"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":"205395878"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":51660.00,"providers":[{"billed_charge":132000.00,"npi":[1790925972]}]}]}]},{"name":"DETOX/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"126","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -DETOXIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"921915185"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":168068.00,"providers":[{"billed_charge":1654560.00,"npi":[1578261202]}]}]},{"tin":{"type":"ein","value":"931384444"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":12264.00,"providers":[{"billed_charge":94500.00,"npi":[1003507278]}]}]},{"tin":{"type":"ein","value":"993979121"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":54076.00,"providers":[{"billed_charge":409200.00,"npi":[1720815129]}]}]}]},{"name":"REHAB/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"128","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"251652127"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":18360.00,"providers":[{"billed_charge":31050.00,"npi":[1265406102]}]}]}]},{"name":"INJ TENDON SHEATH/LIGAMENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"20550","description":"\"INJECTION(S); SINGLE TENDON SHEATH, OR LIGAMENT, APONEUROSIS (EG, PLANTAR \"\"FASCIA\"\")\"","allowed_amounts":[{"tin":{"type":"ein","value":"475538580"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3568.80,"providers":[{"billed_charge":4900.00,"npi":[1437913514]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":191.35,"providers":[{"billed_charge":5768.43,"npi":[1043043524]}]},{"allowed_amount":185.57,"providers":[{"billed_charge":618.50,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":224.15,"providers":[{"billed_charge":777.64,"npi":[1558365890]}]},{"allowed_amount":17107.06,"providers":[{"billed_charge":70919.44,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1693.71,"providers":[{"billed_charge":44241.14,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":115.36,"providers":[{"billed_charge":384.53,"npi":[1760443980]}]},{"allowed_amount":1353.42,"providers":[{"billed_charge":20997.40,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":161.58,"providers":[{"billed_charge":276.45,"npi":[1265407001]}]},{"allowed_amount":275.44,"providers":[{"billed_charge":227.95,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13570.39,"providers":[{"billed_charge":45242.33,"npi":[1972070993]}]}]}]},{"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":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":12.18,"providers":[{"billed_charge":40.60,"npi":[1558365890]}]},{"allowed_amount":100.92,"providers":[{"billed_charge":7436.55,"npi":[1558365890]}]}]}]},{"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":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":323.35,"providers":[{"billed_charge":1868.70,"npi":[1558365890]}]},{"allowed_amount":139.47,"providers":[{"billed_charge":492.58,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":492.09,"providers":[{"billed_charge":4988.80,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":728.34,"providers":[{"billed_charge":2427.50,"npi":[1760443980]}]},{"allowed_amount":637.41,"providers":[{"billed_charge":1032.79,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1975.68,"providers":[{"billed_charge":6585.60,"npi":[1972070993]}]}]}]},{"name":"DRUGS/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"259","description":"PHARMACY - OTHER PHARMACY","allowed_amounts":[{"tin":{"type":"ein","value":"440577118"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20.92,"providers":[{"billed_charge":69.74,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":153.18,"providers":[{"billed_charge":510.56,"npi":[1760443980]}]}]}]},{"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":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":252.95,"providers":[{"billed_charge":843.37,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":388.84,"providers":[{"billed_charge":1448.00,"npi":[1558365890]}]},{"allowed_amount":6364.66,"providers":[{"billed_charge":10543.21,"npi":[1558365890]}]},{"allowed_amount":9232.01,"providers":[{"billed_charge":47417.01,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10175.83,"providers":[{"billed_charge":40256.46,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":299.16,"providers":[{"billed_charge":19750.36,"npi":[1811912009]}]},{"allowed_amount":2009.79,"providers":[{"billed_charge":5741.51,"npi":[1811912009]}]},{"allowed_amount":186.36,"providers":[{"billed_charge":705.60,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7781.40,"providers":[{"billed_charge":139061.13,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"473923087"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":534.22,"providers":[{"billed_charge":2326.58,"npi":[1366815144]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2158.13,"providers":[{"billed_charge":7534.00,"npi":[1760443980]}]},{"allowed_amount":12227.53,"providers":[{"billed_charge":18616.90,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10883.59,"providers":[{"billed_charge":12967.00,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":29541.01,"providers":[{"billed_charge":85961.82,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":369.24,"providers":[{"billed_charge":2567.13,"npi":[1104551134]}]},{"allowed_amount":12610.80,"providers":[{"billed_charge":35475.51,"npi":[1104551134]}]}]}]},{"name":"IV THERAPY/OTHER","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"269","description":"IV THERAPY - OTHER IV THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3569.19,"providers":[{"billed_charge":17380.08,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":26859.67,"providers":[{"billed_charge":113760.13,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":489.00,"providers":[{"billed_charge":2552.82,"npi":[1104551134]}]},{"allowed_amount":10335.90,"providers":[{"billed_charge":34104.46,"npi":[1104551134]}]}]}]},{"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":"710338243"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":456.21,"providers":[{"billed_charge":627.84,"npi":[1265407001]}]},{"allowed_amount":479.86,"providers":[{"billed_charge":800.81,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":94.57,"providers":[{"billed_charge":315.23,"npi":[1972070993]}]}]}]},{"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":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":191.38,"providers":[{"billed_charge":637.93,"npi":[1972070993]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"994554436"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2114.45,"providers":[{"billed_charge":27158.39,"npi":[1043043524]}]},{"allowed_amount":1144.81,"providers":[{"billed_charge":12434.71,"npi":[1043043524]}]},{"allowed_amount":13019.79,"providers":[{"billed_charge":46741.53,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"710290019"},"service_code":["22","19"],"billing_class":"institutional","payments":[{"allowed_amount":871.83,"providers":[{"billed_charge":1950.00,"npi":[1922043686]}]},{"allowed_amount":144.22,"providers":[{"billed_charge":1575.00,"npi":[1922043686]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2246.47,"providers":[{"billed_charge":4854.00,"npi":[1558365890]}]},{"allowed_amount":3420.49,"providers":[{"billed_charge":49992.00,"npi":[1558365890]}]},{"allowed_amount":261.58,"providers":[{"billed_charge":836.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":50417.28,"providers":[{"billed_charge":101050.43,"npi":[1760443980]}]},{"allowed_amount":352.43,"providers":[{"billed_charge":5556.43,"npi":[1760443980]}]},{"allowed_amount":7172.88,"providers":[{"billed_charge":73691.27,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5889.92,"providers":[{"billed_charge":11213.61,"npi":[1265407001]}]},{"allowed_amount":9226.44,"providers":[{"billed_charge":12871.46,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"450226909"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":189.54,"providers":[{"billed_charge":425.00,"npi":[1528009412]}]}]},{"tin":{"type":"ein","value":"991142081"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":293.75,"providers":[{"billed_charge":786.70,"npi":[1376391177]}]},{"allowed_amount":928.46,"providers":[{"billed_charge":1414.10,"npi":[1376391177]}]}]},{"tin":{"type":"ein","value":"237246265"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2165.17,"providers":[{"billed_charge":4407.00,"npi":[1467412726]}]},{"allowed_amount":45.36,"providers":[{"billed_charge":349.00,"npi":[1467412726]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":48.09,"providers":[{"billed_charge":676.96,"npi":[1972070993]}]},{"allowed_amount":30744.09,"providers":[{"billed_charge":155574.93,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"850672191"},"service_code":["22","21"],"billing_class":"institutional","payments":[{"allowed_amount":127.20,"providers":[{"billed_charge":424.00,"npi":[1285253252]}]},{"allowed_amount":106.86,"providers":[{"billed_charge":948.00,"npi":[1285253252]}]}]},{"tin":{"type":"ein","value":"841276376"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":234.24,"providers":[{"billed_charge":234.24,"npi":[1396783981]}]}]},{"tin":{"type":"ein","value":"730757033"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":78.16,"providers":[{"billed_charge":78.16,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"381358208"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":9.09,"providers":[{"billed_charge":29.00,"npi":[1063414233]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":380.85,"providers":[{"billed_charge":153781.43,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":258.37,"providers":[{"billed_charge":551.70,"npi":[1275506115]}]},{"allowed_amount":284.77,"providers":[{"billed_charge":907.70,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":365.33,"providers":[{"billed_charge":12467.78,"npi":[1811912009]}]},{"allowed_amount":515.84,"providers":[{"billed_charge":1462.65,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":118.00,"providers":[{"billed_charge":118021.92,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":16937.78,"providers":[{"billed_charge":70477.59,"npi":[1093740128]}]},{"allowed_amount":11414.42,"providers":[{"billed_charge":24316.32,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"370662569"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":309.69,"providers":[{"billed_charge":1123.00,"npi":[1043260482]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":247.79,"providers":[{"billed_charge":292.75,"npi":[1871221176]}]},{"allowed_amount":4597.21,"providers":[{"billed_charge":5709.50,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"843945620"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":507.14,"providers":[{"billed_charge":473.28,"npi":[1295362564]}]}]},{"tin":{"type":"ein","value":"800945173"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":32.60,"providers":[{"billed_charge":200.00,"npi":[1215939210]}]},{"allowed_amount":1290.89,"providers":[{"billed_charge":4029.00,"npi":[1215939210]}]}]},{"tin":{"type":"ein","value":"831173631"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":162.62,"providers":[{"billed_charge":1493.00,"npi":[1427536325]}]},{"allowed_amount":649.12,"providers":[{"billed_charge":975.00,"npi":[1427536325]}]},{"allowed_amount":830.67,"providers":[{"billed_charge":7059.00,"npi":[1427536325]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":392.13,"providers":[{"billed_charge":6852.59,"npi":[1104551134]}]},{"allowed_amount":12354.14,"providers":[{"billed_charge":124158.54,"npi":[1104551134]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"237309937"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":290.12,"providers":[{"billed_charge":884.00,"npi":[1649299827]}]},{"allowed_amount":5540.43,"providers":[{"billed_charge":46539.00,"npi":[1649299827]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":24659.79,"providers":[{"billed_charge":76696.00,"npi":[1558365890]}]},{"allowed_amount":34.78,"providers":[{"billed_charge":241.00,"npi":[1386709871]}]},{"allowed_amount":12487.15,"providers":[{"billed_charge":20223.00,"npi":[1558365890]}]},{"allowed_amount":113.74,"providers":[{"billed_charge":165.00,"npi":[1386709871]}]}]},{"tin":{"type":"ein","value":"160743209"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":104.57,"providers":[{"billed_charge":310.00,"npi":[1346285657]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":160.71,"providers":[{"billed_charge":215.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"264572436"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":84.61,"providers":[{"billed_charge":6014.00,"npi":[1235417288]}]}]},{"tin":{"type":"ein","value":"756003935"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13.93,"providers":[{"billed_charge":501.00,"npi":[1174526529]}]}]},{"tin":{"type":"ein","value":"461481133"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":45.73,"providers":[{"billed_charge":821.00,"npi":[1801990825]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":8518.91,"providers":[{"billed_charge":70461.72,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":54.27,"providers":[{"billed_charge":12372.75,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":790.88,"providers":[{"billed_charge":790.88,"npi":[1275799645]}]},{"allowed_amount":1528.63,"providers":[{"billed_charge":1528.63,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1704.31,"providers":[{"billed_charge":46277.43,"npi":[1811912009]}]},{"allowed_amount":38.84,"providers":[{"billed_charge":203204.88,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2692.21,"providers":[{"billed_charge":2889.84,"npi":[1275506115]}]},{"allowed_amount":528.64,"providers":[{"billed_charge":1681.56,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"730717979"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1743.91,"providers":[{"billed_charge":1743.91,"npi":[1659347623]}]},{"allowed_amount":1462.84,"providers":[{"billed_charge":1462.84,"npi":[1659347623]}]}]},{"tin":{"type":"ein","value":"581694098"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":740.42,"providers":[{"billed_charge":2303.00,"npi":[1427055821]}]}]},{"tin":{"type":"ein","value":"710744870"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":879.77,"providers":[{"billed_charge":21720.05,"npi":[1619926268]}]},{"allowed_amount":21.72,"providers":[{"billed_charge":49.25,"npi":[1619926268]}]}]},{"tin":{"type":"ein","value":"710548518"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":46.08,"providers":[{"billed_charge":797.57,"npi":[1003867326]}]}]},{"tin":{"type":"ein","value":"720408984"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":331.64,"providers":[{"billed_charge":1167.00,"npi":[1639160799]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":454.10,"providers":[{"billed_charge":648.25,"npi":[1871221176]}]},{"allowed_amount":6974.60,"providers":[{"billed_charge":7660.00,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"314394942"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":726.39,"providers":[{"billed_charge":921.00,"npi":[1255377149]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1216.24,"providers":[{"billed_charge":19952.90,"npi":[1104551134]}]},{"allowed_amount":143.44,"providers":[{"billed_charge":1800.19,"npi":[1104551134]}]}]},{"tin":{"type":"ein","value":"831173631"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":61.91,"providers":[{"billed_charge":345.00,"npi":[1427536325]}]},{"allowed_amount":236.29,"providers":[{"billed_charge":284.00,"npi":[1427536325]}]},{"allowed_amount":217.00,"providers":[{"billed_charge":217.00,"npi":[1427536325]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":363.23,"providers":[{"billed_charge":3907.28,"npi":[1811912009]}]}]}]},{"name":"LAB/NR DIALYSIS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"304","description":"LABORATORY - NON-ROUTINE DIALYSIS","allowed_amounts":[{"tin":{"type":"ein","value":"42505389"},"service_code":["65"],"billing_class":"institutional","payments":[{"allowed_amount":192.39,"providers":[{"billed_charge":8379.27,"npi":[1821100678]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2684.69,"providers":[{"billed_charge":19394.00,"npi":[1558365890]}]},{"allowed_amount":2673.09,"providers":[{"billed_charge":4609.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":50.16,"providers":[{"billed_charge":14290.61,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":124.57,"providers":[{"billed_charge":394.44,"npi":[1275506115]}]},{"allowed_amount":621.71,"providers":[{"billed_charge":629.82,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":454.86,"providers":[{"billed_charge":7143.99,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"730717979"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":31.18,"providers":[{"billed_charge":31.18,"npi":[1659347623]}]},{"allowed_amount":29.00,"providers":[{"billed_charge":29.00,"npi":[1659347623]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":960.32,"providers":[{"billed_charge":1059.00,"npi":[1871221176]}]},{"allowed_amount":201.60,"providers":[{"billed_charge":260.50,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2986.68,"providers":[{"billed_charge":48067.03,"npi":[1972070993]}]},{"allowed_amount":7.77,"providers":[{"billed_charge":154.70,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5447.63,"providers":[{"billed_charge":1122.65,"npi":[1104551134]}]},{"allowed_amount":1773.40,"providers":[{"billed_charge":28187.32,"npi":[1104551134]}]}]}]},{"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":"204217095"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":190.43,"providers":[{"billed_charge":4763.64,"npi":[1811912009]}]},{"allowed_amount":1044.16,"providers":[{"billed_charge":11751.63,"npi":[1811912009]}]},{"allowed_amount":3362.29,"providers":[{"billed_charge":40118.85,"npi":[1811912009]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":430.58,"providers":[{"billed_charge":502.00,"npi":[1558365890]}]},{"allowed_amount":178.90,"providers":[{"billed_charge":590.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31.49,"providers":[{"billed_charge":8751.96,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35.97,"providers":[{"billed_charge":7053.09,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1245.38,"providers":[{"billed_charge":20930.06,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":500.54,"providers":[{"billed_charge":13516.07,"npi":[1104551134]}]},{"allowed_amount":58.34,"providers":[{"billed_charge":388.94,"npi":[1104551134]}]}]}]},{"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":"750818167"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":686.44,"providers":[{"billed_charge":1081.00,"npi":[1679578439]}]}]}]},{"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":"994554436"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":507.93,"providers":[{"billed_charge":2426.84,"npi":[1043043524]}]},{"allowed_amount":2707.38,"providers":[{"billed_charge":12673.95,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1055.12,"providers":[{"billed_charge":4796.00,"npi":[1558365890]}]},{"allowed_amount":489.61,"providers":[{"billed_charge":1100.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3772.16,"providers":[{"billed_charge":22718.91,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":135.55,"providers":[{"billed_charge":10768.91,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":2335.47,"providers":[{"billed_charge":3868.64,"npi":[1265407001]}]},{"allowed_amount":2218.56,"providers":[{"billed_charge":3080.81,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":9972.37,"providers":[{"billed_charge":12060.00,"npi":[1871221176]}]},{"allowed_amount":11741.60,"providers":[{"billed_charge":14458.00,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":8312.18,"providers":[{"billed_charge":65389.00,"npi":[1972070993]}]},{"allowed_amount":87.82,"providers":[{"billed_charge":581.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":4149.19,"providers":[{"billed_charge":25776.00,"npi":[1104551134]}]},{"allowed_amount":235.73,"providers":[{"billed_charge":917.10,"npi":[1104551134]}]}]},{"tin":{"type":"ein","value":"831173631"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":182.41,"providers":[{"billed_charge":3781.00,"npi":[1427536325]}]}]}]},{"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":"994554436"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":232.04,"providers":[{"billed_charge":3321.30,"npi":[1043043524]}]},{"allowed_amount":1350.68,"providers":[{"billed_charge":4600.56,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":952.62,"providers":[{"billed_charge":10512.00,"npi":[1558365890]}]},{"allowed_amount":2965.21,"providers":[{"billed_charge":6570.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":10886.30,"providers":[{"billed_charge":35448.52,"npi":[1811912009]}]},{"allowed_amount":1328.08,"providers":[{"billed_charge":4238.41,"npi":[1811912009]}]},{"allowed_amount":327.92,"providers":[{"billed_charge":1155.93,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":547.72,"providers":[{"billed_charge":767.38,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3089.06,"providers":[{"billed_charge":36608.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4010.62,"providers":[{"billed_charge":24154.00,"npi":[1104551134]}]}]}]},{"name":"CHEMOTHERP-IV","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"335","description":"RADIOLOGY--THERAPEUTIC - CHEMOTHERAPY--IV","allowed_amounts":[{"tin":{"type":"ein","value":"264572436"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":990.06,"providers":[{"billed_charge":2139.00,"npi":[1235417288]}]}]}]},{"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":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":616.18,"providers":[{"billed_charge":14746.30,"npi":[1376018382]}]}]}]},{"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":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":392.64,"providers":[{"billed_charge":61186.00,"npi":[1558365890]}]},{"allowed_amount":4698.70,"providers":[{"billed_charge":16720.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["23","20"],"billing_class":"institutional","payments":[{"allowed_amount":6735.76,"providers":[{"billed_charge":64540.15,"npi":[1811912009]}]},{"allowed_amount":788.65,"providers":[{"billed_charge":8724.10,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":9488.07,"providers":[{"billed_charge":11373.30,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4323.92,"providers":[{"billed_charge":98419.00,"npi":[1972070993]}]}]}]},{"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":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10762.10,"providers":[{"billed_charge":316869.00,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23","21"],"billing_class":"institutional","payments":[{"allowed_amount":6348.46,"providers":[{"billed_charge":24126.00,"npi":[1558365890]}]},{"allowed_amount":3987.90,"providers":[{"billed_charge":13293.00,"npi":[1558365890]}]},{"allowed_amount":164.27,"providers":[{"billed_charge":5158.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":11790.43,"providers":[{"billed_charge":146064.38,"npi":[1811912009]}]},{"allowed_amount":1523.87,"providers":[{"billed_charge":15698.50,"npi":[1811912009]}]},{"allowed_amount":2589.06,"providers":[{"billed_charge":16162.89,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16943.35,"providers":[{"billed_charge":23412.32,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":52949.04,"providers":[{"billed_charge":905631.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":2421.30,"providers":[{"billed_charge":8071.00,"npi":[1104551134]}]},{"allowed_amount":30997.11,"providers":[{"billed_charge":419473.00,"npi":[1104551134]}]}]}]},{"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":"204217095"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":237335.85,"providers":[{"billed_charge":514587.08,"npi":[1811912009]}]},{"allowed_amount":11312.90,"providers":[{"billed_charge":22495.82,"npi":[1811912009]}]}]}]},{"name":"OR/MINOR","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"361","description":"OPERATING ROOM SERVICES - MINOR SURGERY","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4059.05,"providers":[{"billed_charge":20875.68,"npi":[1811912009]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5373.04,"providers":[{"billed_charge":54206.36,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":88.50,"providers":[{"billed_charge":540.00,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":28.80,"providers":[{"billed_charge":28.80,"npi":[1780497909]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.00,"providers":[{"billed_charge":6.00,"npi":[1891544888]}]},{"allowed_amount":54.00,"providers":[{"billed_charge":54.00,"npi":[1477321917]}]},{"allowed_amount":2.56,"providers":[{"billed_charge":12.00,"npi":[1649744244]}]}]},{"tin":{"type":"ein","value":"932686392"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1.28,"providers":[{"billed_charge":7.20,"npi":[1245877794]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":280.90,"providers":[{"billed_charge":1929.20,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"716046242"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6.06,"providers":[{"billed_charge":46.00,"npi":[1740274448]}]}]},{"tin":{"type":"ein","value":"824681345"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":24.00,"providers":[{"billed_charge":54.00,"npi":[1740423912]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":28.50,"providers":[{"billed_charge":304.00,"npi":[1275558918]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":158.40,"providers":[{"billed_charge":158.40,"npi":[1033960265]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":30.80,"providers":[{"billed_charge":224.00,"npi":[1952784829]}]},{"allowed_amount":25.52,"providers":[{"billed_charge":128.00,"npi":[1275132474]}]},{"allowed_amount":12.76,"providers":[{"billed_charge":64.00,"npi":[1275132474]}]},{"allowed_amount":6.40,"providers":[{"billed_charge":80.00,"npi":[1952784829]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.36,"providers":[{"billed_charge":180.00,"npi":[1205407962]}]},{"allowed_amount":6.40,"providers":[{"billed_charge":75.00,"npi":[1770075558]}]}]}]},{"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":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":322.72,"providers":[{"billed_charge":4979.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1035.17,"providers":[{"billed_charge":8384.00,"npi":[1104551134]}]}]}]},{"name":"SCRN MAMMOGRAPHY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"403","description":"OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5698.79,"providers":[{"billed_charge":18535.92,"npi":[1811912009]}]}]}]},{"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":"994554436"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":387.48,"providers":[{"billed_charge":1291.59,"npi":[1043043524]}]},{"allowed_amount":625.75,"providers":[{"billed_charge":5990.28,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":442.15,"providers":[{"billed_charge":1565.48,"npi":[1811912009]}]}]}]},{"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":"736060835"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":8.92,"providers":[{"billed_charge":31.57,"npi":[1396767158]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":22515.03,"providers":[{"billed_charge":38790.95,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"991142081"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1842.82,"providers":[{"billed_charge":3259.85,"npi":[1376391177]}]}]}]},{"name":"EGD BIOPSY SINGLE/MULTIPLE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"43239","description":"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE","allowed_amounts":[{"tin":{"type":"ein","value":"752005254"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":235.84,"providers":[{"billed_charge":1360.00,"npi":[1215970561]}]}]}]},{"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":"994554436"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":95980.20,"providers":[{"billed_charge":219037.12,"npi":[1043043524]}]},{"allowed_amount":1598.05,"providers":[{"billed_charge":9487.48,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":4132.99,"providers":[{"billed_charge":56853.00,"npi":[1558365890]}]},{"allowed_amount":73169.32,"providers":[{"billed_charge":124664.