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938.98, "providers": [{ "billed_charge": 2247.00, "npi": [1275021958] } ] }, { "allowed_amount": 268.28, "providers": [{ "billed_charge": 642.00, "npi": [1275021958] } ] }, { "allowed_amount": 2012.10, "providers": [{ "billed_charge": 4815.00, "npi": [1