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3933.89,"providers":[{"billed_charge":25030.94,"npi":[1760443980]}]},{"allowed_amount":86604.49,"providers":[{"billed_charge":185212.71,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":20427.05,"providers":[{"billed_charge":28249.86,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"750974351"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":510.16,"providers":[{"billed_charge":1514.00,"npi":[1124092036]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":351580.96,"providers":[{"billed_charge":1316246.34,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"730757033"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1238.37,"providers":[{"billed_charge":1238.37,"npi":[1275799645]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":90487.56,"providers":[{"billed_charge":562481.04,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":240217.02,"providers":[{"billed_charge":677358.18,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13842.23,"providers":[{"billed_charge":21247.95,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":3901.61,"providers":[{"billed_charge":29976.02,"npi":[1093740128]}]},{"allowed_amount":32688.11,"providers":[{"billed_charge":64755.95,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"831886473"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":57996.36,"providers":[{"billed_charge":520478.78,"npi":[1376018382]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22663.57,"providers":[{"billed_charge":24875.00,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"750818167"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":272.19,"providers":[{"billed_charge":2461.00,"npi":[1679578439]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":13418.24,"providers":[{"billed_charge":15012.00,"npi":[1104551134]}]},{"allowed_amount":165971.74,"providers":[{"billed_charge":882172.89,"npi":[1104551134]}]}]}]},{"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":"204217095"},"service_code":["20"],"billing_class":"institutional","payments":[{"allowed_amount":44193.34,"providers":[{"billed_charge":100347.17,"npi":[1811912009]}]}]}]},{"name":"PULMONARY FUNC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"460","description":"PULMONARY FUNCTION - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6407.56,"providers":[{"billed_charge":27954.16,"npi":[1811912009]}]}]}]},{"name":"AUDIOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"470","description":"AUDIOLOGY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"710236857"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1675.38,"providers":[{"billed_charge":1861.52,"npi":[1255875746]}]}]}]},{"name":"CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"510","description":"CLINIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"730717979"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5867.70,"providers":[{"billed_charge":5867.70,"npi":[1659347623]}]}]}]},{"name":"RURAL/CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"521","description":"FREE-STANDING CLINIC - RURAL HEALTH-CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"273046997"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":7934.83,"providers":[{"billed_charge":18198.38,"npi":[1982381752]}]}]}]},{"name":"DRUG/SNGL","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"631","description":"DRUGS REQUIRING SPECIFIC IDENTIFICATION - SINGLE SOURCE DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"730757033"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1254.20,"providers":[{"billed_charge":1254.20,"npi":[1275799645]}]},{"allowed_amount":2077.60,"providers":[{"billed_charge":2077.60,"npi":[1275799645]}]}]}]},{"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":"994554436"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":356.53,"providers":[{"billed_charge":1018.70,"npi":[1043043524]}]}]},{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":39.58,"providers":[{"billed_charge":148.20,"npi":[1386709871]}]},{"allowed_amount":818.40,"providers":[{"billed_charge":2254.13,"npi":[1558365890]}]},{"allowed_amount":5309.58,"providers":[{"billed_charge":26002.16,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":13060.34,"providers":[{"billed_charge":19996.54,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22","23","72"],"billing_class":"institutional","payments":[{"allowed_amount":48.61,"providers":[{"billed_charge":86.00,"npi":[1265407001]}]},{"allowed_amount":1429.53,"providers":[{"billed_charge":1995.90,"npi":[1265407001]}]},{"allowed_amount":3275.47,"providers":[{"billed_charge":5590.95,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"264572436"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":18667.59,"providers":[{"billed_charge":475109.77,"npi":[1235417288]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":31740.88,"providers":[{"billed_charge":104363.87,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"473231590"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":101.04,"providers":[{"billed_charge":39910.57,"npi":[1578933818]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22","23","20"],"billing_class":"institutional","payments":[{"allowed_amount":2.00,"providers":[{"billed_charge":139.02,"npi":[1811912009]}]},{"allowed_amount":173.17,"providers":[{"billed_charge":54309.50,"npi":[1811912009]}]},{"allowed_amount":311.79,"providers":[{"billed_charge":35466.30,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"721479692"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":381.97,"providers":[{"billed_charge":1273.21,"npi":[1275506115]}]}]},{"tin":{"type":"ein","value":"440577118"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":931.13,"providers":[{"billed_charge":3081.65,"npi":[1093740128]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":258.41,"providers":[{"billed_charge":366.00,"npi":[1871221176]}]},{"allowed_amount":1862.94,"providers":[{"billed_charge":2236.25,"npi":[1871221176]}]}]},{"tin":{"type":"ein","value":"843050337"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":231.04,"providers":[{"billed_charge":770.13,"npi":[1720623853]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":18.77,"providers":[{"billed_charge":1415.94,"npi":[1104551134]}]},{"allowed_amount":13040.04,"providers":[{"billed_charge":47240.29,"npi":[1104551134]}]}]}]},{"name":"SELF-ADMINISTRABLE DRUGS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"637","description":"SELF-ADMINISTRABLE DRUGS","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":1465.75,"providers":[{"billed_charge":2184.03,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"540519577"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":15.22,"providers":[{"billed_charge":50.75,"npi":[1942288527]}]}]},{"tin":{"type":"ein","value":"863590894"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":49.65,"providers":[{"billed_charge":54.75,"npi":[1871221176]}]}]}]},{"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":"204175975"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":1884.80,"providers":[{"billed_charge":2869.00,"npi":[1033366794]}]}]}]},{"name":"INJECTION EYE DRUG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"67028","description":"INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT (SEPARATE PROCEDURE)","allowed_amounts":[{"tin":{"type":"ein","value":"710706742"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1578.25,"providers":[{"billed_charge":11400.00,"npi":[1255350021]}]}]}]},{"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":"710395194"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":843.96,"providers":[{"billed_charge":1820.00,"npi":[1063478113]}]},{"allowed_amount":64.92,"providers":[{"billed_charge":140.00,"npi":[1063478113]}]},{"allowed_amount":129.84,"providers":[{"billed_charge":280.00,"npi":[1902834187]}]}]}]},{"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":"710395194"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":56.04,"providers":[{"billed_charge":124.00,"npi":[1922560747]}]},{"allowed_amount":14.01,"providers":[{"billed_charge":31.00,"npi":[1063973618,1922560747]}]}]}]},{"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":"620479367"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":1339.90,"providers":[{"billed_charge":6052.00,"npi":[1558365890]}]},{"allowed_amount":2652.17,"providers":[{"billed_charge":6052.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":84.35,"providers":[{"billed_charge":1918.24,"npi":[1811912009]}]}]},{"tin":{"type":"ein","value":"440584290"},"service_code":["23","21"],"billing_class":"institutional","payments":[{"allowed_amount":5094.63,"providers":[{"billed_charge":10249.17,"npi":[1760443980]}]},{"allowed_amount":112.95,"providers":[{"billed_charge":1882.55,"npi":[1760443980]}]}]},{"tin":{"type":"ein","value":"710338243"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":246.58,"providers":[{"billed_charge":339.36,"npi":[1265407001]}]},{"allowed_amount":95.92,"providers":[{"billed_charge":169.68,"npi":[1265407001]}]}]},{"tin":{"type":"ein","value":"824121998"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4027.47,"providers":[{"billed_charge":30804.00,"npi":[1972070993]}]}]},{"tin":{"type":"ein","value":"862211233"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3748.16,"providers":[{"billed_charge":19932.00,"npi":[1104551134]}]}]}]},{"name":"X-RAY EXAM OF FOOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"73630","description":"RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF 3 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"710837110"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":392.71,"providers":[{"billed_charge":585.00,"npi":[1699778407]}]}]}]},{"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":"710395194"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2227.84,"providers":[{"billed_charge":4736.00,"npi":[1902834187]}]},{"allowed_amount":139.24,"providers":[{"billed_charge":296.00,"npi":[1063478113]}]}]}]},{"name":"GASTR-INTS SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"750","description":"GASTRO-INTESTINAL SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":46315.20,"providers":[{"billed_charge":237886.29,"npi":[1811912009]}]}]}]},{"name":"ULTRASOUND BREAST LIMITED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76642","description":"ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED;","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":821.70,"providers":[{"billed_charge":1639.00,"npi":[1235317496]}]}]}]},{"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":"261318597"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":2637.56,"providers":[{"billed_charge":3956.00,"npi":[1891145538]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77062","description":"DIGITAL BREAST TOMOSYNTHESIS; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":108.15,"providers":[{"billed_charge":234.00,"npi":[1235317496]}]}]}]},{"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":"620809858"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":917.70,"providers":[{"billed_charge":1848.00,"npi":[1235317496]}]},{"allowed_amount":196.65,"providers":[{"billed_charge":396.00,"npi":[1235317496]}]}]}]},{"name":"DX MAMMO INCL CAD BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77066","description":"DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL","allowed_amounts":[{"tin":{"type":"ein","value":"620809858"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":108.15,"providers":[{"billed_charge":220.00,"npi":[1235317496]}]}]}]},{"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":"620809858"},"service_code":["22","11"],"billing_class":"professional","payments":[{"allowed_amount":1414.91,"providers":[{"billed_charge":2856.00,"npi":[1235317496]}]},{"allowed_amount":83.23,"providers":[{"billed_charge":168.00,"npi":[1235317496]}]}]}]},{"name":"RADIATION TX MANAGEMENT X5","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77427","description":"RADIATION TREATMENT MANAGEMENT, 5 TREATMENTS","allowed_amounts":[{"tin":{"type":"ein","value":"261318597"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":2295.84,"providers":[{"billed_charge":3280.00,"npi":[1891145538]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1581.72,"providers":[{"billed_charge":10685.72,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.70,"providers":[{"billed_charge":35.00,"npi":[1649933417]}]}]}]},{"name":"GENERAL HEALTH PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80050","description":"GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL","allowed_amounts":[{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1812.48,"providers":[{"billed_charge":7249.92,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"463496428"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":105.74,"providers":[{"billed_charge":130.00,"npi":[1265497242]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":44.94,"providers":[{"billed_charge":65.00,"npi":[1174160089]}]}]}]},{"name":"ELECTROLYTE PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80051","description":"ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (BICARBONATE) (82374) CHLORI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":155.84,"providers":[{"billed_charge":758.47,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":33.46,"providers":[{"billed_charge":595.00,"npi":[1982606992]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":49938.40,"providers":[{"billed_charge":308534.40,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":992.22,"providers":[{"billed_charge":1894.74,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":304.32,"providers":[{"billed_charge":4803.24,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"710788742"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":31.68,"providers":[{"billed_charge":105.00,"npi":[1639520406]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.90,"providers":[{"billed_charge":350.00,"npi":[1518949429]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":42.77,"providers":[{"billed_charge":308.00,"npi":[1457930497]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10.56,"providers":[{"billed_charge":23.46,"npi":[1578026027]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":15.27,"providers":[{"billed_charge":30.00,"npi":[1275132474]}]},{"allowed_amount":30.54,"providers":[{"billed_charge":60.00,"npi":[1275132474]}]},{"allowed_amount":18.33,"providers":[{"billed_charge":90.00,"npi":[1952784829]}]},{"allowed_amount":107.64,"providers":[{"billed_charge":360.00,"npi":[1952784829]}]}]},{"tin":{"type":"ein","value":"710836622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":57.52,"providers":[{"billed_charge":200.00,"npi":[1427311919]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40816.47,"providers":[{"billed_charge":381256.40,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":401.50,"providers":[{"billed_charge":8471.50,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"463496428"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.27,"providers":[{"billed_charge":108.00,"npi":[1265497242]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":44.16,"providers":[{"billed_charge":300.00,"npi":[1457930497]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14422.88,"providers":[{"billed_charge":177090.56,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2463.92,"providers":[{"billed_charge":4705.92,"npi":[1629632203]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":994.00,"providers":[{"billed_charge":6589.00,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.70,"providers":[{"billed_charge":35.00,"npi":[1649933417]}]}]}]},{"name":"OBSTETRIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80081","description":"OBSTETRIC PANEL (INCLUDES HIV TESTING)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3899.25,"providers":[{"billed_charge":39638.11,"npi":[1265418669]}]}]}]},{"name":"ASSAY DIPROPYLACETIC ACD TOT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80164","description":"VALPROIC ACID (DIPROPYLACETIC ACID); TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":37.64,"providers":[{"billed_charge":508.73,"npi":[1265418669]}]}]}]},{"name":"DRUG SCRN QUAN LEVETIRACETAM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80177","description":"LEVETIRACETAM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":36.84,"providers":[{"billed_charge":672.00,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF LITHIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80178","description":"LITHIUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32.13,"providers":[{"billed_charge":526.75,"npi":[1265418669]}]}]}]},{"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":"710401764"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":74.97,"providers":[{"billed_charge":175.00,"npi":[1184237786]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":331.98,"providers":[{"billed_charge":1221.00,"npi":[1790891448]}]},{"allowed_amount":1956.82,"providers":[{"billed_charge":7141.00,"npi":[1275558918]}]},{"allowed_amount":10.06,"providers":[{"billed_charge":37.00,"npi":[1861695132,1386623049]}]},{"allowed_amount":30.18,"providers":[{"billed_charge":111.00,"npi":[1518949429]}]}]},{"tin":{"type":"ein","value":"900937634"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":171.02,"providers":[{"billed_charge":1285.20,"npi":[1619219433]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":40.41,"providers":[{"billed_charge":183.75,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":25473.63,"providers":[{"billed_charge":68250.00,"npi":[1649933417]}]},{"allowed_amount":9296.32,"providers":[{"billed_charge":45000.00,"npi":[1629531595]}]},{"allowed_amount":5299.84,"providers":[{"billed_charge":24500.00,"npi":[1124687157]}]},{"allowed_amount":93.31,"providers":[{"billed_charge":250.00,"npi":[1649933417]}]},{"allowed_amount":9137.86,"providers":[{"billed_charge":43250.00,"npi":[1932806494]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2122.08,"providers":[{"billed_charge":7800.00,"npi":[1487422572]}]}]},{"tin":{"type":"ein","value":"843045583"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":216.32,"providers":[{"billed_charge":17101.12,"npi":[1508499393]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6032.13,"providers":[{"billed_charge":14508.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"823268636"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4083.17,"providers":[{"billed_charge":171600.00,"npi":[1457863391]}]}]},{"tin":{"type":"ein","value":"760182737"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":186.42,"providers":[{"billed_charge":900.00,"npi":[1104839380]}]}]},{"tin":{"type":"ein","value":"452215107"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6489.60,"providers":[{"billed_charge":22370.40,"npi":[1801226543]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25819.17,"providers":[{"billed_charge":64818.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"472303825"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":590.33,"providers":[{"billed_charge":3705.00,"npi":[1740675297]}]}]},{"tin":{"type":"ein","value":"991629650"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":158.46,"providers":[{"billed_charge":559.26,"npi":[1871986315]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":372.84,"providers":[{"billed_charge":780.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"113387538"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":108.16,"providers":[{"billed_charge":388.36,"npi":[1336361575]}]}]}]},{"name":"ALKALOIDS NOS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80323","description":"ALKALOIDS, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":204.17,"providers":[{"billed_charge":2091.00,"npi":[1245838671]}]}]}]},{"name":"ANTIDEPRESSANTS CLASS 3-5","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80333","description":"ANTIDEPRESSANTS, SEROTONERGIC CLASS; 3-5","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":377.40,"providers":[{"billed_charge":1258.00,"npi":[1245838671]}]}]}]},{"name":"ANTIDEPRESSANT TRICYCLIC 3-5","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80336","description":"ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS; 3-5","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":377.40,"providers":[{"billed_charge":1258.00,"npi":[1245838671]}]}]}]},{"name":"ANTIDEPRESSANT NOT SPECIFIED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80338","description":"ANTIDEPRESSANTS, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":377.40,"providers":[{"billed_charge":1258.00,"npi":[1245838671]}]}]}]},{"name":"GABAPENTIN, NON-BLOOD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80355","description":"GABAPENTIN, NON-BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":204.17,"providers":[{"billed_charge":935.00,"npi":[1245838671]}]}]}]},{"name":"DRUG SCREENING PREGABALIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80366","description":"PREGABALIN","allowed_amounts":[{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":204.17,"providers":[{"billed_charge":986.00,"npi":[1245838671]}]}]}]},{"name":"URINALYSIS NONAUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81000","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES,","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4.32,"providers":[{"billed_charge":10.46,"npi":[1629632203]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1053.00,"providers":[{"billed_charge":18944.98,"npi":[1265418669]}]}]}]},{"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":"710850123"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":16.46,"providers":[{"billed_charge":91.00,"npi":[1952784829]}]},{"allowed_amount":11.93,"providers":[{"billed_charge":39.00,"npi":[1275132474]}]},{"allowed_amount":5.92,"providers":[{"billed_charge":52.00,"npi":[1952784829]}]},{"allowed_amount":14.80,"providers":[{"billed_charge":52.00,"npi":[1275132474]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":143.52,"providers":[{"billed_charge":2577.40,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.28,"providers":[{"billed_charge":36.64,"npi":[1780497909]}]}]},{"tin":{"type":"ein","value":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":14.74,"providers":[{"billed_charge":405.00,"npi":[1255405379]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":22.14,"providers":[{"billed_charge":126.00,"npi":[1275558918]}]}]},{"tin":{"type":"ein","value":"822116964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":39.15,"providers":[{"billed_charge":130.00,"npi":[1194967414]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":18.20,"providers":[{"billed_charge":210.00,"npi":[1316510043]}]},{"allowed_amount":41.60,"providers":[{"billed_charge":480.00,"npi":[1376006585]}]},{"allowed_amount":3.90,"providers":[{"billed_charge":45.00,"npi":[1063870467]}]},{"allowed_amount":14.30,"providers":[{"billed_charge":165.00,"npi":[1861242455]}]}]},{"tin":{"type":"ein","value":"237128104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.25,"providers":[{"billed_charge":174.00,"npi":[1720617616]}]}]}]},{"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":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":7.32,"providers":[{"billed_charge":26.00,"npi":[1255405379]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":51.24,"providers":[{"billed_charge":241.08,"npi":[1376006585]}]}]}]},{"name":"BRCA1&2 SEQ & FULL DUP/DEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81162","description":"BRCA1, BRCA2 (BREAST CANCER 1 AND 2) (EG, HEREDITARY BREAST AND OVARIAN CANCER) GENE ANALYSIS; FULL","allowed_amounts":[{"tin":{"type":"ein","value":"330892453"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18248.75,"providers":[{"billed_charge":82250.00,"npi":[1861568784]}]}]}]},{"name":"ANES LWR INTST SCR COLSC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"812","description":"ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODENUM; SCRE","allowed_amounts":[{"tin":{"type":"ein","value":"752572296"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":992.49,"providers":[{"billed_charge":4810.00,"npi":[1831375096]}]}]},{"tin":{"type":"ein","value":"455180638"},"service_code":["24"],"billing_class":"professional","payments":[{"allowed_amount":208.08,"providers":[{"billed_charge":900.00,"npi":[1023637071]}]}]}]},{"name":"HLA I TYPING 1 ANTIGEN LR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81374","description":"HLA CLASS I TYPING, LOW RESOLUTION (EG, ANTIGEN EQUIVALENTS); ONE ANTIGEN EQUIVALENT (EG, B*27), EAC","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2273.40,"providers":[{"billed_charge":9639.00,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6167.33,"providers":[{"billed_charge":15015.00,"npi":[1265418669]}]}]}]},{"name":"NFCT DS BV RNA VAG FLU ALG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81513","description":"NFCT DS BACTERAL VAGINOSIS RNA VAGINAL-FLUID ALG","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19928.98,"providers":[{"billed_charge":53843.58,"npi":[1003863580]}]}]}]},{"name":"NFCT DS CHRNC HCV 6 ASSAYS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81596","description":"NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":992.64,"providers":[{"billed_charge":7322.70,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF ACTH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82024","description":"ADRENOCORTICOTROPIC HORMONE (ACTH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2279.70,"providers":[{"billed_charge":17851.21,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":323.57,"providers":[{"billed_charge":661.46,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4126.29,"providers":[{"billed_charge":73295.06,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":41.64,"providers":[{"billed_charge":799.12,"npi":[1609812445]}]}]}]},{"name":"ASSAY OF BREATH ETHANOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82075","description":"ALCOHOL (ETHANOL), BREATH","allowed_amounts":[{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2065.50,"providers":[{"billed_charge":9720.00,"npi":[1932806494]}]},{"allowed_amount":1887.00,"providers":[{"billed_charge":8880.00,"npi":[1629531595]}]},{"allowed_amount":690.03,"providers":[{"billed_charge":11880.00,"npi":[1649933417]}]}]}]},{"name":"ASSAY OF ALDOLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82085","description":"ALDOLASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":222.42,"providers":[{"billed_charge":2891.54,"npi":[1265418669]}]}]}]},{"name":"ALPHA-1-ANTITRYPSIN, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82103","description":"ALPHA-1-ANTITRYPSIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":111.96,"providers":[{"billed_charge":1170.50,"npi":[1265418669]}]}]}]},{"name":"ALPHA-FETOPROTEIN, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82105","description":"ALPHA-FETOPROTEIN (AFP); SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1013.55,"providers":[{"billed_charge":9213.68,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF AMMONIA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82140","description":"AMMONIA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":141.68,"providers":[{"billed_charge":1649.75,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":580.50,"providers":[{"billed_charge":7703.28,"npi":[1265418669]}]}]}]},{"name":"chemistry test for anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82166","description":"chemistry test for anti-mullerian hormone (AMH)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":700.06,"providers":[{"billed_charge":4919.97,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF APOLIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82172","description":"APOLIPOPROTEIN, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13.18,"providers":[{"billed_charge":21.00,"npi":[1265418669]}]}]}]},{"name":"BILIRUBIN, TOTAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82247","description":"BILIRUBIN; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.36,"providers":[{"billed_charge":489.75,"npi":[1265418669]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":765.53,"providers":[{"billed_charge":2124.73,"npi":[1265418669]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":52665.16,"providers":[{"billed_charge":540404.26,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":142.08,"providers":[{"billed_charge":2213.28,"npi":[1609812445]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82310","description":"CALCIUM; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":309.12,"providers":[{"billed_charge":730.79,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.57,"providers":[{"billed_charge":434.00,"npi":[1982606992]}]}]}]},{"name":"ASSAY OF CALCIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82330","description":"CALCIUM; IONIZED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9.50,"providers":[{"billed_charge":66.13,"npi":[1265418669]}]}]}]},{"name":"ASSAY, BLOOD CARBON DIOXIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82374","description":"CARBON DIOXIDE (BICARBONATE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":67.00,"providers":[{"billed_charge":70.15,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF CERULOPLASMIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82390","description":"CERULOPLASMIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":186.50,"providers":[{"billed_charge":2259.46,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF BLOOD CHLORIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82435","description":"CHLORIDE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":197.05,"providers":[{"billed_charge":220.11,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF COPPER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82525","description":"COPPER","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.62,"providers":[{"billed_charge":74.55,"npi":[1265418669]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1381.04,"providers":[{"billed_charge":13176.86,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":592.12,"providers":[{"billed_charge":4573.16,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF CREATININE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82565","description":"CREATININE; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1323.23,"providers":[{"billed_charge":6748.46,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24.43,"providers":[{"billed_charge":434.00,"npi":[1982606992]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3816.17,"providers":[{"billed_charge":67199.60,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":46.65,"providers":[{"billed_charge":926.13,"npi":[1609812445]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12225.49,"providers":[{"billed_charge":119144.14,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":27.15,"providers":[{"billed_charge":413.10,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"463496428"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":47.50,"providers":[{"billed_charge":84.00,"npi":[1265497242]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1914.56,"providers":[{"billed_charge":18354.18,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF ESTRADIOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82670","description":"ESTRADIOL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10379.00,"providers":[{"billed_charge":91903.11,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF ESTROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82672","description":"ESTROGENS; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1039.83,"providers":[{"billed_charge":10548.98,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF FERRITIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82728","description":"FERRITIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6884.69,"providers":[{"billed_charge":54374.97,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":129.78,"providers":[{"billed_charge":2296.00,"npi":[1982606992]}]}]}]},{"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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":520.52,"providers":[{"billed_charge":993.72,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6441.01,"providers":[{"billed_charge":61739.14,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1079.21,"providers":[{"billed_charge":12302.11,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF IGE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82785","description":"GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":400.05,"providers":[{"billed_charge":3388.78,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":330.23,"providers":[{"billed_charge":1737.16,"npi":[1265418669]}]}]}]},{"name":"GLUCOSE TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82950","description":"GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":223.72,"providers":[{"billed_charge":2144.84,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":445.00,"providers":[{"billed_charge":2770.80,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5590.03,"providers":[{"billed_charge":52311.18,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3922.30,"providers":[{"billed_charge":35912.50,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":327.46,"providers":[{"billed_charge":2218.32,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":178.80,"providers":[{"billed_charge":2478.00,"npi":[1265418669]}]}]}]},{"name":"GLYCOSYLATED HEMOGLOBIN TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83036","description":"HEMOGLOBIN; GLYCOSYLATED (A1C)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16591.29,"providers":[{"billed_charge":157257.51,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.25,"providers":[{"billed_charge":98.95,"npi":[1780497909]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":180.73,"providers":[{"billed_charge":2633.45,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":39.66,"providers":[{"billed_charge":193.00,"npi":[1518949429]}]},{"allowed_amount":155.13,"providers":[{"billed_charge":690.00,"npi":[1275558918]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":39.27,"providers":[{"billed_charge":163.17,"npi":[1801373824]}]}]}]},{"name":"ASSAY OF HOMOCYSTINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83090","description":"HOMOCYSTEINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":163.94,"providers":[{"billed_charge":2526.72,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROGESTERONE 17-D","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83498","description":"HYDROXYPROGESTERONE, 17-D","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":584.97,"providers":[{"billed_charge":5087.17,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY NONANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83516","description":"IMMUNOASSAY FOR ANALYTE OTH THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":928.84,"providers":[{"billed_charge":16474.24,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY QUANT NOS NONAB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83520","description":"IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":43.18,"providers":[{"billed_charge":741.00,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1294.22,"providers":[{"billed_charge":14954.88,"npi":[1265418669]}]}]}]},{"name":"ASAY OF INTERLEUKIN-6 (IL-6)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83529","description":"ASSAY OF INTERLEUKIN-6 (IL-6)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.58,"providers":[{"billed_charge":308.70,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF IRON","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83540","description":"IRON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3465.25,"providers":[{"billed_charge":22630.82,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":57.33,"providers":[{"billed_charge":1014.00,"npi":[1982606992]}]}]}]},{"name":"IRON BINDING TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83550","description":"IRON BINDING CAPACITY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3853.38,"providers":[{"billed_charge":26161.73,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":215.97,"providers":[{"billed_charge":1240.84,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF LIPASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83690","description":"LIPASE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":831.72,"providers":[{"billed_charge":9509.99,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF BLOOD LIPOPROTEIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83721","description":"LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":66.30,"providers":[{"billed_charge":976.50,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":328.32,"providers":[{"billed_charge":627.12,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1753.05,"providers":[{"billed_charge":14650.21,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31.92,"providers":[{"billed_charge":567.00,"npi":[1982606992]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1791.42,"providers":[{"billed_charge":16159.95,"npi":[1265418669]}]}]}]},{"name":"ORGANIC ACID SINGLE QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83921","description":"ORGANIC ACID, SINGLE, QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":92.82,"providers":[{"billed_charge":1674.60,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1404.34,"providers":[{"billed_charge":7850.39,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":505.62,"providers":[{"billed_charge":8928.00,"npi":[1982606992]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":288.24,"providers":[{"billed_charge":415.91,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":156.30,"providers":[{"billed_charge":847.41,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":58.14,"providers":[{"billed_charge":1026.00,"npi":[1982606992]}]}]}]},{"name":"ASSAY OF SERUM POTASSIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84132","description":"POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":167.19,"providers":[{"billed_charge":932.40,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROGESTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84144","description":"PROGESTERONE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3912.30,"providers":[{"billed_charge":34699.78,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1870.91,"providers":[{"billed_charge":18311.63,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3437.82,"providers":[{"billed_charge":33742.08,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":318.40,"providers":[{"billed_charge":1510.33,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":114.30,"providers":[{"billed_charge":1804.75,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":432.68,"providers":[{"billed_charge":3801.42,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":633.78,"providers":[{"billed_charge":5314.24,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF SERUM SODIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84295","description":"SODIUM; SERUM, PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":214.29,"providers":[{"billed_charge":303.20,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF FREE TESTOSTERONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84402","description":"TESTOSTERONE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8650.41,"providers":[{"billed_charge":84900.65,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":15007.40,"providers":[{"billed_charge":135473.81,"npi":[1265418669]}]}]}]},{"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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":63.60,"providers":[{"billed_charge":134.10,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2613.96,"providers":[{"billed_charge":22299.00,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF FREE THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84439","description":"THYROXINE; FREE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7199.00,"providers":[{"billed_charge":100063.35,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.64,"providers":[{"billed_charge":669.12,"npi":[1609812445]}]}]}]},{"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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":251.68,"providers":[{"billed_charge":480.48,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":49640.58,"providers":[{"billed_charge":425688.86,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":80.64,"providers":[{"billed_charge":1194.24,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":57.20,"providers":[{"billed_charge":210.00,"npi":[1518949429]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1048.12,"providers":[{"billed_charge":8008.20,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1019.19,"providers":[{"billed_charge":8256.13,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF TRANSFERRIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84466","description":"TRANSFERRIN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":443.00,"providers":[{"billed_charge":5273.70,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":112.97,"providers":[{"billed_charge":2002.00,"npi":[1982606992]}]}]}]},{"name":"ASSAY OF THYROID (T3 OR T4)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84479","description":"THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)","allowed_amounts":[{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":83.79,"providers":[{"billed_charge":159.98,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1607.42,"providers":[{"billed_charge":13544.87,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1279.20,"providers":[{"billed_charge":15149.53,"npi":[1265418669]}]}]}]},{"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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":219.07,"providers":[{"billed_charge":418.57,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4609.92,"providers":[{"billed_charge":84428.73,"npi":[1265418669]}]}]}]},{"name":"T3 REVERSE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84482","description":"TRIIODOTHYRONINE T3; REVERSE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":65.64,"providers":[{"billed_charge":1201.94,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF UREA NITROGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84520","description":"UREA NITROGEN; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":969.67,"providers":[{"billed_charge":5733.26,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":34.97,"providers":[{"billed_charge":624.00,"npi":[1982606992]}]}]}]},{"name":"ASSAY OF BLOOD/URIC ACID","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84550","description":"URIC ACID; BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1153.02,"providers":[{"billed_charge":11979.05,"npi":[1265418669]}]}]}]},{"name":"ASSAY OF C-PEPTIDE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84681","description":"C-PEPTIDE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":216.90,"providers":[{"billed_charge":2114.56,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1694.52,"providers":[{"billed_charge":14415.80,"npi":[1265418669]}]}]}]},{"name":"HEMATOCRIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85014","description":"BLOOD COUNT; HEMATOCRIT (HCT)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.48,"providers":[{"billed_charge":163.95,"npi":[1265418669]}]}]}]},{"name":"HEMOGLOBIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85018","description":"BLOOD COUNT; HEMOGLOBIN (HGB)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":11.48,"providers":[{"billed_charge":163.95,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25.92,"providers":[{"billed_charge":464.00,"npi":[1982606992]}]}]}]},{"name":"COMPLETE CBC W/AUTO DIFF WBC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85025","description":"BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32464.38,"providers":[{"billed_charge":184001.25,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":777.63,"providers":[{"billed_charge":1486.17,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"431039532"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":172.42,"providers":[{"billed_charge":1925.85,"npi":[1609812445]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":95.22,"providers":[{"billed_charge":1692.00,"npi":[1982606992]}]}]},{"tin":{"type":"ein","value":"710788742"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.85,"providers":[{"billed_charge":125.00,"npi":[1639520406]}]}]},{"tin":{"type":"ein","value":"824681345"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":86.13,"providers":[{"billed_charge":377.00,"npi":[1740423912]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":37.03,"providers":[{"billed_charge":154.00,"npi":[1518949429]}]},{"allowed_amount":42.32,"providers":[{"billed_charge":176.00,"npi":[1861695132]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":31.50,"providers":[{"billed_charge":210.00,"npi":[1457930497]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":38.85,"providers":[{"billed_charge":105.80,"npi":[1578026027]}]}]},{"tin":{"type":"ein","value":"710850123"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":27.00,"providers":[{"billed_charge":150.00,"npi":[1952784829]}]},{"allowed_amount":22.48,"providers":[{"billed_charge":50.00,"npi":[1275132474]}]},{"allowed_amount":78.98,"providers":[{"billed_charge":275.00,"npi":[1952784829]}]},{"allowed_amount":33.72,"providers":[{"billed_charge":75.00,"npi":[1275132474]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1207.81,"providers":[{"billed_charge":7201.54,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":519.86,"providers":[{"billed_charge":7234.43,"npi":[1265418669]}]}]}]},{"name":"FIBRIN DEGRADATION, QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85379","description":"FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":148.47,"providers":[{"billed_charge":5137.65,"npi":[1265418669]}]}]}]},{"name":"PROTHROMBIN TIME","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85610","description":"PROTHROMBIN TIME;","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":592.41,"providers":[{"billed_charge":7795.84,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1364.88,"providers":[{"billed_charge":28151.31,"npi":[1265418669]}]}]}]},{"name":"RBC SICKLE CELL TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85660","description":"SICKLING OF RBC, REDUCTION","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":88.09,"providers":[{"billed_charge":1452.91,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":183.48,"providers":[{"billed_charge":2732.99,"npi":[1265418669]}]}]}]},{"name":"ACTIN ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86015","description":"ACTIN SMOOTH MUSCLE ANTIBODY EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":218.37,"providers":[{"billed_charge":3386.64,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4832.64,"providers":[{"billed_charge":50757.57,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2861.23,"providers":[{"billed_charge":50112.31,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":98.89,"providers":[{"billed_charge":857.25,"npi":[1265418669]}]}]}]},{"name":"CARDIOLIPIN ANTIBODY EA IG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86147","description":"CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3429.27,"providers":[{"billed_charge":30353.72,"npi":[1265418669]}]}]}]},{"name":"COMPLEMENT, ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86160","description":"COMPLEMENT; ANTIGEN, EACH COMPONENT","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2524.00,"providers":[{"billed_charge":28253.15,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1519.31,"providers":[{"billed_charge":18949.24,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1993.86,"providers":[{"billed_charge":20763.80,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19020.70,"providers":[{"billed_charge":194547.00,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY, TUMOR, CA 15-3","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86300","description":"IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":202.43,"providers":[{"billed_charge":2106.77,"npi":[1265418669]}]}]}]},{"name":"IMMUNOASSAY INFECTIOUS AGENT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86317","description":"IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1072.23,"providers":[{"billed_charge":9249.32,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":124.16,"providers":[{"billed_charge":1180.18,"npi":[1265418669]}]}]}]},{"name":"T CELL, ABSOLUTE COUNT/RATIO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86360","description":"T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":293.67,"providers":[{"billed_charge":2654.20,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2360.93,"providers":[{"billed_charge":22146.48,"npi":[1265418669]}]}]}]},{"name":"TISS TRNSGLTMNASE EA IG CLAS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86364","description":"TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":345.99,"providers":[{"billed_charge":6216.04,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2992.54,"providers":[{"billed_charge":29318.11,"npi":[1265418669]}]}]}]},{"name":"MITOCHONDRIAL ANTIBODY EACH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86381","description":"MITOCHONDRIAL ANTIBODY EACH","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":429.57,"providers":[{"billed_charge":3554.36,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1587.82,"providers":[{"billed_charge":24180.10,"npi":[1265418669]}]}]}]},{"name":"TB TEST CELL IMMUN MEASURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86480","description":"TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8263.68,"providers":[{"billed_charge":47540.46,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":295.26,"providers":[{"billed_charge":564.06,"npi":[1629632203]}]}]}]},{"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":"833547008"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":279.36,"providers":[{"billed_charge":1099.20,"npi":[1629632203]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2272.05,"providers":[{"billed_charge":31884.42,"npi":[1265418669]}]}]}]},{"name":"SYPHILIS TEST NON-TREP QUANT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86593","description":"SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":296.80,"providers":[{"billed_charge":3743.46,"npi":[1265418669]}]}]}]},{"name":"LYME DISEASE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86618","description":"ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":319.40,"providers":[{"billed_charge":4305.46,"npi":[1265418669]}]}]}]},{"name":"EPSTEIN-BARR CAPSID VCA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86665","description":"ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":100.80,"providers":[{"billed_charge":815.15,"npi":[1265418669]}]}]}]},{"name":"EHRLICHIA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86666","description":"ANTIBODY; EHRLICHIA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":226.24,"providers":[{"billed_charge":4491.48,"npi":[1265418669]}]}]}]},{"name":"FRANCISELLA TULARENSIS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86668","description":"ANTIBODY; FRANCISELLA TULARENSIS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.80,"providers":[{"billed_charge":705.60,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1923.60,"providers":[{"billed_charge":17803.88,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3064.32,"providers":[{"billed_charge":28671.84,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2410.56,"providers":[{"billed_charge":27865.53,"npi":[1265418669]}]}]}]},{"name":"HEP B CORE ANTIBODY, IGM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86705","description":"HEPATITIS B CORE ANTIBODY (HBCAB); IGM ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":155.42,"providers":[{"billed_charge":1640.24,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1775.48,"providers":[{"billed_charge":19565.68,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":782.60,"providers":[{"billed_charge":8475.24,"npi":[1265418669]}]}]}]},{"name":"HEPATITIS A IGM ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86709","description":"HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":195.50,"providers":[{"billed_charge":2402.40,"npi":[1265418669]}]}]}]},{"name":"RICKETTSIA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86757","description":"ANTIBODY; RICKETTSIA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":564.69,"providers":[{"billed_charge":6394.50,"npi":[1265418669]}]}]}]},{"name":"RUBELLA ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86762","description":"ANTIBODY; RUBELLA","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":199.80,"providers":[{"billed_charge":1794.81,"npi":[1265418669]}]}]}]},{"name":"TOXOPLASMA ANTIBODY, IGM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86778","description":"ANTIBODY; TOXOPLASMA, IGM","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":160.16,"providers":[{"billed_charge":2194.32,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2591.71,"providers":[{"billed_charge":29656.97,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":223.51,"providers":[{"billed_charge":2492.74,"npi":[1265418669]}]}]}]},{"name":"THYROGLOBULIN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86800","description":"THYROGLOBULIN ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":949.44,"providers":[{"billed_charge":9135.19,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6808.17,"providers":[{"billed_charge":68370.37,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":421.59,"providers":[{"billed_charge":3772.76,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":131.04,"providers":[{"billed_charge":2309.32,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":124.80,"providers":[{"billed_charge":2134.54,"npi":[1265418669]}]}]}]},{"name":"FECES CULTURE AEROBIC BACT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87045","description":"CULTURE, BACTERIAL; STOOL, AEROBIC, WITH ISOLATION AND PRELIMINARY EXAMINATION (EG, KIA, LIA), SALMO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":98.40,"providers":[{"billed_charge":886.92,"npi":[1265418669]}]}]}]},{"name":"STOOL CULTR AEROBIC BACT EA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87046","description":"CULTURE, BACTERIAL; STOOL, AEROBIC, ADDITIONAL PATHOGENS, ISOLATION AND PRESUMPTIVE IDENTIFICATION O","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":98.40,"providers":[{"billed_charge":965.12,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":938.86,"providers":[{"billed_charge":12901.57,"npi":[1265418669]}]}]}]},{"name":"CULTR BACTERIA, EXCEPT BLOOD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87075","description":"CULTURE, BACTERIAL; ANY SOURCE, EXCEPT BLOOD, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATIO","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":157.92,"providers":[{"billed_charge":2720.84,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":981.75,"providers":[{"billed_charge":4511.65,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":630.20,"providers":[{"billed_charge":6537.87,"npi":[1265418669]}]}]}]},{"name":"URINE CULTURE/COLONY COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87086","description":"CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6788.08,"providers":[{"billed_charge":64762.11,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2113.12,"providers":[{"billed_charge":11017.74,"npi":[1265418669]}]}]}]},{"name":"DNA/RNA AMPLIFIED PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87150","description":"CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, AMPLIFIED PROBE TECHNIQUE, PER C","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":584.88,"providers":[{"billed_charge":2167.84,"npi":[1265418669]}]}]}]},{"name":"OVA AND PARASITES SMEARS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87177","description":"OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":92.70,"providers":[{"billed_charge":579.59,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2419.82,"providers":[{"billed_charge":29629.78,"npi":[1265418669]}]}]}]},{"name":"SMEAR, GRAM STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87205","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20.79,"providers":[{"billed_charge":378.11,"npi":[1265418669]}]}]}]},{"name":"SMEAR, COMPLEX STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87209","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; COMPLEX SPECIAL STAIN (EG, TRICHROME, IRON HEMOTOXYLIN) F","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":187.20,"providers":[{"billed_charge":900.88,"npi":[1265418669]}]}]}]},{"name":"CLOSTRIDIUM AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87324","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, CLOSTRIDIUM DIFFICILE TOXIN(S); (EG, EN","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":149.94,"providers":[{"billed_charge":2438.10,"npi":[1265418669]}]}]}]},{"name":"HPYLORI STOOL IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87338","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HELICOBACTER PYLORI, STOOL; (EG, ENZYME","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.98,"providers":[{"billed_charge":464.10,"npi":[1265418669]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2591.98,"providers":[{"billed_charge":26569.64,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"943357013"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":119.51,"providers":[{"billed_charge":2108.00,"npi":[1982606992]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":18692.96,"providers":[{"billed_charge":179281.12,"npi":[1265418669]}]}]}]},{"name":"SHIGA-LIKE TOXIN AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87427","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, SHIGA-LIKE TOXIN; (EG, ENZYME IMMUNOASS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":124.95,"providers":[{"billed_charge":1125.79,"npi":[1265418669]}]}]}]},{"name":"SARSCOV & INF VIR A&B AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","allowed_amounts":[{"tin":{"type":"ein","value":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":537.66,"providers":[{"billed_charge":3600.00,"npi":[1255405379]}]}]}]},{"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":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":20967.51,"providers":[{"billed_charge":52580.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1508.91,"providers":[{"billed_charge":4558.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1480.56,"providers":[{"billed_charge":5432.90,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1280.87,"providers":[{"billed_charge":5694.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9559.23,"providers":[{"billed_charge":23892.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":736.96,"providers":[{"billed_charge":1473.78,"npi":[1689639544]}]}]}]},{"name":"CHYLMD PNEUM, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87486","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":52.65,"providers":[{"billed_charge":105.27,"npi":[1689639544]}]}]}]},{"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":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":596.70,"providers":[{"billed_charge":1802.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29585.18,"providers":[{"billed_charge":145091.03,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3334.50,"providers":[{"billed_charge":8360.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":931.32,"providers":[{"billed_charge":2469.50,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":690.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2287.83,"providers":[{"billed_charge":5720.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":252.60,"providers":[{"billed_charge":720.00,"npi":[1023098928]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":210.60,"providers":[{"billed_charge":421.08,"npi":[1689639544]}]}]}]},{"name":"VANOMYCIN DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87500","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); VANCOMYCIN RESISTANCE (EG, ENTEROCOCCUS SPE","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3896.10,"providers":[{"billed_charge":9768.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1246.05,"providers":[{"billed_charge":3763.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":1360.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1989.48,"providers":[{"billed_charge":4972.00,"npi":[1841798667]}]}]}]},{"name":"IADNA-DNA/RNA PROBE TQ 12-25","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87507","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GASTROINTESTINAL PATHOGEN (EG, CLOSTRIDIUM","allowed_amounts":[{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":500.14,"providers":[{"billed_charge":1418.00,"npi":[1659574127]}]}]}]},{"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":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":597.00,"providers":[{"billed_charge":2370.72,"npi":[1003863580]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5236.00,"providers":[{"billed_charge":95720.73,"npi":[1265418669]}]}]}]},{"name":"HSV, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87529","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHN","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5614.40,"providers":[{"billed_charge":14080.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":286.56,"providers":[{"billed_charge":889.02,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":596.53,"providers":[{"billed_charge":1360.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2666.89,"providers":[{"billed_charge":6688.00,"npi":[1841798667]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8213.51,"providers":[{"billed_charge":69272.07,"npi":[1265418669]}]}]}]},{"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":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3369.60,"providers":[{"billed_charge":8448.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1561.95,"providers":[{"billed_charge":4717.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2039.49,"providers":[{"billed_charge":9584.60,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":219.10,"providers":[{"billed_charge":736.89,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":680.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2386.68,"providers":[{"billed_charge":5984.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":87.75,"providers":[{"billed_charge":175.45,"npi":[1689639544]}]}]}]},{"name":"M.PNEUMON, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87581","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":87.75,"providers":[{"billed_charge":175.45,"npi":[1689639544]}]}]}]},{"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":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":596.70,"providers":[{"billed_charge":1802.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3299.40,"providers":[{"billed_charge":8272.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":29365.85,"providers":[{"billed_charge":143714.24,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1002.96,"providers":[{"billed_charge":2469.50,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":680.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2316.60,"providers":[{"billed_charge":5808.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":252.60,"providers":[{"billed_charge":720.00,"npi":[1023098928]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":210.60,"providers":[{"billed_charge":421.08,"npi":[1689639544]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10089.18,"providers":[{"billed_charge":56704.02,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"813919645"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":1098.48,"providers":[{"billed_charge":7544.00,"npi":[1760681381]}]},{"allowed_amount":71.64,"providers":[{"billed_charge":492.00,"npi":[1760681381]}]}]},{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":245.70,"providers":[{"billed_charge":742.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":23.88,"providers":[{"billed_charge":110.00,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":421.00,"providers":[{"billed_charge":1200.00,"npi":[1023098928]}]}]}]},{"name":"RESP VIRUS 3-5 TARGETS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87631","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ","allowed_amounts":[{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":427.92,"providers":[{"billed_charge":855.78,"npi":[1689639544]}]}]}]},{"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":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":395.94,"providers":[{"billed_charge":1283.67,"npi":[1003863580]}]}]}]},{"name":"STAPH A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87640","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":947.70,"providers":[{"billed_charge":2862.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.55,"providers":[{"billed_charge":44.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":315.90,"providers":[{"billed_charge":631.62,"npi":[1689639544]}]}]},{"tin":{"type":"ein","value":"863569910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.55,"providers":[{"billed_charge":55.00,"npi":[1851966105]}]}]}]},{"name":"MR-STAPH DNA AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87641","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, METHICILLIN RESISTAN","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4071.60,"providers":[{"billed_charge":10208.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":1360.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1989.48,"providers":[{"billed_charge":4972.00,"npi":[1841798667]}]}]}]},{"name":"STREP A, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87651","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3931.20,"providers":[{"billed_charge":9856.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":1360.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1392.78,"providers":[{"billed_charge":3476.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":438.75,"providers":[{"billed_charge":877.25,"npi":[1689639544]}]}]},{"tin":{"type":"ein","value":"863569910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.55,"providers":[{"billed_charge":55.00,"npi":[1851966105]}]}]}]},{"name":"STREP B, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87653","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":842.40,"providers":[{"billed_charge":2544.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4475.25,"providers":[{"billed_charge":11220.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":1360.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2322.93,"providers":[{"billed_charge":5808.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":315.90,"providers":[{"billed_charge":631.62,"npi":[1689639544]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":22347.29,"providers":[{"billed_charge":111052.85,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3299.40,"providers":[{"billed_charge":8272.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":70.20,"providers":[{"billed_charge":212.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1170.12,"providers":[{"billed_charge":3710.08,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"853374426"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":298.35,"providers":[{"billed_charge":680.00,"npi":[1245838671]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2305.38,"providers":[{"billed_charge":5764.00,"npi":[1841798667]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":210.60,"providers":[{"billed_charge":421.08,"npi":[1689639544]}]}]}]},{"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":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1824.72,"providers":[{"billed_charge":5512.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":907.44,"providers":[{"billed_charge":3753.64,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"621433252"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":772.20,"providers":[{"billed_charge":1543.96,"npi":[1689639544]}]}]}]},{"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":"821936336"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1755.00,"providers":[{"billed_charge":5250.00,"npi":[1619488418]}]}]},{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8627.00,"providers":[{"billed_charge":61334.11,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":7272.74,"providers":[{"billed_charge":46777.53,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":463.32,"providers":[{"billed_charge":1309.00,"npi":[1023098928]}]}]}]},{"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":"822116964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":117.27,"providers":[{"billed_charge":396.00,"npi":[1053835215]}]},{"allowed_amount":270.90,"providers":[{"billed_charge":748.00,"npi":[1194967414]}]},{"allowed_amount":143.33,"providers":[{"billed_charge":484.00,"npi":[1336780279]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["11","72","20"],"billing_class":"professional","payments":[{"allowed_amount":18.39,"providers":[{"billed_charge":93.48,"npi":[1033659677]}]},{"allowed_amount":126.63,"providers":[{"billed_charge":280.44,"npi":[1043028939]}]},{"allowed_amount":182.05,"providers":[{"billed_charge":342.76,"npi":[1578026027]}]},{"allowed_amount":349.07,"providers":[{"billed_charge":2087.72,"npi":[1376006585]}]},{"allowed_amount":171.93,"providers":[{"billed_charge":1028.28,"npi":[1285327452]}]},{"allowed_amount":24.49,"providers":[{"billed_charge":93.48,"npi":[1801449384]}]},{"allowed_amount":36.47,"providers":[{"billed_charge":218.12,"npi":[1427666346]}]},{"allowed_amount":109.41,"providers":[{"billed_charge":654.36,"npi":[1689240913]}]},{"allowed_amount":203.19,"providers":[{"billed_charge":1215.24,"npi":[1861242455]}]},{"allowed_amount":98.99,"providers":[{"billed_charge":592.04,"npi":[1669933370]}]},{"allowed_amount":140.67,"providers":[{"billed_charge":841.32,"npi":[1396191136]}]},{"allowed_amount":265.71,"providers":[{"billed_charge":1589.16,"npi":[1316510043]}]},{"allowed_amount":612.35,"providers":[{"billed_charge":1152.92,"npi":[1891433124]}]},{"allowed_amount":253.26,"providers":[{"billed_charge":560.88,"npi":[1043931793]}]},{"allowed_amount":14.07,"providers":[{"billed_charge":31.16,"npi":[1043931793]}]},{"allowed_amount":119.83,"providers":[{"billed_charge":716.68,"npi":[1174034565]}]},{"allowed_amount":46.89,"providers":[{"billed_charge":280.44,"npi":[1659012425]}]},{"allowed_amount":243.31,"providers":[{"billed_charge":1402.20,"npi":[1063870467]}]},{"allowed_amount":99.30,"providers":[{"billed_charge":186.96,"npi":[1891433124]}]}]}]},{"name":"SARS-COV-2 COVID19 W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87811","description":"IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"822116964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":136.29,"providers":[{"billed_charge":313.00,"npi":[1336780279]}]},{"allowed_amount":1199.84,"providers":[{"billed_charge":2304.00,"npi":[1194967414]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["72","20"],"billing_class":"professional","payments":[{"allowed_amount":163.53,"providers":[{"billed_charge":1809.00,"npi":[1396191136]}]},{"allowed_amount":413.80,"providers":[{"billed_charge":2010.00,"npi":[1891433124]}]},{"allowed_amount":417.91,"providers":[{"billed_charge":4623.00,"npi":[1316510043]}]},{"allowed_amount":526.93,"providers":[{"billed_charge":5829.00,"npi":[1376006585]}]},{"allowed_amount":345.23,"providers":[{"billed_charge":3819.00,"npi":[1063870467]}]},{"allowed_amount":127.19,"providers":[{"billed_charge":1407.00,"npi":[1285327452]}]},{"allowed_amount":124.14,"providers":[{"billed_charge":603.00,"npi":[1578026027]}]},{"allowed_amount":54.51,"providers":[{"billed_charge":603.00,"npi":[1669933370,1689240913]}]},{"allowed_amount":109.02,"providers":[{"billed_charge":1206.00,"npi":[1174034565]}]},{"allowed_amount":399.74,"providers":[{"billed_charge":4422.00,"npi":[1861242455]}]},{"allowed_amount":82.76,"providers":[{"billed_charge":402.00,"npi":[1891433124]}]}]}]},{"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":"822116964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":65.15,"providers":[{"billed_charge":220.00,"npi":[1336780279]}]},{"allowed_amount":175.49,"providers":[{"billed_charge":484.00,"npi":[1194967414]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["72","20"],"billing_class":"professional","payments":[{"allowed_amount":5.21,"providers":[{"billed_charge":31.16,"npi":[1285327452]}]},{"allowed_amount":31.26,"providers":[{"billed_charge":186.96,"npi":[1063870467]}]},{"allowed_amount":33.06,"providers":[{"billed_charge":62.32,"npi":[1891433124]}]},{"allowed_amount":26.05,"providers":[{"billed_charge":155.80,"npi":[1689240913]}]},{"allowed_amount":166.72,"providers":[{"billed_charge":997.12,"npi":[1174034565]}]},{"allowed_amount":20.84,"providers":[{"billed_charge":124.64,"npi":[1316510043]}]},{"allowed_amount":83.36,"providers":[{"billed_charge":498.56,"npi":[1376006585]}]},{"allowed_amount":15.63,"providers":[{"billed_charge":93.48,"npi":[1669933370]}]},{"allowed_amount":57.31,"providers":[{"billed_charge":342.76,"npi":[1861242455]}]},{"allowed_amount":82.65,"providers":[{"billed_charge":155.80,"npi":[1891433124]}]}]}]},{"name":"GENOTYPE DNA/RNA HEP C","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87902","description":"INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C VIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4111.94,"providers":[{"billed_charge":16277.67,"npi":[1265418669]}]}]}]},{"name":"CYTOPATH CELL ENHANCE TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88112","description":"CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (EG, LIQUID BASED SLIDE","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":256.74,"providers":[{"billed_charge":1064.70,"npi":[1265418669]}]}]}]},{"name":"CYTOPATH, C/V, INTERPRET","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88141","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), REQUIRING INTERPRETATION BY PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"813919645"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":359.70,"providers":[{"billed_charge":979.00,"npi":[1760681381]}]}]}]},{"name":"CYTOPATH C/V THIN LAYER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88142","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"813919645"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":1274.10,"providers":[{"billed_charge":5766.00,"npi":[1760681381]}]},{"allowed_amount":164.40,"providers":[{"billed_charge":744.00,"npi":[1760681381]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":717.60,"providers":[{"billed_charge":3919.03,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":213.60,"providers":[{"billed_charge":940.00,"npi":[1003863580]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":287.46,"providers":[{"billed_charge":810.00,"npi":[1023098928]}]}]}]},{"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":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4304.89,"providers":[{"billed_charge":15302.85,"npi":[1265418669]}]}]},{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3624.25,"providers":[{"billed_charge":6650.00,"npi":[1164955928]}]},{"allowed_amount":610.40,"providers":[{"billed_charge":1120.00,"npi":[1003073628]}]}]},{"tin":{"type":"ein","value":"710467949"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1138.74,"providers":[{"billed_charge":2425.00,"npi":[1770621658]}]}]},{"tin":{"type":"ein","value":"710410253"},"service_code":["22","81","21"],"billing_class":"professional","payments":[{"allowed_amount":142.34,"providers":[{"billed_charge":340.00,"npi":[1497384523]}]},{"allowed_amount":427.02,"providers":[{"billed_charge":1020.00,"npi":[1497384523]}]},{"allowed_amount":610.35,"providers":[{"billed_charge":1360.00,"npi":[1497384523]}]}]}]},{"name":"SPECIAL STAINS GROUP 1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88312","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":464.10,"providers":[{"billed_charge":850.00,"npi":[1164955928]}]}]}]},{"name":"SPECIAL STAINS GROUP 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88313","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":428.05,"providers":[{"billed_charge":805.00,"npi":[1164955928]}]}]}]},{"name":"IMMUNOHISTO ANTB 1ST STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88342","description":"IMMUNOHISTOCHEMISTRY OR IMMUNOCYTOCHEMISTRY, PER SPECIMEN; INITIAL SINGLE ANTIBODY STAIN PROCEDURE","allowed_amounts":[{"tin":{"type":"ein","value":"454486874"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1711.60,"providers":[{"billed_charge":4380.00,"npi":[1164955928]}]}]}]},{"name":"BH/INTENS OP/PSYCH","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"905","description":"INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"452488557"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":24800.00,"providers":[{"billed_charge":25600.00,"npi":[1578825626]}]}]}]},{"name":"BH/INTENS OP/CHEM DEP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"906","description":"INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"931916110"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1805.76,"providers":[{"billed_charge":40500.00,"npi":[1013732114]}]}]},{"tin":{"type":"ein","value":"320478538"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":95.37,"providers":[{"billed_charge":3000.00,"npi":[1346747235]}]}]},{"tin":{"type":"ein","value":"931952443"},"service_code":["99"],"billing_class":"institutional","payments":[{"allowed_amount":49920.00,"providers":[{"billed_charge":208000.00,"npi":[1730866021]}]}]},{"tin":{"type":"ein","value":"924017362"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1875.84,"providers":[{"billed_charge":114000.00,"npi":[1518721786]}]}]},{"tin":{"type":"ein","value":"333805968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6876.48,"providers":[{"billed_charge":47614.08,"npi":[1891683850]}]}]},{"tin":{"type":"ein","value":"861790384"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10200.00,"providers":[{"billed_charge":188496.00,"npi":[1912670068]}]}]},{"tin":{"type":"ein","value":"954107286"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2774.40,"providers":[{"billed_charge":113400.00,"npi":[1831284843]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5760.00,"providers":[{"billed_charge":19200.00,"npi":[1447723143]}]}]}]},{"name":"PSYTX COMPLEX INTERACTIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90785","description":"INTERACTIVE COMPLEXITY (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE)","allowed_amounts":[{"tin":{"type":"ein","value":"844538314"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":149.94,"providers":[{"billed_charge":360.00,"npi":[1922758259]}]}]},{"tin":{"type":"ein","value":"931482298"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":90.36,"providers":[{"billed_charge":132.00,"npi":[1720538069]}]},{"allowed_amount":62.52,"providers":[{"billed_charge":88.00,"npi":[1720538069]}]}]}]},{"name":"PSYCH DIAGNOSTIC EVALUATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90791","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":1295.00,"providers":[{"billed_charge":1295.00,"npi":[1265657274]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":366.80,"providers":[{"billed_charge":490.00,"npi":[1932540192]}]},{"allowed_amount":2017.40,"providers":[{"billed_charge":3115.00,"npi":[1932540192]}]},{"allowed_amount":550.20,"providers":[{"billed_charge":735.00,"npi":[1932540192]}]}]}]},{"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":"821171262"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":168.00,"providers":[{"billed_charge":168.00,"npi":[1114995198]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":187.93,"providers":[{"billed_charge":388.00,"npi":[1376158998]}]},{"allowed_amount":1503.44,"providers":[{"billed_charge":3338.00,"npi":[1518475466]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1127.58,"providers":[{"billed_charge":2364.00,"npi":[1234567893]}]},{"allowed_amount":1503.44,"providers":[{"billed_charge":3152.00,"npi":[1234567893]}]}]}]},{"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":"237198398"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":87.05,"providers":[{"billed_charge":112.71,"npi":[1811916547]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":75.00,"providers":[{"billed_charge":75.00,"npi":[1770212219]}]}]},{"tin":{"type":"ein","value":"710360221"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":863.70,"providers":[{"billed_charge":900.00,"npi":[1235170382]}]},{"allowed_amount":450.00,"providers":[{"billed_charge":450.00,"npi":[1639137458]}]},{"allowed_amount":609.35,"providers":[{"billed_charge":630.00,"npi":[1275960700]}]},{"allowed_amount":348.20,"providers":[{"billed_charge":360.00,"npi":[1275960700]}]},{"allowed_amount":174.10,"providers":[{"billed_charge":180.00,"npi":[1235170382]}]},{"allowed_amount":1824.65,"providers":[{"billed_charge":1890.00,"npi":[1275960700]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":87.05,"providers":[{"billed_charge":140.00,"npi":[1427633163]}]},{"allowed_amount":348.20,"providers":[{"billed_charge":560.00,"npi":[1427633163]}]}]},{"tin":{"type":"ein","value":"824561401"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":1566.90,"providers":[{"billed_charge":2160.00,"npi":[1336408533]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":236.79,"providers":[{"billed_charge":543.00,"npi":[1487297008]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":261.15,"providers":[{"billed_charge":536.40,"npi":[1750789178]}]},{"allowed_amount":435.25,"providers":[{"billed_charge":894.00,"npi":[1750789178]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1131.65,"providers":[{"billed_charge":1918.02,"npi":[1295378289]}]},{"allowed_amount":174.10,"providers":[{"billed_charge":295.08,"npi":[1295378289,1851738660]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":2611.50,"providers":[{"billed_charge":4823.97,"npi":[1770605057]}]}]}]},{"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":"993152887"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":159.16,"providers":[{"billed_charge":200.00,"npi":[1396464475]}]},{"allowed_amount":79.58,"providers":[{"billed_charge":100.00,"npi":[1396464475,1821619370]}]}]},{"tin":{"type":"ein","value":"710290019"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":323.16,"providers":[{"billed_charge":620.00,"npi":[1437803814]}]},{"allowed_amount":450.95,"providers":[{"billed_charge":775.00,"npi":[1437803814]}]}]},{"tin":{"type":"ein","value":"831529526"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":318.32,"providers":[{"billed_charge":506.48,"npi":[1386397651,1114797883]}]},{"allowed_amount":477.48,"providers":[{"billed_charge":759.72,"npi":[1114627163]}]},{"allowed_amount":1114.12,"providers":[{"billed_charge":1772.68,"npi":[1386397651]}]},{"allowed_amount":281.00,"providers":[{"billed_charge":633.10,"npi":[1801649421]}]},{"allowed_amount":562.00,"providers":[{"billed_charge":1266.20,"npi":[1801649421]}]},{"allowed_amount":557.06,"providers":[{"billed_charge":886.34,"npi":[1104464445]}]},{"allowed_amount":159.16,"providers":[{"billed_charge":253.24,"npi":[1114627163,1114797883]}]},{"allowed_amount":1034.54,"providers":[{"billed_charge":1646.06,"npi":[1386397651]}]},{"allowed_amount":636.64,"providers":[{"billed_charge":1012.96,"npi":[1104464445,1114797883]}]},{"allowed_amount":79.58,"providers":[{"billed_charge":126.62,"npi":[1114627163]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2794.06,"providers":[{"billed_charge":3410.00,"npi":[1376664342]}]},{"allowed_amount":6054.12,"providers":[{"billed_charge":7920.00,"npi":[1831206341]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5411.44,"providers":[{"billed_charge":10200.00,"npi":[1487422572]}]},{"allowed_amount":4615.64,"providers":[{"billed_charge":8700.00,"npi":[1417238981]}]},{"allowed_amount":5172.70,"providers":[{"billed_charge":9750.00,"npi":[1093550741]}]}]},{"tin":{"type":"ein","value":"844538314"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":416.78,"providers":[{"billed_charge":800.00,"npi":[1922758259]}]},{"allowed_amount":360.58,"providers":[{"billed_charge":650.00,"npi":[1922758259]}]}]},{"tin":{"type":"ein","value":"333151160"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1067.80,"providers":[{"billed_charge":3515.00,"npi":[1346339066]}]},{"allowed_amount":393.40,"providers":[{"billed_charge":1295.00,"npi":[1346339066]}]}]},{"tin":{"type":"ein","value":"710772737"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4992.00,"providers":[{"billed_charge":4992.00,"npi":[1629784251]}]}]}]},{"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":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":344.64,"providers":[{"billed_charge":452.73,"npi":[1497449318]}]}]},{"tin":{"type":"ein","value":"474591265"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1134.39,"providers":[{"billed_charge":3000.00,"npi":[1164659132]}]},{"allowed_amount":234.36,"providers":[{"billed_charge":600.00,"npi":[1164659132]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1378.56,"providers":[{"billed_charge":1920.00,"npi":[1194242099]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":905.67,"providers":[{"billed_charge":2340.00,"npi":[1427480847]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":344.64,"providers":[{"billed_charge":409.14,"npi":[1730491598]}]},{"allowed_amount":689.28,"providers":[{"billed_charge":818.28,"npi":[1730491598]}]}]},{"tin":{"type":"ein","value":"431713439"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2144.95,"providers":[{"billed_charge":4400.00,"npi":[1427480847]}]},{"allowed_amount":676.69,"providers":[{"billed_charge":1400.00,"npi":[1427480847]}]}]},{"tin":{"type":"ein","value":"710717967"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":72.39,"providers":[{"billed_charge":167.00,"npi":[1720029523]}]},{"allowed_amount":676.89,"providers":[{"billed_charge":1002.00,"npi":[1720029523]}]}]}]},{"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":"208182251"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1050.00,"npi":[1407137029]}]},{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1568034668]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":1400.00,"npi":[1568034668]}]}]},{"tin":{"type":"ein","value":"843838374"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":440.00,"npi":[1265070718]}]}]},{"tin":{"type":"ein","value":"331180453"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1304.76,"providers":[{"billed_charge":2520.00,"npi":[1407951247]}]},{"allowed_amount":869.84,"providers":[{"billed_charge":1680.00,"npi":[1407951247]}]}]},{"tin":{"type":"ein","value":"751759262"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":283.41,"providers":[{"billed_charge":1050.00,"npi":[1023340544]}]},{"allowed_amount":94.47,"providers":[{"billed_charge":350.00,"npi":[1023340544]}]}]},{"tin":{"type":"ein","value":"273366569"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9015.83,"providers":[{"billed_charge":11130.00,"npi":[1316957830]}]}]},{"tin":{"type":"ein","value":"831018926"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":170.00,"providers":[{"billed_charge":170.00,"npi":[1326222076]}]},{"allowed_amount":5378.73,"providers":[{"billed_charge":5440.00,"npi":[1326222076]}]}]},{"tin":{"type":"ein","value":"562570576"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1701.10,"providers":[{"billed_charge":1800.00,"npi":[1982261251]}]},{"allowed_amount":2381.54,"providers":[{"billed_charge":2520.00,"npi":[1982261251]}]}]},{"tin":{"type":"ein","value":"831722673"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2490.27,"providers":[{"billed_charge":3375.00,"npi":[1184132417]}]}]},{"tin":{"type":"ein","value":"863638488"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":400.00,"npi":[1013211424]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1013211424]}]}]},{"tin":{"type":"ein","value":"824288082"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1750964912]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":400.00,"npi":[1750964912]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1380.00,"npi":[1750828133]}]}]},{"tin":{"type":"ein","value":"810844380"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":880.00,"npi":[1376122622]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":660.00,"npi":[1962067959]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1100.00,"npi":[1376122622]}]}]},{"tin":{"type":"ein","value":"882773209"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":600.00,"providers":[{"billed_charge":600.00,"npi":[1376268060]}]},{"allowed_amount":3200.00,"providers":[{"billed_charge":3200.00,"npi":[1376268060]}]}]},{"tin":{"type":"ein","value":"331430091"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":992.60,"providers":[{"billed_charge":1600.00,"npi":[1720360381]}]},{"allowed_amount":3156.68,"providers":[{"billed_charge":4000.00,"npi":[1720360381]}]}]},{"tin":{"type":"ein","value":"823611843"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1871994145]}]}]},{"tin":{"type":"ein","value":"264248303"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3228.34,"providers":[{"billed_charge":4275.00,"npi":[1184752412]}]},{"allowed_amount":1357.13,"providers":[{"billed_charge":1800.00,"npi":[1447620844]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":450.00,"npi":[1184752412]}]}]},{"tin":{"type":"ein","value":"830857052"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":800.00,"npi":[1376774216]}]},{"allowed_amount":3742.42,"providers":[{"billed_charge":4400.00,"npi":[1376774216]}]}]},{"tin":{"type":"ein","value":"461736154"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":450.00,"npi":[1548464852]}]}]},{"tin":{"type":"ein","value":"263442072"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8926.20,"providers":[{"billed_charge":12240.00,"npi":[1861639940]}]}]},{"tin":{"type":"ein","value":"814647676"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2721.76,"providers":[{"billed_charge":2800.00,"npi":[1508439472]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":175.00,"npi":[1508439472]}]}]},{"tin":{"type":"ein","value":"263447487"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":4968.48,"providers":[{"billed_charge":6000.00,"npi":[1326090440]}]},{"allowed_amount":828.08,"providers":[{"billed_charge":1000.00,"npi":[1326090440]}]}]},{"tin":{"type":"ein","value":"932569871"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":400.00,"npi":[1174199087]}]},{"allowed_amount":2381.54,"providers":[{"billed_charge":2800.00,"npi":[1174199087]}]}]},{"tin":{"type":"ein","value":"812793571"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2551.65,"providers":[{"billed_charge":2850.00,"npi":[1174094825]}]},{"allowed_amount":16493.17,"providers":[{"billed_charge":18430.00,"npi":[1174094825]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":470.00,"npi":[1932540192]}]},{"allowed_amount":2381.54,"providers":[{"billed_charge":3620.00,"npi":[1932540192]}]}]},{"tin":{"type":"ein","value":"812632214"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":3659.92,"providers":[{"billed_charge":5500.00,"npi":[1962630947]}]},{"allowed_amount":4990.80,"providers":[{"billed_charge":7500.00,"npi":[1275960700]}]}]},{"tin":{"type":"ein","value":"710715998"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4252.75,"providers":[{"billed_charge":5191.02,"npi":[1972939304]}]}]},{"tin":{"type":"ein","value":"821110519"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":410.00,"npi":[1891181475]}]}]},{"tin":{"type":"ein","value":"571176963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":10807.02,"providers":[{"billed_charge":16200.00,"npi":[1275784506]}]}]},{"tin":{"type":"ein","value":"474151500"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3522.96,"providers":[{"billed_charge":3988.62,"npi":[1295910974]}]}]},{"tin":{"type":"ein","value":"993141896"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1801956578]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":525.00,"npi":[1841557840,1801956578]}]},{"allowed_amount":5953.85,"providers":[{"billed_charge":6125.00,"npi":[1841557840]}]},{"allowed_amount":1530.99,"providers":[{"billed_charge":1575.00,"npi":[1831127075,1609559137]}]},{"allowed_amount":4082.64,"providers":[{"billed_charge":4200.00,"npi":[1831127075]}]}]},{"tin":{"type":"ein","value":"822126642"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1701.10,"providers":[{"billed_charge":2000.00,"npi":[1679029201]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1679029201]}]}]},{"tin":{"type":"ein","value":"820932212"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":880.00,"npi":[1144497652]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1100.00,"npi":[1144497652]}]}]},{"tin":{"type":"ein","value":"270746053"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6604.29,"providers":[{"billed_charge":8043.75,"npi":[1972051126]}]}]},{"tin":{"type":"ein","value":"872869056"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":740.00,"npi":[1649789215]}]}]},{"tin":{"type":"ein","value":"872620079"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1050.00,"npi":[1811562515]}]}]},{"tin":{"type":"ein","value":"920827831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2668.48,"providers":[{"billed_charge":4000.00,"npi":[1912664228]}]}]},{"tin":{"type":"ein","value":"474826984"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1871.21,"providers":[{"billed_charge":2437.16,"npi":[1154960946]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":443.12,"npi":[1790166403]}]},{"allowed_amount":2211.43,"providers":[{"billed_charge":2880.28,"npi":[1790166403]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":221.56,"npi":[1154960946]}]}]},{"tin":{"type":"ein","value":"844286440"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2381.54,"providers":[{"billed_charge":3356.08,"npi":[1780063438]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":239.72,"npi":[1780063438]}]}]},{"tin":{"type":"ein","value":"710296619"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":180.00,"npi":[1619607207]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1260.00,"npi":[1609973254]}]}]},{"tin":{"type":"ein","value":"991515413"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":500.00,"npi":[1881335537]}]},{"allowed_amount":2211.43,"providers":[{"billed_charge":3250.00,"npi":[1881335537]}]}]},{"tin":{"type":"ein","value":"882272859"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":360.00,"npi":[1659701654]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1260.00,"npi":[1659701654]}]}]},{"tin":{"type":"ein","value":"273532705"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1200.78,"providers":[{"billed_charge":1500.00,"npi":[1639400294]}]},{"allowed_amount":3572.31,"providers":[{"billed_charge":5250.00,"npi":[1699193110]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":2000.00,"npi":[1861797227]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":500.00,"npi":[1427305663]}]},{"allowed_amount":800.52,"providers":[{"billed_charge":1000.00,"npi":[1639400294]}]},{"allowed_amount":3402.20,"providers":[{"billed_charge":5000.00,"npi":[1104066299]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":250.00,"npi":[1861797227]}]}]},{"tin":{"type":"ein","value":"812549778"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3742.42,"providers":[{"billed_charge":4730.00,"npi":[1295861649]}]}]},{"tin":{"type":"ein","value":"332412853"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":240.00,"npi":[1689634255]}]}]},{"tin":{"type":"ein","value":"824561401"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":5273.41,"providers":[{"billed_charge":7750.00,"npi":[1336408533]}]}]},{"tin":{"type":"ein","value":"994371815"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1194556753]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1000.00,"npi":[1194556753]}]}]},{"tin":{"type":"ein","value":"832184795"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1396177531]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1396177531]}]}]},{"tin":{"type":"ein","value":"873695970"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":17521.33,"providers":[{"billed_charge":20600.00,"npi":[1245995398]}]},{"allowed_amount":4933.19,"providers":[{"billed_charge":5800.00,"npi":[1245995398]}]}]},{"tin":{"type":"ein","value":"832504107"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":900.00,"npi":[1154570521]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":450.00,"npi":[1225508047,1154570521]}]}]},{"tin":{"type":"ein","value":"432395130"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5103.30,"providers":[{"billed_charge":6600.00,"npi":[1770638355]}]}]},{"tin":{"type":"ein","value":"842581036"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":900.00,"npi":[1477076222]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":6017.31,"providers":[{"billed_charge":13689.00,"npi":[1497992440]}]},{"allowed_amount":6171.60,"providers":[{"billed_charge":14040.00,"npi":[1780275123]}]}]},{"tin":{"type":"ein","value":"824019156"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5440.00,"providers":[{"billed_charge":5440.00,"npi":[1376235804]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1307.58,"npi":[1730491598]}]},{"allowed_amount":680.44,"providers":[{"billed_charge":871.72,"npi":[1952786162]}]},{"allowed_amount":4843.75,"providers":[{"billed_charge":6755.83,"npi":[1407435035]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":653.79,"npi":[1366785909]}]},{"allowed_amount":3061.98,"providers":[{"billed_charge":3922.74,"npi":[1043951106]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":217.93,"npi":[1407435035,1043951106,1730491598]}]}]},{"tin":{"type":"ein","value":"923180531"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4350.00,"providers":[{"billed_charge":4350.00,"npi":[1902352115]}]}]},{"tin":{"type":"ein","value":"831287025"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3450.00,"providers":[{"billed_charge":3450.00,"npi":[1174771091]}]},{"allowed_amount":5100.00,"providers":[{"billed_charge":5100.00,"npi":[1174771091]}]}]},{"tin":{"type":"ein","value":"993152887"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":4252.75,"providers":[{"billed_charge":4375.00,"npi":[1841045234]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1225.00,"npi":[1841045234]}]}]},{"tin":{"type":"ein","value":"842185036"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":420.00,"npi":[1861959066]}]}]},{"tin":{"type":"ein","value":"475082528"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1871.21,"providers":[{"billed_charge":2420.00,"npi":[1568834471]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1013.16,"providers":[{"billed_charge":1800.00,"npi":[1679724504]}]}]},{"tin":{"type":"ein","value":"871555737"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":1000.00,"npi":[1528302213]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":500.00,"npi":[1528302213]}]}]},{"tin":{"type":"ein","value":"844538314"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1497095517]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":350.00,"npi":[1497095517]}]},{"allowed_amount":2869.07,"providers":[{"billed_charge":4025.00,"npi":[1548745706]}]},{"allowed_amount":2830.49,"providers":[{"billed_charge":2975.00,"npi":[1174009260]}]}]},{"tin":{"type":"ein","value":"845175286"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":5273.41,"providers":[{"billed_charge":5580.00,"npi":[1831538917]}]},{"allowed_amount":1530.99,"providers":[{"billed_charge":1620.00,"npi":[1205003688]}]}]},{"tin":{"type":"ein","value":"710859088"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":175.00,"npi":[1124535638]}]}]},{"tin":{"type":"ein","value":"882760550"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":800.00,"npi":[1659542686]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":1600.00,"npi":[1912550070]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1000.00,"npi":[1659542686]}]},{"allowed_amount":3402.20,"providers":[{"billed_charge":4000.00,"npi":[1659542686]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1912550070]}]}]},{"tin":{"type":"ein","value":"203396304"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3061.98,"providers":[{"billed_charge":3870.00,"npi":[1962783852]}]},{"allowed_amount":2891.87,"providers":[{"billed_charge":3655.00,"npi":[1962783852]}]}]},{"tin":{"type":"ein","value":"205386448"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2551.65,"providers":[{"billed_charge":3300.00,"npi":[1609413111]}]},{"allowed_amount":1016.91,"providers":[{"billed_charge":1320.00,"npi":[1609413111]}]}]},{"tin":{"type":"ein","value":"832952547"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2380.00,"providers":[{"billed_charge":2380.00,"npi":[1407253222]}]},{"allowed_amount":3570.00,"providers":[{"billed_charge":3570.00,"npi":[1790398311]}]},{"allowed_amount":1360.00,"providers":[{"billed_charge":1360.00,"npi":[1407253222,1548772361]}]}]},{"tin":{"type":"ein","value":"920960944"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":235.00,"npi":[1356712616]}]}]},{"tin":{"type":"ein","value":"862709461"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1190.77,"providers":[{"billed_charge":1925.00,"npi":[1710658208]}]}]},{"tin":{"type":"ein","value":"871169237"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1050.00,"npi":[1265980593]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1225.00,"npi":[1265980593]}]}]},{"tin":{"type":"ein","value":"874033729"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":11397.37,"providers":[{"billed_charge":13400.00,"npi":[1396158564]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1396158564]}]}]},{"tin":{"type":"ein","value":"331504137"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1701.10,"providers":[{"billed_charge":2000.00,"npi":[1407589732]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1407589732]}]}]},{"tin":{"type":"ein","value":"842209520"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":940.00,"npi":[1477195576]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":705.00,"npi":[1639346786]}]},{"allowed_amount":6974.51,"providers":[{"billed_charge":9635.00,"npi":[1639346786]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":235.00,"npi":[1477195576]}]}]},{"tin":{"type":"ein","value":"873364225"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2381.54,"providers":[{"billed_charge":2800.00,"npi":[1780177113]}]},{"allowed_amount":4252.75,"providers":[{"billed_charge":5000.00,"npi":[1780177113]}]}]},{"tin":{"type":"ein","value":"710408284"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":240.00,"npi":[1578837100]}]}]},{"tin":{"type":"ein","value":"824467994"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1829.96,"providers":[{"billed_charge":3300.00,"npi":[1548362353]}]},{"allowed_amount":499.08,"providers":[{"billed_charge":900.00,"npi":[1548362353]}]}]},{"tin":{"type":"ein","value":"30538912"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":3572.31,"providers":[{"billed_charge":5094.39,"npi":[1770605057]}]}]},{"tin":{"type":"ein","value":"710290019"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1928.00,"providers":[{"billed_charge":3022.50,"npi":[1629107214]}]},{"allowed_amount":170.73,"providers":[{"billed_charge":310.00,"npi":[1629107214]}]}]},{"tin":{"type":"ein","value":"621665314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":326.19,"providers":[{"billed_charge":660.00,"npi":[1447086673]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":6294.07,"providers":[{"billed_charge":8140.00,"npi":[1407250525]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":660.00,"npi":[1588640551]}]},{"allowed_amount":2551.65,"providers":[{"billed_charge":3300.00,"npi":[1588640551]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":440.00,"npi":[1427633163]}]},{"allowed_amount":1530.99,"providers":[{"billed_charge":1980.00,"npi":[1902220668]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1540.00,"npi":[1427633163]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":220.00,"npi":[1154998136]}]}]},{"tin":{"type":"ein","value":"861873310"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1360.88,"providers":[{"billed_charge":2400.00,"npi":[1669187514]}]},{"allowed_amount":4763.08,"providers":[{"billed_charge":8400.00,"npi":[1669187514]}]}]},{"tin":{"type":"ein","value":"474981058"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":448.95,"providers":[{"billed_charge":720.00,"npi":[1184857369]}]}]},{"tin":{"type":"ein","value":"472679851"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":217.46,"providers":[{"billed_charge":400.00,"npi":[1144500570]}]},{"allowed_amount":108.73,"providers":[{"billed_charge":200.00,"npi":[1144500570]}]}]},{"tin":{"type":"ein","value":"993888211"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2551.65,"providers":[{"billed_charge":3323.85,"npi":[1023666351]}]},{"allowed_amount":12418.03,"providers":[{"billed_charge":16176.07,"npi":[1023666351]}]}]},{"tin":{"type":"ein","value":"710828877"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1871.21,"providers":[{"billed_charge":2805.00,"npi":[1942526645]}]},{"allowed_amount":2599.00,"providers":[{"billed_charge":4080.00,"npi":[1124563234]}]},{"allowed_amount":2551.65,"providers":[{"billed_charge":3825.00,"npi":[1730356312]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":510.00,"npi":[1124563234,1710237581]}]},{"allowed_amount":6112.71,"providers":[{"billed_charge":9180.00,"npi":[1437328960]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1275.00,"npi":[1730356312]}]}]},{"tin":{"type":"ein","value":"237198398"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":4592.97,"providers":[{"billed_charge":6472.44,"npi":[1841760675]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":239.72,"npi":[1841760675]}]}]},{"tin":{"type":"ein","value":"874108485"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":350.00,"npi":[1477720951]}]}]},{"tin":{"type":"ein","value":"621658502"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":744.00,"npi":[1740981364]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":372.00,"npi":[1962870618]}]},{"allowed_amount":2207.68,"providers":[{"billed_charge":2418.00,"npi":[1740981364]}]}]},{"tin":{"type":"ein","value":"874418116"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":3370.63,"providers":[{"billed_charge":6200.00,"npi":[1164782124]}]}]},{"tin":{"type":"ein","value":"830733449"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":4252.75,"providers":[{"billed_charge":5000.00,"npi":[1497110043]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1497110043]}]}]},{"tin":{"type":"ein","value":"991043950"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2065.87,"providers":[{"billed_charge":3800.00,"npi":[1063833812]}]},{"allowed_amount":1087.30,"providers":[{"billed_charge":2000.00,"npi":[1063833812]}]}]},{"tin":{"type":"ein","value":"710416869"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":4249.00,"providers":[{"billed_charge":5993.00,"npi":[1760529549]}]},{"allowed_amount":680.44,"providers":[{"billed_charge":958.88,"npi":[1760529549,1053675686]}]},{"allowed_amount":4929.44,"providers":[{"billed_charge":6951.88,"npi":[1760529549]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":1917.76,"npi":[1053675686]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1198.60,"npi":[1053675686]}]}]},{"tin":{"type":"ein","value":"710795585"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":806.44,"providers":[{"billed_charge":1160.00,"npi":[1295147676]}]}]},{"tin":{"type":"ein","value":"853720009"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1871.21,"providers":[{"billed_charge":2200.00,"npi":[1245842764]}]},{"allowed_amount":850.55,"providers":[{"billed_charge":1000.00,"npi":[1245842764]}]}]},{"tin":{"type":"ein","value":"841975348"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1528412269]}]},{"allowed_amount":502.83,"providers":[{"billed_charge":600.00,"npi":[1528412269]}]}]},{"tin":{"type":"ein","value":"844183033"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4422.86,"providers":[{"billed_charge":5666.18,"npi":[1720007339]}]},{"allowed_amount":1502.93,"providers":[{"billed_charge":2397.23,"npi":[1811619331]}]}]},{"tin":{"type":"ein","value":"854094783"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1320.00,"npi":[1104957414]}]},{"allowed_amount":1530.99,"providers":[{"billed_charge":1980.00,"npi":[1104957414]}]}]},{"tin":{"type":"ein","value":"822551204"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3742.42,"providers":[{"billed_charge":4400.00,"npi":[1801101126]}]},{"allowed_amount":5273.41,"providers":[{"billed_charge":6200.00,"npi":[1801101126]}]}]},{"tin":{"type":"ein","value":"881221742"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":3232.09,"providers":[{"billed_charge":4275.00,"npi":[1437362803]}]}]},{"tin":{"type":"ein","value":"831552964"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1814.49,"providers":[{"billed_charge":2160.00,"npi":[1487843967]}]},{"allowed_amount":8669.23,"providers":[{"billed_charge":10320.00,"npi":[1487843967]}]}]},{"tin":{"type":"ein","value":"462017854"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1209.66,"providers":[{"billed_charge":1620.00,"npi":[1487167045]}]},{"allowed_amount":604.83,"providers":[{"billed_charge":810.00,"npi":[1487167045]}]}]},{"tin":{"type":"ein","value":"272253123"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1701.10,"providers":[{"billed_charge":1800.00,"npi":[1629247564]}]},{"allowed_amount":3912.53,"providers":[{"billed_charge":4140.00,"npi":[1053161539]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":180.00,"npi":[1902277924,1861786436]}]}]},{"tin":{"type":"ein","value":"922116792"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":14969.68,"providers":[{"billed_charge":15400.00,"npi":[1134337744]}]},{"allowed_amount":6974.51,"providers":[{"billed_charge":7175.00,"npi":[1134337744]}]}]},{"tin":{"type":"ein","value":"923043960"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":543.65,"providers":[{"billed_charge":975.00,"npi":[1679079990]}]}]},{"tin":{"type":"ein","value":"427477026"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4200.00,"providers":[{"billed_charge":4200.00,"npi":[1447399878]}]}]},{"tin":{"type":"ein","value":"261598119"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":825.00,"providers":[{"billed_charge":825.00,"npi":[1932247392]}]},{"allowed_amount":5610.00,"providers":[{"billed_charge":5610.00,"npi":[1063689560]}]},{"allowed_amount":5775.00,"providers":[{"billed_charge":5775.00,"npi":[1063689560]}]},{"allowed_amount":1815.00,"providers":[{"billed_charge":1815.00,"npi":[1356595540]}]},{"allowed_amount":4950.00,"providers":[{"billed_charge":4950.00,"npi":[1205003688]}]},{"allowed_amount":5940.00,"providers":[{"billed_charge":5940.00,"npi":[1932247392]}]},{"allowed_amount":4785.00,"providers":[{"billed_charge":4785.00,"npi":[1356595540]}]},{"allowed_amount":3465.00,"providers":[{"billed_charge":3465.00,"npi":[1205003688]}]}]},{"tin":{"type":"ein","value":"994127997"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":3061.98,"providers":[{"billed_charge":3600.00,"npi":[1659915577]}]}]},{"tin":{"type":"ein","value":"200551714"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1190.77,"providers":[{"billed_charge":1575.00,"npi":[1154535169]}]}]},{"tin":{"type":"ein","value":"822571151"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7825.06,"providers":[{"billed_charge":12650.00,"npi":[1699199398]}]}]},{"tin":{"type":"ein","value":"882792730"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3912.53,"providers":[{"billed_charge":5520.00,"npi":[1265609747]}]}]},{"tin":{"type":"ein","value":"461893699"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1304.76,"providers":[{"billed_charge":2100.00,"npi":[1295246536]}]},{"allowed_amount":340.22,"providers":[{"billed_charge":350.00,"npi":[1356458269]}]},{"allowed_amount":1087.30,"providers":[{"billed_charge":1750.00,"npi":[1295246536]}]}]},{"tin":{"type":"ein","value":"831555272"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":555.00,"npi":[1912298811]}]}]},{"tin":{"type":"ein","value":"815312220"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":1360.88,"providers":[{"billed_charge":1400.00,"npi":[1760511489]}]}]},{"tin":{"type":"ein","value":"923764897"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":170.00,"providers":[{"billed_charge":170.00,"npi":[1649572835]}]},{"allowed_amount":340.00,"providers":[{"billed_charge":340.00,"npi":[1649572835]}]}]},{"tin":{"type":"ein","value":"472633987"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":500.00,"npi":[1942236047]}]},{"allowed_amount":2211.43,"providers":[{"billed_charge":3250.00,"npi":[1942236047]}]}]},{"tin":{"type":"ein","value":"831159576"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1679913743]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2646.35,"providers":[{"billed_charge":5334.94,"npi":[1295004836]}]}]},{"tin":{"type":"ein","value":"932326187"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":750.00,"npi":[1811313885]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":250.00,"npi":[1811313885]}]}]},{"tin":{"type":"ein","value":"833078399"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":795.00,"npi":[1609624824]}]}]},{"tin":{"type":"ein","value":"710391252"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":434.92,"providers":[{"billed_charge":434.92,"npi":[1215775580]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":622.76,"npi":[1215775580]},{"billed_charge":621.18,"npi":[1831956580]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":1658.06,"npi":[1093548380]}]},{"allowed_amount":652.38,"providers":[{"billed_charge":652.38,"npi":[1093548380]}]},{"allowed_amount":326.19,"providers":[{"billed_charge":326.19,"npi":[1831956580]}]}]},{"tin":{"type":"ein","value":"922525306"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1912115353]}]},{"allowed_amount":5273.41,"providers":[{"billed_charge":5425.00,"npi":[1912115353]}]}]},{"tin":{"type":"ein","value":"824818957"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.73,"providers":[{"billed_charge":240.00,"npi":[1760076608]}]}]},{"tin":{"type":"ein","value":"883432860"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":200.00,"npi":[1821743105]}]}]},{"tin":{"type":"ein","value":"814430335"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":340.00,"providers":[{"billed_charge":340.00,"npi":[1659422160]}]},{"allowed_amount":5946.36,"providers":[{"billed_charge":5950.00,"npi":[1659422160]}]}]},{"tin":{"type":"ein","value":"474270177"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1164010484]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":525.00,"npi":[1164010484]}]}]},{"tin":{"type":"ein","value":"464518730"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":2305.13,"providers":[{"billed_charge":3150.00,"npi":[1407029606]}]},{"allowed_amount":304.45,"providers":[{"billed_charge":450.00,"npi":[1407029606]}]}]},{"tin":{"type":"ein","value":"473259723"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1500.00,"npi":[1124474556]}]},{"allowed_amount":1701.10,"providers":[{"billed_charge":2500.00,"npi":[1952798423]}]},{"allowed_amount":680.44,"providers":[{"billed_charge":1000.00,"npi":[1952798423,1073110524]}]},{"allowed_amount":510.33,"providers":[{"billed_charge":750.00,"npi":[1073110524]}]},{"allowed_amount":2211.43,"providers":[{"billed_charge":3250.00,"npi":[1902929417]}]},{"allowed_amount":3232.09,"providers":[{"billed_charge":4750.00,"npi":[1902929417]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":250.00,"npi":[1497980643]}]},{"allowed_amount":1190.77,"providers":[{"billed_charge":1750.00,"npi":[1497980643]}]}]},{"tin":{"type":"ein","value":"883048824"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":16330.56,"providers":[{"billed_charge":16800.00,"npi":[1457739898]}]},{"allowed_amount":24155.62,"providers":[{"billed_charge":24850.00,"npi":[1942920947]}]}]},{"tin":{"type":"ein","value":"842463871"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":4002.60,"providers":[{"billed_charge":5000.00,"npi":[1215208392]}]}]},{"tin":{"type":"ein","value":"823884531"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":680.44,"providers":[{"billed_charge":700.00,"npi":[1497959118]}]},{"allowed_amount":1530.99,"providers":[{"billed_charge":1575.00,"npi":[1073529491]}]}]},{"tin":{"type":"ein","value":"843309752"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1360.88,"providers":[{"billed_charge":1520.00,"npi":[1407120801]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":190.00,"npi":[1407120801]}]}]},{"tin":{"type":"ein","value":"823876873"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1068.01,"providers":[{"billed_charge":1225.00,"npi":[1912079245]}]}]},{"tin":{"type":"ein","value":"473599124"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":5241.86,"providers":[{"billed_charge":7670.00,"npi":[1295489987]}]},{"allowed_amount":1209.66,"providers":[{"billed_charge":1770.00,"npi":[1700412012]}]},{"allowed_amount":1612.88,"providers":[{"billed_charge":2360.00,"npi":[1942695572]}]},{"allowed_amount":4435.42,"providers":[{"billed_charge":6490.00,"npi":[1942695572]}]}]},{"tin":{"type":"ein","value":"454787259"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1500.00,"npi":[1811108129]}]},{"allowed_amount":3742.42,"providers":[{"billed_charge":5500.00,"npi":[1811108129]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":250.00,"npi":[1104713676]}]}]},{"tin":{"type":"ein","value":"822090910"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":600.00,"npi":[1548656846]}]},{"allowed_amount":1360.88,"providers":[{"billed_charge":1600.00,"npi":[1972083319]}]}]},{"tin":{"type":"ein","value":"371847272"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":220.00,"npi":[1790152999]}]}]},{"tin":{"type":"ein","value":"716046242"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1789.92,"providers":[{"billed_charge":4301.00,"npi":[1487934766]}]}]},{"tin":{"type":"ein","value":"710276839"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":354.44,"providers":[{"billed_charge":755.58,"npi":[1114310133]}]}]},{"tin":{"type":"ein","value":"931482298"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":400.00,"npi":[1720538069]}]},{"allowed_amount":1238.12,"providers":[{"billed_charge":1600.00,"npi":[1720538069]}]}]},{"tin":{"type":"ein","value":"874189866"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1020.66,"providers":[{"billed_charge":1200.00,"npi":[1962960237]}]}]},{"tin":{"type":"ein","value":"922518727"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":525.00,"npi":[1881121879]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":175.00,"npi":[1881121879]}]}]},{"tin":{"type":"ein","value":"853231473"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2381.54,"providers":[{"billed_charge":2800.00,"npi":[1720125578]}]}]},{"tin":{"type":"ein","value":"833367250"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":510.33,"providers":[{"billed_charge":651.00,"npi":[1114409174]}]},{"allowed_amount":170.11,"providers":[{"billed_charge":217.00,"npi":[1114409174]}]}]},{"tin":{"type":"ein","value":"273363386"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.22,"providers":[{"billed_charge":360.00,"npi":[1942255336]}]}]},{"tin":{"type":"ein","value":"474972316"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":170.11,"providers":[{"billed_charge":180.00,"npi":[1801234752]}]}]},{"tin":{"type":"ein","value":"901498800"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":5323.52,"providers":[{"billed_charge":8224.00,"npi":[1184054819]}]},{"allowed_amount":1164.52,"providers":[{"billed_charge":1799.00,"npi":[1184054819]}]}]}]},{"name":"PSYTX W PT W E/M 60 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90838","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"993161677"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":8435.07,"providers":[{"billed_charge":12600.00,"npi":[1598417511]}]}]}]},{"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":"882773209"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1538.04,"providers":[{"billed_charge":3360.00,"npi":[1376268060]}]},{"allowed_amount":622.54,"providers":[{"billed_charge":1360.00,"npi":[1376268060]}]}]},{"tin":{"type":"ein","value":"710391252"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":741.60,"providers":[{"billed_charge":981.60,"npi":[1093548380]}]},{"allowed_amount":1514.10,"providers":[{"billed_charge":2004.10,"npi":[1780987362]}]},{"allowed_amount":1390.50,"providers":[{"billed_charge":1840.50,"npi":[1215775580]}]},{"allowed_amount":61.80,"providers":[{"billed_charge":81.80,"npi":[1851877849]}]},{"allowed_amount":278.10,"providers":[{"billed_charge":368.10,"npi":[1215775580]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":79.26,"providers":[{"billed_charge":79.26,"npi":[1306492129,1619501657]}]},{"allowed_amount":29299.78,"providers":[{"billed_charge":29299.78,"npi":[1770212219]}]},{"allowed_amount":284.57,"providers":[{"billed_charge":290.62,"npi":[1508412339]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":865.20,"providers":[{"billed_charge":4200.00,"npi":[1588090526]}]}]}]},{"name":"TCRANIAL MAGN STIM TX DELI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90868","description":"THERAPEUTIC REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (TMS) TREATMENT; SUBSEQUENT DELIVERY AND MA","allowed_amounts":[{"tin":{"type":"ein","value":"883261915"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":16992.41,"providers":[{"billed_charge":22750.00,"npi":[1013987510]}]}]}]},{"name":"PSTAY/PARTIAL HOSP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"912","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - PARTIAL HOSPITALIZATION","allowed_amounts":[{"tin":{"type":"ein","value":"921915185"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10533.60,"providers":[{"billed_charge":150360.00,"npi":[1578261202]}]}]},{"tin":{"type":"ein","value":"650101421"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":21850.00,"providers":[{"billed_charge":174597.60,"npi":[1801227046]}]}]},{"tin":{"type":"ein","value":"931916110"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":5812.80,"providers":[{"billed_charge":39000.00,"npi":[1013732114]}]}]},{"tin":{"type":"ein","value":"931952443"},"service_code":["99"],"billing_class":"institutional","payments":[{"allowed_amount":44400.00,"providers":[{"billed_charge":195360.00,"npi":[1730866021]}]}]},{"tin":{"type":"ein","value":"832201591"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":6716.15,"providers":[{"billed_charge":16500.00,"npi":[1710614367]}]}]},{"tin":{"type":"ein","value":"465287425"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":10540.00,"providers":[{"billed_charge":105065.44,"npi":[1952719189]}]}]},{"tin":{"type":"ein","value":"461499880"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":40200.00,"providers":[{"billed_charge":67000.00,"npi":[1447723143]}]}]}]},{"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":"921915185"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":35745.60,"providers":[{"billed_charge":511940.00,"npi":[1578261202]}]}]},{"tin":{"type":"ein","value":"931384444"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":77308.80,"providers":[{"billed_charge":872100.00,"npi":[1003507278]}]}]},{"tin":{"type":"ein","value":"333805968"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":46663.20,"providers":[{"billed_charge":170515.21,"npi":[1891683850]}]}]},{"tin":{"type":"ein","value":"861790384"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":4200.00,"providers":[{"billed_charge":56280.00,"npi":[1912670068]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":40200.00,"providers":[{"billed_charge":41460.00,"npi":[1447099056]}]}]},{"tin":{"type":"ein","value":"993979121"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":28875.60,"providers":[{"billed_charge":462000.00,"npi":[1720815129]}]}]},{"tin":{"type":"ein","value":"991295264"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2151.82,"providers":[{"billed_charge":36565.00,"npi":[1043050982]}]}]},{"tin":{"type":"ein","value":"611895106"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2640.00,"providers":[{"billed_charge":44968.77,"npi":[1609352186]}]}]}]},{"name":"OTHER DX SVS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"920","description":"OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"204217095"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3622.00,"providers":[{"billed_charge":11156.18,"npi":[1811912009]}]}]}]},{"name":"CPTR OPHTH DX IMG POST SEGMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92134","description":"SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING, POSTERIOR SEGMENT, W INTERPRETATION AND RPT, UN","allowed_amounts":[{"tin":{"type":"ein","value":"710706742"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1277.92,"providers":[{"billed_charge":2800.00,"npi":[1255350021]}]}]}]},{"name":"SPEECH/HEARING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92507","description":"TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER; INDIVIDUAL","allowed_amounts":[{"tin":{"type":"ein","value":"621665314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":368.02,"providers":[{"billed_charge":627.50,"npi":[1801178314]}]}]},{"tin":{"type":"ein","value":"710259137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":284.10,"providers":[{"billed_charge":650.00,"npi":[1821423948]}]}]},{"tin":{"type":"ein","value":"710762181"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":490.40,"providers":[{"billed_charge":1600.00,"npi":[1205350063]}]}]}]},{"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":"710236870"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":17.24,"providers":[{"billed_charge":40.00,"npi":[1811921455]}]},{"allowed_amount":418.98,"providers":[{"billed_charge":960.00,"npi":[1811921455]}]}]},{"tin":{"type":"ein","value":"710290019"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":77.58,"providers":[{"billed_charge":315.00,"npi":[1861497349]}]},{"allowed_amount":155.16,"providers":[{"billed_charge":630.00,"npi":[1003066846]}]},{"allowed_amount":612.02,"providers":[{"billed_charge":2485.00,"npi":[1861488017]}]},{"allowed_amount":8.62,"providers":[{"billed_charge":35.00,"npi":[1003066846]}]},{"allowed_amount":68.96,"providers":[{"billed_charge":280.00,"npi":[1851324446]}]},{"allowed_amount":982.68,"providers":[{"billed_charge":3990.00,"npi":[1811983398]}]}]},{"tin":{"type":"ein","value":"261318597"},"service_code":["22","11","23","21"],"billing_class":"professional","payments":[{"allowed_amount":26.38,"providers":[{"billed_charge":42.00,"npi":[1619522125]}]},{"allowed_amount":65.95,"providers":[{"billed_charge":105.00,"npi":[1619522125]}]},{"allowed_amount":79.14,"providers":[{"billed_charge":126.00,"npi":[1619522125]}]},{"allowed_amount":13.19,"providers":[{"billed_charge":21.00,"npi":[1619522125]}]}]},{"tin":{"type":"ein","value":"716046242"},"service_code":["22","11","23"],"billing_class":"professional","payments":[{"allowed_amount":25.86,"providers":[{"billed_charge":102.00,"npi":[1528227667]}]},{"allowed_amount":17.24,"providers":[{"billed_charge":68.00,"npi":[1528227667]}]},{"allowed_amount":14.35,"providers":[{"billed_charge":34.00,"npi":[1528227667]}]}]},{"tin":{"type":"ein","value":"710245507"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":441.44,"providers":[{"billed_charge":1300.00,"npi":[1245322387]}]},{"allowed_amount":17.24,"providers":[{"billed_charge":52.00,"npi":[1245322387]}]}]}]},{"name":"EXT ECG>48HR<7D SCAN A/R","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93243","description":"EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"208149544"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":539.70,"providers":[{"billed_charge":8330.00,"npi":[1710130539]}]}]},{"tin":{"type":"ein","value":"522009409"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":121.80,"providers":[{"billed_charge":11460.00,"npi":[1588610265]}]}]}]},{"name":"EXT ECG>7D<15D SCAN A/R","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93247","description":"EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT","allowed_amounts":[{"tin":{"type":"ein","value":"208149544"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":385.50,"providers":[{"billed_charge":5950.00,"npi":[1710130539]}]}]}]},{"name":"CARDIAC REHAB/MONITOR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93798","description":"PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL SERVICES FOR OUTPATIENT CARDIAC REHABILITATION","allowed_amounts":[{"tin":{"type":"ein","value":"710704090"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":280.61,"providers":[{"billed_charge":550.00,"npi":[1629181433]}]}]}]},{"name":"MEASURE BLOOD OXYGEN LEVEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"94762","description":"NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING (SEPARAT","allowed_amounts":[{"tin":{"type":"ein","value":"203360918"},"service_code":["11","12"],"billing_class":"professional","payments":[{"allowed_amount":91.16,"providers":[{"billed_charge":200.00,"npi":[1518906940]}]},{"allowed_amount":2664.66,"providers":[{"billed_charge":5750.00,"npi":[1518906940]}]}]}]},{"name":"IMMUNOTHERAPY, ONE INJECTION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95115","description":"PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; SIN","allowed_amounts":[{"tin":{"type":"ein","value":"954896822"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":26.94,"providers":[{"billed_charge":45.00,"npi":[1295839397]}]}]}]},{"name":"SLP STDY UNATTENDED","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95800","description":"SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING; HEART RATE, OXYGEN SATURATION, RESPIRATORY ANALYSIS","allowed_amounts":[{"tin":{"type":"ein","value":"262531558"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":9462.82,"providers":[{"billed_charge":63000.00,"npi":[1861655961]}]}]}]},{"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":"861090156"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":80.04,"providers":[{"billed_charge":198.00,"npi":[1063143329]}]},{"allowed_amount":235.22,"providers":[{"billed_charge":803.00,"npi":[1255405379]}]},{"allowed_amount":6.24,"providers":[{"billed_charge":22.00,"npi":[1255405379]}]},{"allowed_amount":81.96,"providers":[{"billed_charge":198.00,"npi":[1780196550]}]}]}]},{"name":"PT-FOCUSED HLTH RISK ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96160","description":"ADMINISTRATION OF PATIENT-FOCUSED HEALTH RISK ASSESSMENT INSTRUMENT (EG, HEALTH HAZARD APPRAISAL) WI","allowed_amounts":[{"tin":{"type":"ein","value":"455513274"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":3.47,"providers":[{"billed_charge":15.00,"npi":[1932806494]}]}]}]},{"name":"THER/PROPH/DIAG IV INF INIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96365","description":"INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); INITIAL, U","allowed_amounts":[{"tin":{"type":"ein","value":"842761955"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":633.87,"providers":[{"billed_charge":2700.00,"npi":[1912962143]}]}]}]},{"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":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1794.37,"providers":[{"billed_charge":2880.00,"npi":[1275558918]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":282.00,"providers":[{"billed_charge":550.80,"npi":[1447012158]}]},{"allowed_amount":115.84,"providers":[{"billed_charge":259.20,"npi":[1972322337]}]},{"allowed_amount":86.88,"providers":[{"billed_charge":194.40,"npi":[1669850384]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":585.47,"providers":[{"billed_charge":1257.12,"npi":[1316510043]}]},{"allowed_amount":455.37,"providers":[{"billed_charge":977.76,"npi":[1497326599]}]},{"allowed_amount":238.56,"providers":[{"billed_charge":651.84,"npi":[1578026027]}]},{"allowed_amount":153.06,"providers":[{"billed_charge":279.36,"npi":[1033659677]}]},{"allowed_amount":255.59,"providers":[{"billed_charge":698.40,"npi":[1891433124]}]},{"allowed_amount":21.68,"providers":[{"billed_charge":46.56,"npi":[1861242455]}]},{"allowed_amount":173.47,"providers":[{"billed_charge":372.48,"npi":[1376006585]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":65.04,"providers":[{"billed_charge":103.47,"npi":[1194148197]}]},{"allowed_amount":303.53,"providers":[{"billed_charge":482.86,"npi":[1124469887]}]},{"allowed_amount":108.40,"providers":[{"billed_charge":172.45,"npi":[1801373824]}]},{"allowed_amount":173.45,"providers":[{"billed_charge":275.92,"npi":[1205407962]}]}]}]},{"name":"MECHANICAL TRACTION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97012","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; TRACTION, MECHANICAL","allowed_amounts":[{"tin":{"type":"ein","value":"471019000"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":111.42,"providers":[{"billed_charge":144.00,"npi":[1538120951]}]}]}]},{"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":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":278.55,"providers":[{"billed_charge":528.00,"npi":[1629085931]}]}]}]},{"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":"205638082"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":124.26,"providers":[{"billed_charge":300.00,"npi":[1922131820]}]}]},{"tin":{"type":"ein","value":"824858673"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":97.78,"providers":[{"billed_charge":375.00,"npi":[1497911820]}]}]},{"tin":{"type":"ein","value":"475240622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":848.06,"providers":[{"billed_charge":1950.00,"npi":[1427438720]}]}]}]},{"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":"824858673"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":154.69,"providers":[{"billed_charge":525.00,"npi":[1497911820]}]}]}]},{"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":"882955188"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2450.00,"providers":[{"billed_charge":2450.00,"npi":[1912631185]}]}]},{"tin":{"type":"ein","value":"993870384"},"service_code":["12","03"],"billing_class":"professional","payments":[{"allowed_amount":1335.00,"providers":[{"billed_charge":1335.00,"npi":[1801690714]}]},{"allowed_amount":5550.00,"providers":[{"billed_charge":5550.00,"npi":[1801690714]}]}]},{"tin":{"type":"ein","value":"710123680"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":17580.00,"providers":[{"billed_charge":17580.00,"npi":[1396220836]}]}]}]},{"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":"710259137"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":233.85,"providers":[{"billed_charge":600.00,"npi":[1578229878]}]}]},{"tin":{"type":"ein","value":"710307372"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1177.86,"providers":[{"billed_charge":1540.00,"npi":[1902955743]}]}]},{"tin":{"type":"ein","value":"205638082"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":66.90,"providers":[{"billed_charge":150.00,"npi":[1922131820]}]}]},{"tin":{"type":"ein","value":"462694404"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2940.00,"providers":[{"billed_charge":2940.00,"npi":[1366086712]}]}]},{"tin":{"type":"ein","value":"824858673"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":496.26,"providers":[{"billed_charge":1625.00,"npi":[1497911820]}]}]},{"tin":{"type":"ein","value":"475240622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":478.53,"providers":[{"billed_charge":975.00,"npi":[1427438720]}]}]},{"tin":{"type":"ein","value":"921732203"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4477.05,"providers":[{"billed_charge":6720.00,"npi":[1639447915]}]}]}]},{"name":"MED NUTRITION, INDIV, SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97803","description":"MEDICAL NUTRITION THERAPY; RE-ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE-TO-FACE WITH THE PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"992665478"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":394.26,"providers":[{"billed_charge":600.00,"npi":[1356017230]}]},{"allowed_amount":1314.20,"providers":[{"billed_charge":2000.00,"npi":[1356017230]}]}]}]},{"name":"CHIROPRACT MANJ 1-2 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98940","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 1-2 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"820701328"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":511.02,"providers":[{"billed_charge":1350.00,"npi":[1770940371]}]}]},{"tin":{"type":"ein","value":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":305.36,"providers":[{"billed_charge":484.00,"npi":[1629085931]}]}]},{"tin":{"type":"ein","value":"832726704"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1533.06,"providers":[{"billed_charge":2160.00,"npi":[1003889148]}]}]},{"tin":{"type":"ein","value":"471019000"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":229.02,"providers":[{"billed_charge":258.00,"npi":[1538120951]}]}]},{"tin":{"type":"ein","value":"710621361"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":227.12,"providers":[{"billed_charge":336.00,"npi":[1659708568]}]}]},{"tin":{"type":"ein","value":"113684414"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":85.17,"providers":[{"billed_charge":129.00,"npi":[1760410484]}]}]},{"tin":{"type":"ein","value":"271767183"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":425.85,"providers":[{"billed_charge":825.00,"npi":[1265755607]}]}]}]},{"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":"911947465"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":495.84,"providers":[{"billed_charge":828.00,"npi":[1306854625]}]}]},{"tin":{"type":"ein","value":"451744689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2397.68,"providers":[{"billed_charge":2451.00,"npi":[1922108000]}]}]},{"tin":{"type":"ein","value":"271222951"},"service_code":["49"],"billing_class":"professional","payments":[{"allowed_amount":867.72,"providers":[{"billed_charge":1071.00,"npi":[1376698662]}]}]},{"tin":{"type":"ein","value":"562646164"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1394.00,"providers":[{"billed_charge":1800.00,"npi":[1922436864]}]}]},{"tin":{"type":"ein","value":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":111.52,"providers":[{"billed_charge":154.00,"npi":[1629085931]}]}]},{"tin":{"type":"ein","value":"854395052"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":55.76,"providers":[{"billed_charge":91.00,"npi":[1730192162]}]}]},{"tin":{"type":"ein","value":"900672697"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":165.28,"providers":[{"billed_charge":220.00,"npi":[1487961322]}]}]},{"tin":{"type":"ein","value":"760824513"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":371.88,"providers":[{"billed_charge":495.00,"npi":[1306892963]}]}]},{"tin":{"type":"ein","value":"455451212"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1033.00,"providers":[{"billed_charge":1033.00,"npi":[1659502482]}]},{"allowed_amount":826.40,"providers":[{"billed_charge":826.40,"npi":[1184326910]}]}]},{"tin":{"type":"ein","value":"710817843"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":330.56,"providers":[{"billed_charge":400.00,"npi":[1568508620]}]}]},{"tin":{"type":"ein","value":"270130512"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1446.20,"providers":[{"billed_charge":2270.00,"npi":[1598801003]}]}]}]},{"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":"451744689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4485.00,"providers":[{"billed_charge":4485.00,"npi":[1922108000]}]}]},{"tin":{"type":"ein","value":"203481397"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":539.00,"providers":[{"billed_charge":650.00,"npi":[1124082961]}]}]},{"tin":{"type":"ein","value":"710850649"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2682.50,"providers":[{"billed_charge":3459.50,"npi":[1629085931]}]}]},{"tin":{"type":"ein","value":"822422275"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":53.90,"providers":[{"billed_charge":100.00,"npi":[1083778625]}]}]}]},{"name":"CHIROPRACT MANJ XTRSPINL 1/>","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98943","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); EXTRASPINAL, 1 OR MORE REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"451744689"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3378.24,"providers":[{"billed_charge":5400.00,"npi":[1922108000]}]}]},{"tin":{"type":"ein","value":"455451212"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":250.24,"providers":[{"billed_charge":400.00,"npi":[1659502482]}]}]}]},{"name":"MED SERV EVE/WKEND/HOLIDAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99051","description":"SERVICE(S) PROVIDED IN THE OFFICE DURING REGULARLY SCHEDULED EVENING, WEEKEND, OR HOLIDAY OFFICE HOU","allowed_amounts":[{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.48,"providers":[{"billed_charge":240.00,"npi":[1972322337]}]}]}]},{"name":"HYPERBARIC OXYGEN THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99183","description":"PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ATTENDANCE AND SUPERVISION OF HYPERBARIC OXYGE","allowed_amounts":[{"tin":{"type":"ein","value":"471765618"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":339.57,"providers":[{"billed_charge":1350.00,"npi":[1134304512]}]}]}]},{"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":"461470761"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":750.00,"providers":[{"billed_charge":875.00,"npi":[1689083537]}]}]},{"tin":{"type":"ein","value":"822116964"},"service_code":["20","10"],"billing_class":"professional","payments":[{"allowed_amount":6659.10,"providers":[{"billed_charge":10682.00,"npi":[1194967414]}]},{"allowed_amount":135.90,"providers":[{"billed_charge":218.00,"npi":[1194967414]}]},{"allowed_amount":2194.88,"providers":[{"billed_charge":4142.00,"npi":[1336780279]}]},{"allowed_amount":1686.24,"providers":[{"billed_charge":3052.00,"npi":[1275995383]}]},{"allowed_amount":693.12,"providers":[{"billed_charge":1308.00,"npi":[1366873887,1053835215]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":462.36,"providers":[{"billed_charge":988.80,"npi":[1215505615]}]},{"allowed_amount":98.25,"providers":[{"billed_charge":247.20,"npi":[1669850384,1972322337]}]}]}]},{"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":"261318597"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":166.73,"providers":[{"billed_charge":273.00,"npi":[1609412766]}]}]},{"tin":{"type":"ein","value":"861090156"},"service_code":["02","20"],"billing_class":"professional","payments":[{"allowed_amount":4941.67,"providers":[{"billed_charge":15800.00,"npi":[1255405379]}]},{"allowed_amount":99.03,"providers":[{"billed_charge":395.00,"npi":[1255405379]}]}]},{"tin":{"type":"ein","value":"461470761"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":5816.88,"providers":[{"billed_charge":9555.00,"npi":[1487744942]}]},{"allowed_amount":2966.88,"providers":[{"billed_charge":4900.00,"npi":[1689083537]}]}]},{"tin":{"type":"ein","value":"710858717"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":527.52,"providers":[{"billed_charge":1655.20,"npi":[1417925314]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":333.46,"providers":[{"billed_charge":480.00,"npi":[1275558918]}]},{"allowed_amount":3023.79,"providers":[{"billed_charge":4320.00,"npi":[1275558918]}]}]}]},{"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":"810576831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":563.55,"providers":[{"billed_charge":930.00,"npi":[1861825911]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":102.34,"providers":[{"billed_charge":172.00,"npi":[1275558918]}]},{"allowed_amount":44.20,"providers":[{"billed_charge":86.00,"npi":[1831353937]}]}]},{"tin":{"type":"ein","value":"710837110"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":54.81,"providers":[{"billed_charge":60.00,"npi":[1699778407]}]}]}]},{"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":"331180453"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":146.60,"providers":[{"billed_charge":176.54,"npi":[1881658094]}]}]},{"tin":{"type":"ein","value":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2414.70,"providers":[{"billed_charge":4050.00,"npi":[1780497909]}]}]},{"tin":{"type":"ein","value":"710401764"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1609.80,"providers":[{"billed_charge":3500.00,"npi":[1184237786]}]},{"allowed_amount":3380.58,"providers":[{"billed_charge":7350.00,"npi":[1184237786]}]}]},{"tin":{"type":"ein","value":"822116964"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":309.04,"providers":[{"billed_charge":852.00,"npi":[1366873887]}]},{"allowed_amount":1699.72,"providers":[{"billed_charge":4686.00,"npi":[1336780279]}]},{"allowed_amount":186.93,"providers":[{"billed_charge":639.00,"npi":[1801403217]}]},{"allowed_amount":1390.68,"providers":[{"billed_charge":3834.00,"npi":[1053835215]}]},{"allowed_amount":5089.84,"providers":[{"billed_charge":11928.00,"npi":[1194967414]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":885.39,"providers":[{"billed_charge":2217.60,"npi":[1639814742]}]},{"allowed_amount":965.88,"providers":[{"billed_charge":2419.20,"npi":[1972322337]}]},{"allowed_amount":1844.81,"providers":[{"billed_charge":4636.80,"npi":[1669850384]}]},{"allowed_amount":3940.78,"providers":[{"billed_charge":9878.40,"npi":[1033960265]}]},{"allowed_amount":563.43,"providers":[{"billed_charge":1411.20,"npi":[1083433403]}]},{"allowed_amount":2177.87,"providers":[{"billed_charge":4636.80,"npi":[1215505615]}]}]},{"tin":{"type":"ein","value":"710787860"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":321.96,"providers":[{"billed_charge":600.00,"npi":[1831665744]}]},{"allowed_amount":747.72,"providers":[{"billed_charge":1800.00,"npi":[1043611502]}]}]},{"tin":{"type":"ein","value":"452901217"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1046.37,"providers":[{"billed_charge":1462.50,"npi":[1760925598]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14829.78,"providers":[{"billed_charge":22302.98,"npi":[1790380574]}]},{"allowed_amount":6036.75,"providers":[{"billed_charge":7028.25,"npi":[1073099198]}]}]},{"tin":{"type":"ein","value":"208881376"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":757.52,"providers":[{"billed_charge":800.00,"npi":[1609439611]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1535.52,"providers":[{"billed_charge":2730.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":321.96,"providers":[{"billed_charge":368.00,"npi":[1912663758]}]},{"allowed_amount":1690.29,"providers":[{"billed_charge":3120.00,"npi":[1518496660]}]},{"allowed_amount":160.98,"providers":[{"billed_charge":184.00,"npi":[1912663758]}]}]},{"tin":{"type":"ein","value":"992323196"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1084.87,"providers":[{"billed_charge":1470.00,"npi":[1588396857]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":978.45,"providers":[{"billed_charge":2002.00,"npi":[1234567893]}]},{"allowed_amount":1956.90,"providers":[{"billed_charge":4004.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"237128104"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":62.31,"providers":[{"billed_charge":168.00,"npi":[1144294646]}]}]},{"tin":{"type":"ein","value":"716042625"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2565.50,"providers":[{"billed_charge":4725.00,"npi":[1346220449]}]}]},{"tin":{"type":"ein","value":"800264610"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1682.37,"providers":[{"billed_charge":3672.00,"npi":[1790014447]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.38,"providers":[{"billed_charge":336.00,"npi":[1295538247]}]}]},{"tin":{"type":"ein","value":"710411459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1284.61,"providers":[{"billed_charge":1984.00,"npi":[1245726512]}]},{"allowed_amount":2334.21,"providers":[{"billed_charge":3596.00,"npi":[1194232439]}]},{"allowed_amount":399.22,"providers":[{"billed_charge":620.00,"npi":[1578372660]}]}]},{"tin":{"type":"ein","value":"853756788"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":274.08,"providers":[{"billed_charge":1500.00,"npi":[1558970129]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":14101.25,"providers":[{"billed_charge":21620.00,"npi":[1275558918]}]},{"allowed_amount":4398.00,"providers":[{"billed_charge":7100.00,"npi":[1386623049]}]},{"allowed_amount":3005.30,"providers":[{"billed_charge":4715.00,"npi":[1861695132]}]},{"allowed_amount":1466.00,"providers":[{"billed_charge":2300.00,"npi":[1831353937]}]},{"allowed_amount":73.30,"providers":[{"billed_charge":115.00,"npi":[1861695132,1518949429]}]},{"allowed_amount":293.20,"providers":[{"billed_charge":460.00,"npi":[1275558918]}]},{"allowed_amount":3371.80,"providers":[{"billed_charge":5290.00,"npi":[1790891448]}]},{"allowed_amount":482.58,"providers":[{"billed_charge":690.00,"npi":[1275558918]}]},{"allowed_amount":5277.60,"providers":[{"billed_charge":8320.00,"npi":[1518949429]}]}]},{"tin":{"type":"ein","value":"710276839"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":473.45,"providers":[{"billed_charge":671.25,"npi":[1245286442]}]},{"allowed_amount":189.38,"providers":[{"billed_charge":268.50,"npi":[1912647355]}]}]},{"tin":{"type":"ein","value":"812677745"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":568.14,"providers":[{"billed_charge":816.00,"npi":[1508599622]}]}]},{"tin":{"type":"ein","value":"261125131"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":146.24,"providers":[{"billed_charge":260.00,"npi":[1174685465]}]},{"allowed_amount":511.84,"providers":[{"billed_charge":910.00,"npi":[1417210543]}]}]},{"tin":{"type":"ein","value":"954896822"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":1905.80,"providers":[{"billed_charge":2366.00,"npi":[1295839397]}]},{"allowed_amount":219.90,"providers":[{"billed_charge":480.00,"npi":[1295722668]}]},{"allowed_amount":1059.27,"providers":[{"billed_charge":2720.00,"npi":[1902427925]}]}]},{"tin":{"type":"ein","value":"471765618"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":616.56,"providers":[{"billed_charge":2496.00,"npi":[1134304512]}]}]},{"tin":{"type":"ein","value":"752405203"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":1307.54,"providers":[{"billed_charge":2366.00,"npi":[1326460858]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1495.44,"providers":[{"billed_charge":2735.76,"npi":[1649744244]}]},{"allowed_amount":1136.28,"providers":[{"billed_charge":1367.88,"npi":[1477321917]}]}]},{"tin":{"type":"ein","value":"861090156"},"service_code":["02","20"],"billing_class":"professional","payments":[{"allowed_amount":366.50,"providers":[{"billed_charge":1075.00,"npi":[1801236195]}]},{"allowed_amount":73.30,"providers":[{"billed_charge":215.00,"npi":[1801236195]}]}]},{"tin":{"type":"ein","value":"334646273"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":219.90,"providers":[{"billed_charge":360.00,"npi":[1417929316]}]}]},{"tin":{"type":"ein","value":"710837110"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3726.49,"providers":[{"billed_charge":4100.00,"npi":[1699778407]}]}]},{"tin":{"type":"ein","value":"621689472"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":952.90,"providers":[{"billed_charge":2184.00,"npi":[1578591129]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":62.31,"providers":[{"billed_charge":132.48,"npi":[1023614880,1932681574]}]},{"allowed_amount":124.62,"providers":[{"billed_charge":264.96,"npi":[1205407962,1194148197]}]},{"allowed_amount":5171.73,"providers":[{"billed_charge":10995.84,"npi":[1194148197]}]},{"allowed_amount":1368.33,"providers":[{"billed_charge":2252.16,"npi":[1881256220]}]},{"allowed_amount":2803.95,"providers":[{"billed_charge":5961.60,"npi":[1770075558]}]},{"allowed_amount":4299.39,"providers":[{"billed_charge":9141.12,"npi":[1124469887]}]},{"allowed_amount":810.03,"providers":[{"billed_charge":1722.24,"npi":[1952993925]}]},{"allowed_amount":1495.44,"providers":[{"billed_charge":3179.52,"npi":[1205407962]}]},{"allowed_amount":2173.23,"providers":[{"billed_charge":3576.96,"npi":[1124355623]}]},{"allowed_amount":4324.70,"providers":[{"billed_charge":7816.32,"npi":[1871578500]}]},{"allowed_amount":8785.71,"providers":[{"billed_charge":18679.68,"npi":[1801373824]}]},{"allowed_amount":757.52,"providers":[{"billed_charge":1059.84,"npi":[1720020738]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":80.49,"providers":[{"billed_charge":201.60,"npi":[1669868691]}]},{"allowed_amount":3541.56,"providers":[{"billed_charge":8870.40,"npi":[1669868691]}]},{"allowed_amount":1207.35,"providers":[{"billed_charge":3024.00,"npi":[1780075473]}]},{"allowed_amount":402.45,"providers":[{"billed_charge":1008.00,"npi":[1780075473]}]}]},{"tin":{"type":"ein","value":"710836622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.38,"providers":[{"billed_charge":196.00,"npi":[1710340088]}]}]},{"tin":{"type":"ein","value":"710837434"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":733.00,"providers":[{"billed_charge":1350.00,"npi":[1760472021]}]}]}]},{"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":"710623643"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6012.45,"providers":[{"billed_charge":7425.00,"npi":[1528552130]}]},{"allowed_amount":681.42,"providers":[{"billed_charge":990.00,"npi":[1780497909]}]}]},{"tin":{"type":"ein","value":"261649348"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":227.14,"providers":[{"billed_charge":400.00,"npi":[1881983112]}]}]},{"tin":{"type":"ein","value":"912038569"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1469.71,"providers":[{"billed_charge":1672.00,"npi":[1528257003]}]}]},{"tin":{"type":"ein","value":"731582026"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7033.80,"providers":[{"billed_charge":12756.60,"npi":[1871554410]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":16203.94,"providers":[{"billed_charge":50955.00,"npi":[1932806494]}]},{"allowed_amount":9618.00,"providers":[{"billed_charge":41475.00,"npi":[1649933417]}]},{"allowed_amount":1740.40,"providers":[{"billed_charge":7505.00,"npi":[1649933417]}]},{"allowed_amount":11820.50,"providers":[{"billed_charge":37130.00,"npi":[1932806494]}]},{"allowed_amount":29605.76,"providers":[{"billed_charge":93220.00,"npi":[1629531595]}]},{"allowed_amount":5552.88,"providers":[{"billed_charge":20145.00,"npi":[1124687157]}]},{"allowed_amount":5879.52,"providers":[{"billed_charge":21330.00,"npi":[1124687157]}]},{"allowed_amount":17012.95,"providers":[{"billed_charge":53720.00,"npi":[1629531595]}]}]},{"tin":{"type":"ein","value":"752616977"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.47,"providers":[{"billed_charge":289.00,"npi":[1184451049]}]}]},{"tin":{"type":"ein","value":"710717967"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":113.57,"providers":[{"billed_charge":177.00,"npi":[1841082955]}]}]},{"tin":{"type":"ein","value":"452297938"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":329.01,"providers":[{"billed_charge":1410.00,"npi":[1467891705]}]}]},{"tin":{"type":"ein","value":"710416869"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":113.57,"providers":[{"billed_charge":163.71,"npi":[1659548105]}]},{"allowed_amount":454.28,"providers":[{"billed_charge":654.84,"npi":[1659548105]}]}]},{"tin":{"type":"ein","value":"823428904"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":227.14,"providers":[{"billed_charge":500.00,"npi":[1669155305]}]}]},{"tin":{"type":"ein","value":"260241028"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":653.28,"providers":[{"billed_charge":1170.00,"npi":[1831178524]}]}]},{"tin":{"type":"ein","value":"455497983"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1524.32,"providers":[{"billed_charge":2520.00,"npi":[1609819077]}]}]},{"tin":{"type":"ein","value":"900937634"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4572.96,"providers":[{"billed_charge":29143.80,"npi":[1619219433]}]}]},{"tin":{"type":"ein","value":"831529526"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":1022.13,"providers":[{"billed_charge":1461.24,"npi":[1386397651,1104464445]}]},{"allowed_amount":567.85,"providers":[{"billed_charge":811.80,"npi":[1104464445]}]},{"allowed_amount":277.65,"providers":[{"billed_charge":487.08,"npi":[1801649421]}]},{"allowed_amount":925.50,"providers":[{"billed_charge":1623.60,"npi":[1801649421]}]},{"allowed_amount":113.57,"providers":[{"billed_charge":162.36,"npi":[1114627163,1114797883]}]},{"allowed_amount":794.99,"providers":[{"billed_charge":1136.52,"npi":[1386397651]}]},{"allowed_amount":1135.70,"providers":[{"billed_charge":1623.60,"npi":[1114797883]}]},{"allowed_amount":454.28,"providers":[{"billed_charge":649.44,"npi":[1114627163]}]},{"allowed_amount":92.55,"providers":[{"billed_charge":162.36,"npi":[1801649421]}]}]},{"tin":{"type":"ein","value":"800264610"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1851.00,"providers":[{"billed_charge":3240.00,"npi":[1790014447]}]},{"allowed_amount":92.55,"providers":[{"billed_charge":162.00,"npi":[1790014447]}]}]},{"tin":{"type":"ein","value":"263442072"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":433.26,"providers":[{"billed_charge":676.00,"npi":[1902683980]}]}]},{"tin":{"type":"ein","value":"261318597"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":675.05,"providers":[{"billed_charge":959.00,"npi":[1023278983]}]}]},{"tin":{"type":"ein","value":"993735707"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":567.85,"providers":[{"billed_charge":1155.00,"npi":[1659879583]}]}]},{"tin":{"type":"ein","value":"710807744"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":60741.16,"providers":[{"billed_charge":85560.00,"npi":[1275558918]}]},{"allowed_amount":1633.20,"providers":[{"billed_charge":2325.00,"npi":[1275558918]}]},{"allowed_amount":544.40,"providers":[{"billed_charge":775.00,"npi":[1518949429]}]},{"allowed_amount":4681.84,"providers":[{"billed_charge":6674.00,"npi":[1861695132]}]},{"allowed_amount":217.76,"providers":[{"billed_charge":310.00,"npi":[1831353937]}]},{"allowed_amount":2286.48,"providers":[{"billed_charge":3255.00,"npi":[1275558918]}]},{"allowed_amount":6859.44,"providers":[{"billed_charge":9765.00,"npi":[1386623049]}]},{"allowed_amount":5879.52,"providers":[{"billed_charge":8370.00,"npi":[1831353937]}]}]},{"tin":{"type":"ein","value":"261125131"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":971.19,"providers":[{"billed_charge":1737.00,"npi":[1417210543]}]}]},{"tin":{"type":"ein","value":"710772737"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6473.49,"providers":[{"billed_charge":13224.00,"npi":[1629784251]}]},{"allowed_amount":6279.67,"providers":[{"billed_charge":10904.00,"npi":[1922066232]}]},{"allowed_amount":3338.64,"providers":[{"billed_charge":5700.00,"npi":[1679934871]}]}]},{"tin":{"type":"ein","value":"861090156"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":4081.32,"providers":[{"billed_charge":13072.00,"npi":[1255405379]}]},{"allowed_amount":2128.65,"providers":[{"billed_charge":6992.00,"npi":[1962898460]}]},{"allowed_amount":1633.20,"providers":[{"billed_charge":4560.00,"npi":[1801236195]}]},{"allowed_amount":555.30,"providers":[{"billed_charge":1824.00,"npi":[1639125719]}]},{"allowed_amount":925.50,"providers":[{"billed_charge":3040.00,"npi":[1780196550]}]},{"allowed_amount":217.76,"providers":[{"billed_charge":608.00,"npi":[1285780643]}]},{"allowed_amount":2696.50,"providers":[{"billed_charge":8512.00,"npi":[1063143329]}]},{"allowed_amount":1585.90,"providers":[{"billed_charge":4864.00,"npi":[1376566182]}]}]},{"tin":{"type":"ein","value":"710388012"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":114.76,"providers":[{"billed_charge":130.00,"npi":[1356038368]}]},{"allowed_amount":227.14,"providers":[{"billed_charge":260.00,"npi":[1356038368]}]},{"allowed_amount":1589.98,"providers":[{"billed_charge":1820.00,"npi":[1356038368]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3408.29,"providers":[{"billed_charge":8532.00,"npi":[1669868691]}]},{"allowed_amount":227.14,"providers":[{"billed_charge":568.80,"npi":[1740844927]}]},{"allowed_amount":796.18,"providers":[{"billed_charge":1990.80,"npi":[1780075473]}]}]},{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3607.47,"providers":[{"billed_charge":5260.41,"npi":[1003097841]}]},{"allowed_amount":277.65,"providers":[{"billed_charge":584.49,"npi":[1952993925]}]}]},{"tin":{"type":"ein","value":"842116266"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":405.03,"providers":[{"billed_charge":498.00,"npi":[1366432247]}]}]},{"tin":{"type":"ein","value":"861082670"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":1591.17,"providers":[{"billed_charge":2030.00,"npi":[1821752825]}]},{"allowed_amount":681.42,"providers":[{"billed_charge":870.00,"npi":[1821752825]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":227.14,"providers":[{"billed_charge":568.80,"npi":[1447012158]}]},{"allowed_amount":567.85,"providers":[{"billed_charge":1422.00,"npi":[1083433403]}]},{"allowed_amount":1703.55,"providers":[{"billed_charge":4266.00,"npi":[1447012158]}]},{"allowed_amount":454.28,"providers":[{"billed_charge":1137.60,"npi":[1083433981]}]}]},{"tin":{"type":"ein","value":"300944331"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6385.95,"providers":[{"billed_charge":9524.07,"npi":[1790380574]}]},{"allowed_amount":5224.22,"providers":[{"billed_charge":6349.38,"npi":[1073099198]}]}]},{"tin":{"type":"ein","value":"932686392"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":567.85,"providers":[{"billed_charge":1422.00,"npi":[1891532685]}]}]},{"tin":{"type":"ein","value":"993161677"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9539.88,"providers":[{"billed_charge":16800.00,"npi":[1598417511]}]}]},{"tin":{"type":"ein","value":"842494027"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":2503.60,"providers":[{"billed_charge":6040.00,"npi":[1376158998]}]}]},{"tin":{"type":"ein","value":"710830696"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2589.84,"providers":[{"billed_charge":4632.00,"npi":[1891155222]}]}]},{"tin":{"type":"ein","value":"237015826"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1704.74,"providers":[{"billed_charge":2029.50,"npi":[1912663758]}]},{"allowed_amount":228.33,"providers":[{"billed_charge":270.60,"npi":[1912663758]}]}]},{"tin":{"type":"ein","value":"992323196"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":228.33,"providers":[{"billed_charge":300.00,"npi":[1588396857]}]}]},{"tin":{"type":"ein","value":"832887237"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":340.71,"providers":[{"billed_charge":600.00,"npi":[1710303631]}]}]},{"tin":{"type":"ein","value":"871543467"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2831.09,"providers":[{"billed_charge":5655.00,"npi":[1750904199]}]}]},{"tin":{"type":"ein","value":"993495411"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":435.52,"providers":[{"billed_charge":944.00,"npi":[1831280593]}]},{"allowed_amount":108.88,"providers":[{"billed_charge":236.00,"npi":[1831280593]}]}]},{"tin":{"type":"ein","value":"710411459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3747.81,"providers":[{"billed_charge":6039.00,"npi":[1861964447]}]}]},{"tin":{"type":"ein","value":"461470761"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":8920.20,"providers":[{"billed_charge":10984.88,"npi":[1689083537]}]},{"allowed_amount":1950.00,"providers":[{"billed_charge":2341.04,"npi":[1487744942]}]}]},{"tin":{"type":"ein","value":"716046242"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2590.84,"providers":[{"billed_charge":4222.00,"npi":[1740274448]}]},{"allowed_amount":833.61,"providers":[{"billed_charge":1556.00,"npi":[1316783848]}]},{"allowed_amount":154.95,"providers":[{"billed_charge":163.00,"npi":[1811383656]}]},{"allowed_amount":133.61,"providers":[{"billed_charge":223.00,"npi":[1811383656]}]},{"allowed_amount":288.56,"providers":[{"billed_charge":441.00,"npi":[1467665984]}]},{"allowed_amount":247.62,"providers":[{"billed_charge":441.00,"npi":[1316783848]}]}]},{"tin":{"type":"ein","value":"841866111"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6587.06,"providers":[{"billed_charge":14500.00,"npi":[1417238981]}]},{"allowed_amount":7268.48,"providers":[{"billed_charge":16000.00,"npi":[1093550741]}]},{"allowed_amount":9653.45,"providers":[{"billed_charge":21250.00,"npi":[1487422572]}]}]},{"tin":{"type":"ein","value":"844538314"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":2305.28,"providers":[{"billed_charge":4200.00,"npi":[1922758259]}]},{"allowed_amount":1430.29,"providers":[{"billed_charge":2625.00,"npi":[1922758259]}]},{"allowed_amount":185.10,"providers":[{"billed_charge":350.00,"npi":[1922758259]}]}]},{"tin":{"type":"ein","value":"710413798"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.10,"providers":[{"billed_charge":290.00,"npi":[1457930497]}]}]},{"tin":{"type":"ein","value":"333151160"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1758.45,"providers":[{"billed_charge":5656.68,"npi":[1346339066]}]},{"allowed_amount":647.85,"providers":[{"billed_charge":2084.04,"npi":[1346339066]}]}]},{"tin":{"type":"ein","value":"820669939"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1018.05,"providers":[{"billed_charge":2431.00,"npi":[1831834829]}]}]},{"tin":{"type":"ein","value":"311553455"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":227.14,"providers":[{"billed_charge":337.74,"npi":[1891544888]}]},{"allowed_amount":1817.12,"providers":[{"billed_charge":2701.92,"npi":[1891544888]}]}]},{"tin":{"type":"ein","value":"710487596"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":135.01,"providers":[{"billed_charge":223.00,"npi":[1437504040]}]}]},{"tin":{"type":"ein","value":"710408284"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":2137.76,"providers":[{"billed_charge":2384.00,"npi":[1356516058]}]},{"allowed_amount":1202.49,"providers":[{"billed_charge":1341.00,"npi":[1356516058]}]}]},{"tin":{"type":"ein","value":"710836622"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4008.30,"providers":[{"billed_charge":4350.00,"npi":[1710340088]}]}]}]},{"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":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":352.66,"providers":[{"billed_charge":1100.00,"npi":[1932806494]}]}]},{"tin":{"type":"ein","value":"883261915"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":6916.41,"providers":[{"billed_charge":8325.00,"npi":[1013987510]}]}]},{"tin":{"type":"ein","value":"872968297"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4492.39,"providers":[{"billed_charge":7975.00,"npi":[1447481072]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99221","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"752888880"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":292.84,"providers":[{"billed_charge":540.00,"npi":[1467043224]}]}]}]},{"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":"471052932"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":332.94,"providers":[{"billed_charge":1125.00,"npi":[1992371330]}]}]}]},{"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":"710830696"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":239.70,"providers":[{"billed_charge":369.00,"npi":[1295231504]}]}]}]},{"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":"752888880"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":262.98,"providers":[{"billed_charge":360.00,"npi":[1467043224]}]}]},{"tin":{"type":"ein","value":"352564331"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":4021.66,"providers":[{"billed_charge":10320.00,"npi":[1164568598]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2009.28,"providers":[{"billed_charge":3600.00,"npi":[1164104543]}]},{"allowed_amount":2051.14,"providers":[{"billed_charge":3675.00,"npi":[1679235212]}]},{"allowed_amount":209.30,"providers":[{"billed_charge":375.00,"npi":[1205347226]}]},{"allowed_amount":2762.76,"providers":[{"billed_charge":4950.00,"npi":[1992371330]}]}]}]},{"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":"710781138"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":697.34,"providers":[{"billed_charge":1008.00,"npi":[1326006040]}]},{"allowed_amount":293.20,"providers":[{"billed_charge":576.00,"npi":[1124687157]}]}]},{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":6384.72,"providers":[{"billed_charge":10792.00,"npi":[1265657274]}]}]},{"tin":{"type":"ein","value":"933212110"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":495.04,"providers":[{"billed_charge":1050.00,"npi":[1245912898]}]}]},{"tin":{"type":"ein","value":"752888880"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":455.40,"providers":[{"billed_charge":900.00,"npi":[1588278121]}]}]},{"tin":{"type":"ein","value":"432193073"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1248.00,"providers":[{"billed_charge":1800.00,"npi":[1144232091]}]}]},{"tin":{"type":"ein","value":"825023163"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":2404.48,"providers":[{"billed_charge":29693.64,"npi":[1225685142]}]}]},{"tin":{"type":"ein","value":"874449934"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1099.50,"providers":[{"billed_charge":2475.00,"npi":[1891079455]}]}]},{"tin":{"type":"ein","value":"463577952"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":748.80,"providers":[{"billed_charge":1080.00,"npi":[1366676751]}]}]},{"tin":{"type":"ein","value":"710772737"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":930.58,"providers":[{"billed_charge":1067.00,"npi":[1801854195]}]},{"allowed_amount":83.20,"providers":[{"billed_charge":97.00,"npi":[1922066232]}]}]},{"tin":{"type":"ein","value":"473238528"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":461.79,"providers":[{"billed_charge":1400.00,"npi":[1215705074]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1588.49,"providers":[{"billed_charge":2280.00,"npi":[1831206341]}]}]},{"tin":{"type":"ein","value":"933549150"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":366.50,"providers":[{"billed_charge":2445.00,"npi":[1629425913]}]}]},{"tin":{"type":"ein","value":"273705652"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1472.00,"providers":[{"billed_charge":3575.00,"npi":[1881279222]}]},{"allowed_amount":3890.76,"providers":[{"billed_charge":9152.00,"npi":[1982276150]}]}]},{"tin":{"type":"ein","value":"611922162"},"service_code":["51","21"],"billing_class":"professional","payments":[{"allowed_amount":544.05,"providers":[{"billed_charge":3555.90,"npi":[1033786579]}]},{"allowed_amount":127.36,"providers":[{"billed_charge":790.20,"npi":[1770312357]}]},{"allowed_amount":254.72,"providers":[{"billed_charge":1580.40,"npi":[1770312357]}]}]},{"tin":{"type":"ein","value":"208297311"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1164.80,"providers":[{"billed_charge":3304.00,"npi":[1720749740]}]}]}]},{"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":"710781138"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":273.04,"providers":[{"billed_charge":434.00,"npi":[1154359099]}]}]},{"tin":{"type":"ein","value":"821864252"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":747.30,"providers":[{"billed_charge":900.00,"npi":[1831206341]}]},{"allowed_amount":1402.25,"providers":[{"billed_charge":1650.00,"npi":[1376664342]}]}]},{"tin":{"type":"ein","value":"821171262"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":10960.40,"providers":[{"billed_charge":11000.00,"npi":[1114995198]}]}]},{"tin":{"type":"ein","value":"273705652"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":999.57,"providers":[{"billed_charge":2354.00,"npi":[1982276150]}]}]},{"tin":{"type":"ein","value":"463577952"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":373.65,"providers":[{"billed_charge":525.00,"npi":[1366676751]}]}]},{"tin":{"type":"ein","value":"208297311"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2871.09,"providers":[{"billed_charge":7360.00,"npi":[1720749740]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99238","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS","allowed_amounts":[{"tin":{"type":"ein","value":"232238973"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":847.90,"providers":[{"billed_charge":950.00,"npi":[1265657274]}]}]}]},{"name":"HOSPITAL DISCHARGE DAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99239","description":"HOSPITAL DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES","allowed_amounts":[{"tin":{"type":"ein","value":"821171262"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":120.12,"providers":[{"billed_charge":125.00,"npi":[1114995198]}]}]}]},{"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":"954896822"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":598.08,"providers":[{"billed_charge":1463.03,"npi":[1154364545]}]}]},{"tin":{"type":"ein","value":"710411459"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2226.98,"providers":[{"billed_charge":8361.00,"npi":[1427760842]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2679.38,"providers":[{"billed_charge":6171.00,"npi":[1629425061]}]},{"allowed_amount":3657.73,"providers":[{"billed_charge":8415.00,"npi":[1720571102]}]}]},{"tin":{"type":"ein","value":"862564877"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":897.12,"providers":[{"billed_charge":9388.00,"npi":[1114970704]}]}]}]},{"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":"760729179"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":411.61,"providers":[{"billed_charge":993.00,"npi":[1316694466]}]},{"allowed_amount":823.22,"providers":[{"billed_charge":2194.00,"npi":[1568571438]}]},{"allowed_amount":3710.29,"providers":[{"billed_charge":8937.00,"npi":[1538746441]}]},{"allowed_amount":9096.02,"providers":[{"billed_charge":24134.00,"npi":[1629511993]}]},{"allowed_amount":15287.57,"providers":[{"billed_charge":36741.00,"npi":[1407380082]}]},{"allowed_amount":26435.84,"providers":[{"billed_charge":70208.00,"npi":[1881878064]}]},{"allowed_amount":417.41,"providers":[{"billed_charge":993.00,"npi":[1154816098]}]},{"allowed_amount":829.02,"providers":[{"billed_charge":1986.00,"npi":[1043954084]}]},{"allowed_amount":6185.75,"providers":[{"billed_charge":14895.00,"npi":[1184203648]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":9907.64,"providers":[{"billed_charge":25008.00,"npi":[1821785593]}]},{"allowed_amount":4145.10,"providers":[{"billed_charge":13700.00,"npi":[1023873171]}]},{"allowed_amount":24389.39,"providers":[{"billed_charge":57136.00,"npi":[1629425061]}]},{"allowed_amount":3310.28,"providers":[{"billed_charge":9594.00,"npi":[1679153944]}]},{"allowed_amount":3739.29,"providers":[{"billed_charge":10251.00,"npi":[1720575822]}]},{"allowed_amount":829.02,"providers":[{"billed_charge":2740.00,"npi":[1124112727]}]},{"allowed_amount":3292.88,"providers":[{"billed_charge":8688.00,"npi":[1285273326]}]},{"allowed_amount":1234.83,"providers":[{"billed_charge":3126.00,"npi":[1609815919]}]},{"allowed_amount":17797.83,"providers":[{"billed_charge":41108.00,"npi":[1720571102]}]},{"allowed_amount":14870.16,"providers":[{"billed_charge":49320.00,"npi":[1609165760]}]},{"allowed_amount":3304.48,"providers":[{"billed_charge":8688.00,"npi":[1033949409]}]}]}]},{"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":"760729179"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4201.01,"providers":[{"billed_charge":11298.00,"npi":[1881878064]}]},{"allowed_amount":12628.32,"providers":[{"billed_charge":30282.00,"npi":[1407380082]}]},{"allowed_amount":12037.81,"providers":[{"billed_charge":32280.00,"npi":[1629511993]}]},{"allowed_amount":12662.04,"providers":[{"billed_charge":30282.00,"npi":[1538746441]}]},{"allowed_amount":13834.63,"providers":[{"billed_charge":33166.00,"npi":[1184203648]}]},{"allowed_amount":9034.68,"providers":[{"billed_charge":24210.00,"npi":[1447260807]}]},{"allowed_amount":1813.68,"providers":[{"billed_charge":4498.00,"npi":[1215679162]}]},{"allowed_amount":7229.43,"providers":[{"billed_charge":17304.00,"npi":[1043954084]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4201.01,"providers":[{"billed_charge":11690.00,"npi":[1720575822]}]},{"allowed_amount":3003.13,"providers":[{"billed_charge":6955.00,"npi":[1720571102]}]},{"allowed_amount":1206.31,"providers":[{"billed_charge":3072.00,"npi":[1609815919]}]},{"allowed_amount":7811.51,"providers":[{"billed_charge":21866.00,"npi":[1508362591]}]},{"allowed_amount":1805.25,"providers":[{"billed_charge":4608.00,"npi":[1821785593]},{"billed_charge":6132.00,"npi":[1124112727]}]},{"allowed_amount":1214.74,"providers":[{"billed_charge":3372.00,"npi":[1982135000]}]},{"allowed_amount":12636.75,"providers":[{"billed_charge":35322.00,"npi":[1679153944]}]},{"allowed_amount":2994.70,"providers":[{"billed_charge":10220.00,"npi":[1275597171]}]},{"allowed_amount":18685.16,"providers":[{"billed_charge":52142.00,"npi":[1801250865]}]},{"allowed_amount":54174.36,"providers":[{"billed_charge":183960.00,"npi":[1609165760]}]},{"allowed_amount":10856.79,"providers":[{"billed_charge":25317.00,"npi":[1629425061]}]}]}]},{"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":"261318597"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1128.20,"providers":[{"billed_charge":1852.00,"npi":[1780160275]}]}]}]},{"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":"992981066"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":479.45,"providers":[{"billed_charge":900.60,"npi":[1972127793]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["32"],"billing_class":"professional","payments":[{"allowed_amount":2301.36,"providers":[{"billed_charge":4838.40,"npi":[1790260081]}]}]}]},{"name":"PROLNG OFF/OP E/M EA 15 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99417","description":"PROLONGED OFFICE/OUTPATIENT E/M SVC EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"883261915"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5714.07,"providers":[{"billed_charge":10500.00,"npi":[1013987510]}]}]}]},{"name":"CHRNC CARE MGMT SVC EA ADDL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99439","description":"CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":310.48,"providers":[{"billed_charge":583.04,"npi":[1871578500]}]},{"allowed_amount":296.91,"providers":[{"billed_charge":655.92,"npi":[1801373824]}]},{"allowed_amount":664.57,"providers":[{"billed_charge":1166.08,"npi":[1124355623]}]}]}]},{"name":"REM MNTR PHYSIOL PARAM DEV","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99454","description":"REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D","allowed_amounts":[{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":108.74,"providers":[{"billed_charge":241.20,"npi":[1801373824]}]}]}]},{"name":"CHRON CARE MGMT SRVC 20 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99490","description":"CHRONIC CARE MANAGEMENT SERVICES, AT LEAST 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"581666179"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1940.40,"providers":[{"billed_charge":3977.55,"npi":[1871578500]}]},{"allowed_amount":5903.49,"providers":[{"billed_charge":9634.51,"npi":[1124355623]}]},{"allowed_amount":1539.30,"providers":[{"billed_charge":3712.38,"npi":[1801373824]}]}]}]},{"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":"716002614"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":986.40,"providers":[{"billed_charge":986.40,"npi":[1871693721]}]}]},{"tin":{"type":"ein","value":"716010719"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3262.00,"providers":[{"billed_charge":3262.00,"npi":[1144352998]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":51052.58,"providers":[{"billed_charge":53377.10,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3086.40,"providers":[{"billed_charge":3086.40,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"710555170"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8365.70,"providers":[{"billed_charge":8365.70,"npi":[1235129685]}]}]},{"tin":{"type":"ein","value":"883095152"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9908.80,"providers":[{"billed_charge":9908.80,"npi":[1164139036]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":90888.80,"providers":[{"billed_charge":90888.80,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":677857.99,"providers":[{"billed_charge":710579.10,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"710699155"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13261.56,"providers":[{"billed_charge":14624.40,"npi":[1285672659]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":123989.15,"providers":[{"billed_charge":138158.00,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"464461954"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2976.00,"providers":[{"billed_charge":2976.00,"npi":[1821418922]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4052.40,"providers":[{"billed_charge":4052.40,"npi":[1346278348]}]}]},{"tin":{"type":"ein","value":"204139343"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30.00,"providers":[{"billed_charge":30.00,"npi":[1841242435]}]}]},{"tin":{"type":"ein","value":"382947312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":616.29,"providers":[{"billed_charge":1875.00,"npi":[1578510764]}]}]},{"tin":{"type":"ein","value":"716009773"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":29308.95,"providers":[{"billed_charge":29950.80,"npi":[1992708804]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":170998.39,"providers":[{"billed_charge":179305.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"710438062"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4071.04,"providers":[{"billed_charge":7005.60,"npi":[1841359106]}]}]},{"tin":{"type":"ein","value":"412078862"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7846.50,"providers":[{"billed_charge":7970.00,"npi":[1912012337]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":180908.00,"providers":[{"billed_charge":180908.00,"npi":[1396736559]}]}]},{"tin":{"type":"ein","value":"510621641"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":757.50,"providers":[{"billed_charge":757.50,"npi":[1003183526]}]}]},{"tin":{"type":"ein","value":"716000642"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4118.40,"providers":[{"billed_charge":4118.40,"npi":[1871611459]}]}]},{"tin":{"type":"ein","value":"626000361"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":553.14,"providers":[{"billed_charge":1320.00,"npi":[1942381819]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16975.61,"providers":[{"billed_charge":123195.79,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"710583459"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":66381.04,"providers":[{"billed_charge":83055.50,"npi":[1992701981]}]}]},{"tin":{"type":"ein","value":"710774318"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3531.00,"providers":[{"billed_charge":3531.00,"npi":[1104893676]}]}]},{"tin":{"type":"ein","value":"716010871"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1350.31,"providers":[{"billed_charge":1492.60,"npi":[1881319507]}]}]},{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":40276.17,"providers":[{"billed_charge":41352.30,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":140900.21,"providers":[{"billed_charge":145933.70,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"716002030"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3074.50,"providers":[{"billed_charge":3074.50,"npi":[1891738548]}]}]},{"tin":{"type":"ein","value":"237428478"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":51488.86,"providers":[{"billed_charge":53064.00,"npi":[1831272145]}]}]},{"tin":{"type":"ein","value":"710659515"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":16191.90,"providers":[{"billed_charge":16191.90,"npi":[1053361295]}]}]},{"tin":{"type":"ein","value":"204285867"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4162.50,"providers":[{"billed_charge":4162.50,"npi":[1023055118]}]}]},{"tin":{"type":"ein","value":"716003104"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1149.00,"providers":[{"billed_charge":1149.00,"npi":[1770509945]}]}]},{"tin":{"type":"ein","value":"251915451"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7242.78,"providers":[{"billed_charge":7958.25,"npi":[1861422560]}]}]}]},{"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":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":23852.61,"providers":[{"billed_charge":28500.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":19015.10,"providers":[{"billed_charge":20150.00,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"237428478"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4040.00,"providers":[{"billed_charge":4040.00,"npi":[1831272145]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":900.00,"providers":[{"billed_charge":900.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5045.85,"providers":[{"billed_charge":5380.00,"npi":[1396736559]}]}]}]},{"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":"716000642"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":56766.71,"providers":[{"billed_charge":56766.71,"npi":[1871611459]}]}]},{"tin":{"type":"ein","value":"716002614"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20400.00,"providers":[{"billed_charge":20400.00,"npi":[1871693721]}]}]},{"tin":{"type":"ein","value":"716010719"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20850.00,"providers":[{"billed_charge":20850.00,"npi":[1144352998]}]}]},{"tin":{"type":"ein","value":"842568754"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":37675.00,"providers":[{"billed_charge":37675.00,"npi":[1588215628]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1800.00,"providers":[{"billed_charge":1800.00,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":7190.25,"providers":[{"billed_charge":95334.13,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"626000361"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2894.40,"providers":[{"billed_charge":9145.00,"npi":[1942381819]}]}]},{"tin":{"type":"ein","value":"710583459"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":84603.00,"providers":[{"billed_charge":90000.00,"npi":[1992701981]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":124400.00,"providers":[{"billed_charge":124400.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1294313.86,"providers":[{"billed_charge":1481065.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":146936.50,"providers":[{"billed_charge":157330.00,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":32550.00,"providers":[{"billed_charge":32550.00,"npi":[1346278348]}]}]},{"tin":{"type":"ein","value":"716010871"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20933.28,"providers":[{"billed_charge":25200.00,"npi":[1881319507]}]}]},{"tin":{"type":"ein","value":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":45891.99,"providers":[{"billed_charge":56306.94,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":173393.90,"providers":[{"billed_charge":192500.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"382947312"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20615.77,"providers":[{"billed_charge":43387.00,"npi":[1578510764]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":85907.50,"providers":[{"billed_charge":87400.00,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"710438062"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3672.40,"providers":[{"billed_charge":9669.30,"npi":[1841359106]}]}]},{"tin":{"type":"ein","value":"237428478"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11200.00,"providers":[{"billed_charge":11200.00,"npi":[1831272145]}]}]},{"tin":{"type":"ein","value":"204285867"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26450.00,"providers":[{"billed_charge":26450.00,"npi":[1023055118]}]}]},{"tin":{"type":"ein","value":"716003104"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5600.00,"providers":[{"billed_charge":5600.00,"npi":[1770509945]}]}]},{"tin":{"type":"ein","value":"251915451"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":9801.00,"providers":[{"billed_charge":14800.00,"npi":[1861422560]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":134550.00,"providers":[{"billed_charge":134550.00,"npi":[1396736559]}]}]},{"tin":{"type":"ein","value":"510621641"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":825.00,"providers":[{"billed_charge":825.00,"npi":[1003183526]}]}]}]},{"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":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":4413.40,"providers":[{"billed_charge":4413.40,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":44862.66,"providers":[{"billed_charge":45900.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":143700.94,"providers":[{"billed_charge":170010.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":42446.07,"providers":[{"billed_charge":46215.00,"npi":[1396736559]}]}]}]},{"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":"710230218"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":35345.42,"providers":[{"billed_charge":41777.12,"npi":[1578633368]}]}]},{"tin":{"type":"ein","value":"710739237"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26273.40,"providers":[{"billed_charge":26900.00,"npi":[1649200890]}]}]},{"tin":{"type":"ein","value":"710843055"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1400.00,"providers":[{"billed_charge":1400.00,"npi":[1417057480]}]}]},{"tin":{"type":"ein","value":"716042693"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6825.00,"providers":[{"billed_charge":6825.00,"npi":[1902895055]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1093.89,"providers":[{"billed_charge":16823.67,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"710843765"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":52400.00,"providers":[{"billed_charge":52400.00,"npi":[1427017532]}]}]},{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":304225.68,"providers":[{"billed_charge":368140.00,"npi":[1477652501]}]}]},{"tin":{"type":"ein","value":"223877176"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":82596.70,"providers":[{"billed_charge":90880.00,"npi":[1386634442]}]}]},{"tin":{"type":"ein","value":"710447842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":160640.00,"providers":[{"billed_charge":160640.00,"npi":[1396736559]}]}]},{"tin":{"type":"ein","value":"716015810"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":5100.00,"providers":[{"billed_charge":5100.00,"npi":[1346278348]}]}]}]},{"name":"ADVNCED LIFE SUPPORT LEVEL 2","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0433","description":"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)","allowed_amounts":[{"tin":{"type":"ein","value":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":8328.00,"providers":[{"billed_charge":10495.00,"npi":[1477652501]}]}]}]},{"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":"710827582"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":34760.00,"providers":[{"billed_charge":37400.00,"npi":[1477652501]}]}]}]},{"name":"SPLY ALW NONIMPL CGM 1 MO SP=1 UOS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4239","description":"SPLY ALW NONADJUNC NONIMPL CGM 1 MO SPLY= 1 UOS","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":15807.28,"providers":[{"billed_charge":51694.20,"npi":[1234567893]}]}]}]},{"name":"ELECTRODES  PER PAIR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4556","description":"ELECTRODES (E.G., APNEA MONITOR), PER PAIR","allowed_amounts":[{"tin":{"type":"ein","value":"593497691"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":22224.87,"providers":[{"billed_charge":33190.10,"npi":[1124044623]}]}]}]},{"name":"ELEC STIM SPPLS 2 LD PER MTH","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4595","description":"ELECTRICAL STIMULATOR SUPPLIES, 2 LEAD, PER MONTH, (E.G., TENS, NMES)","allowed_amounts":[{"tin":{"type":"ein","value":"841451963"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1669.42,"providers":[{"billed_charge":8530.29,"npi":[1770511552]}]}]}]},{"name":"CRTCHES UNDARM OTH THAN WOOD","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0114","description":"CRUTCHES, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS, AND HANDGRIPS","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":927.78,"providers":[{"billed_charge":1149.73,"npi":[1234567893]}]}]}]},{"name":"CONTINUOUS POS AIRWAY PRESSU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0601","description":"CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"710417374"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":799.37,"providers":[{"billed_charge":1320.00,"npi":[1801610175]}]}]}]},{"name":"NEG PRSS WND TX PUMP STATN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E2402","description":"NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":30459.36,"providers":[{"billed_charge":77928.40,"npi":[1234567893]}]}]}]},{"name":"PROSTATE CANCER SCREENING","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0103","description":"PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4549.68,"providers":[{"billed_charge":43849.10,"npi":[1265418669]}]}]}]},{"name":"SCR CERV/VAG THIN LAY PHYS I","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0124","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1135.68,"providers":[{"billed_charge":3477.61,"npi":[1265418669]}]}]}]},{"name":"SCR CERV/VAG AUTO&MNL RSCR P","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0145","description":"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AU","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10193.60,"providers":[{"billed_charge":53168.36,"npi":[1265418669]}]}]}]},{"name":"PRVS TST MATL&EQUIP HM INR M","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0249","description":"PROVISION OF TEST MATERIALS AND EQUIPMENT FOR HOME INR MONITORING OF PATIENT WITH EITHER MECHANICAL","allowed_amounts":[{"tin":{"type":"ein","value":"592852900"},"service_code":["12","49"],"billing_class":"professional","payments":[{"allowed_amount":509.83,"providers":[{"billed_charge":1400.00,"npi":[1336420140]}]},{"allowed_amount":489.91,"providers":[{"billed_charge":1120.00,"npi":[1336420140]}]}]}]},{"name":"COLOREC CA SCR; FOB TST IMMU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0328","description":"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS DETERMINATIONS","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":135.36,"providers":[{"billed_charge":1197.00,"npi":[1265418669]}]}]}]},{"name":"HEP C ABO SC IND HI RSK&OTH","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0472","description":"HEPATITIS C ANTIBODY SCREENING FOR INDIVIDUAL AT HIGH RISK AND OTHER COVERED INDICATION(S)","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12544.01,"providers":[{"billed_charge":40578.28,"npi":[1265418669]}]}]}]},{"name":"HIV ANTIGEN/ANTIBODY, COMBIN","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0475","description":"HIV ANTIGEN/ANTIBODY, COMBINATION ASSAY, SCREENING","allowed_amounts":[{"tin":{"type":"ein","value":"840611484"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6236.56,"providers":[{"billed_charge":58863.15,"npi":[1265418669]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 1-7","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":24604.60,"providers":[{"billed_charge":61920.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"455513274"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5945.18,"providers":[{"billed_charge":39560.00,"npi":[1649933417]}]},{"allowed_amount":1885.76,"providers":[{"billed_charge":7360.00,"npi":[1124687157]}]},{"allowed_amount":1069.97,"providers":[{"billed_charge":5060.00,"npi":[1932806494]}]},{"allowed_amount":3112.64,"providers":[{"billed_charge":14720.00,"npi":[1629531595]}]}]},{"tin":{"type":"ein","value":"823268636"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1148.92,"providers":[{"billed_charge":33600.00,"npi":[1457863391]}]}]},{"tin":{"type":"ein","value":"452215107"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4242.96,"providers":[{"billed_charge":12362.04,"npi":[1801226543]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 8-1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0481","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"843260526"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9630.90,"providers":[{"billed_charge":24108.00,"npi":[1659900348]}]}]},{"tin":{"type":"ein","value":"822704194"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12762.90,"providers":[{"billed_charge":31948.00,"npi":[1841798667]}]}]}]},{"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":"261318597"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":140.88,"providers":[{"billed_charge":288.00,"npi":[1609412766]}]}]},{"tin":{"type":"ein","value":"932686392"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":74.85,"providers":[{"billed_charge":210.00,"npi":[1245877794]}]},{"allowed_amount":76.60,"providers":[{"billed_charge":168.00,"npi":[1891532685]}]}]},{"tin":{"type":"ein","value":"814599180"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":344.26,"providers":[{"billed_charge":756.00,"npi":[1669850384]}]},{"allowed_amount":134.05,"providers":[{"billed_charge":294.00,"npi":[1083433403]}]},{"allowed_amount":803.86,"providers":[{"billed_charge":1764.00,"npi":[1033960265]}]},{"allowed_amount":247.72,"providers":[{"billed_charge":462.00,"npi":[1215505615]}]},{"allowed_amount":191.50,"providers":[{"billed_charge":420.00,"npi":[1083433981]}]}]},{"tin":{"type":"ein","value":"263054638"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":957.06,"providers":[{"billed_charge":2100.00,"npi":[1669868691]}]}]}]},{"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":"872968297"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2639.34,"providers":[{"billed_charge":5400.00,"npi":[1447481072]}]}]}]},{"name":"STEREO X-R GUID LOC TRG VOL","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G6002","description":"STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR THE DELIVERY OF RADIATION THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"261318597"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1817.60,"providers":[{"billed_charge":3292.00,"npi":[1891145538]}]}]}]},{"name":"ALCOHL&/RX SRVC; INTENSV OP;","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0015","description":"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"923029503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7750.00,"providers":[{"billed_charge":32500.00,"npi":[1174137673]}]}]},{"tin":{"type":"ein","value":"932572939"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11700.00,"providers":[{"billed_charge":29250.00,"npi":[1790120483]}]}]},{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":57024.80,"providers":[{"billed_charge":285124.00,"npi":[1053919423]}]}]}]},{"name":"MENTAL HLTH PART HOSP TX <24","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0035","description":"MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"932572939"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":196000.00,"providers":[{"billed_charge":490000.00,"npi":[1790120483]}]}]},{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":1118.60,"providers":[{"billed_charge":5593.00,"npi":[1053919423]}]}]}]},{"name":"INJ TESTOSTERONE CYPION 1MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1071","description":"INJECTION, TESTOSTERONE CYPIONATE, 1 MG","allowed_amounts":[{"tin":{"type":"ein","value":"810576831"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":117.36,"providers":[{"billed_charge":9202.00,"npi":[1861825911]}]}]}]},{"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":"461235939"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":0.36,"providers":[{"billed_charge":6.40,"npi":[1891433124]}]},{"allowed_amount":1.02,"providers":[{"billed_charge":16.00,"npi":[1497326599]}]}]}]},{"name":"INJECTION BEVACIZUMAB 10 MG","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J9035","description":"INJECTION, BEVACIZUMAB, 10 MG","allowed_amounts":[{"tin":{"type":"ein","value":"710706742"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":876.41,"providers":[{"billed_charge":1020.00,"npi":[1255350021]}]}]}]},{"name":"SHOULDER ORTHOS FIG 8 CANVAS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"L3660","description":"SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, O","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1214.72,"providers":[{"billed_charge":1947.20,"npi":[1234567893]}]}]}]},{"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":44.25,"providers":[{"billed_charge":70.94,"npi":[1234567893]}]}]}]},{"name":"TELEHEALTH ORIG SITE FACILIT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"Q3014","description":"TELEHEALTH ORIGINATING SITE FACILITY FEE","allowed_amounts":[{"tin":{"type":"ein","value":"823218781"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1584.10,"providers":[{"billed_charge":3850.00,"npi":[1750793055]}]},{"allowed_amount":995.72,"providers":[{"billed_charge":2420.00,"npi":[1346752151]}]},{"allowed_amount":611.01,"providers":[{"billed_charge":1485.00,"npi":[1477703973]}]},{"allowed_amount":1127.08,"providers":[{"billed_charge":2860.00,"npi":[1184060980]}]},{"allowed_amount":859.94,"providers":[{"billed_charge":2090.00,"npi":[1760755144,1649933417]}]},{"allowed_amount":2172.48,"providers":[{"billed_charge":5280.00,"npi":[1932806494]}]},{"allowed_amount":2502.28,"providers":[{"billed_charge":5170.00,"npi":[1124687157]}]},{"allowed_amount":4752.30,"providers":[{"billed_charge":11550.00,"npi":[1629531595]}]}]}]},{"name":"LOCM 300-399 MG/ML I CONC PE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"Q9967","description":"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML","allowed_amounts":[{"tin":{"type":"ein","value":"710850123"},"service_code":["11","22"],"billing_class":"professional","payments":[{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1083619456]}]},{"allowed_amount":28.00,"providers":[{"billed_charge":28.00,"npi":[1083619456]}]}]}]},{"name":"PART HOSITALIZATN SRVC<24 HR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S0201","description":"PARTIAL HOSPITALIZATION SERVICES, LESS THAN 24 HOURS, PER DIEM","allowed_amounts":[{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":89488.00,"providers":[{"billed_charge":447440.00,"npi":[1053919423]}]}]}]},{"name":"GLBAL FEE URGNT CARE CENTERS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9083","description":"GLOBAL FEE URGENT CARE CENTERS","allowed_amounts":[{"tin":{"type":"ein","value":"853756788"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":200.00,"providers":[{"billed_charge":1000.00,"npi":[1558970129]}]}]},{"tin":{"type":"ein","value":"461235939"},"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":8177.00,"providers":[{"billed_charge":40885.00,"npi":[1376006585]}]},{"allowed_amount":4110.60,"providers":[{"billed_charge":20553.00,"npi":[1174034565]}]},{"allowed_amount":5356.16,"providers":[{"billed_charge":26720.00,"npi":[1063870467]}]},{"allowed_amount":60.00,"providers":[{"billed_charge":200.00,"npi":[1891433124]}]},{"allowed_amount":2519.40,"providers":[{"billed_charge":12597.00,"npi":[1497326599]}]},{"allowed_amount":751.40,"providers":[{"billed_charge":3757.00,"npi":[1578141180]}]},{"allowed_amount":40.00,"providers":[{"billed_charge":200.00,"npi":[1316510043]}]},{"allowed_amount":7116.20,"providers":[{"billed_charge":35581.00,"npi":[1316510043]}]},{"allowed_amount":5900.70,"providers":[{"billed_charge":19669.00,"npi":[1578026027,1891433124]}]},{"allowed_amount":3005.60,"providers":[{"billed_charge":15028.00,"npi":[1033659677]}]},{"allowed_amount":2210.00,"providers":[{"billed_charge":11050.00,"npi":[1659012425]}]},{"allowed_amount":1158.00,"providers":[{"billed_charge":1326.00,"npi":[1114970704]}]},{"allowed_amount":3268.88,"providers":[{"billed_charge":12818.00,"npi":[1043931793]}]},{"allowed_amount":422.12,"providers":[{"billed_charge":1989.00,"npi":[1801449384]}]},{"allowed_amount":3580.20,"providers":[{"billed_charge":17901.00,"npi":[1396191136]}]},{"allowed_amount":56.36,"providers":[{"billed_charge":221.00,"npi":[1407450539]}]},{"allowed_amount":3138.20,"providers":[{"billed_charge":15691.00,"npi":[1689240913]}]},{"allowed_amount":3889.60,"providers":[{"billed_charge":19448.00,"npi":[1669933370]}]},{"allowed_amount":4552.60,"providers":[{"billed_charge":22763.00,"npi":[1285327452]}]},{"allowed_amount":7248.80,"providers":[{"billed_charge":36244.00,"npi":[1861242455]}]},{"allowed_amount":1370.20,"providers":[{"billed_charge":6851.00,"npi":[1427666346]}]},{"allowed_amount":2987.08,"providers":[{"billed_charge":11713.00,"npi":[1043028939]}]},{"allowed_amount":44.20,"providers":[{"billed_charge":221.00,"npi":[1669933370]}]},{"allowed_amount":2123.00,"providers":[{"billed_charge":2431.00,"npi":[1841922937]}]}]}]},{"name":"HOME INFUS TX IMMUOTHAPY; PE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9338","description":"HOME INFUSION THERAPY, IMMUNOTHERAPY, ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY SERVICES, CARE","allowed_amounts":[{"tin":{"type":"ein","value":"330892907"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":180.00,"providers":[{"billed_charge":600.00,"npi":[1205401338]}]}]}]},{"name":"INTNSVE OP PSYC SVC PER DIEM","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9480","description":"INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM","allowed_amounts":[{"tin":{"type":"ein","value":"853005640"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":20274.70,"providers":[{"billed_charge":104825.00,"npi":[1053919423]}]}]}]}]}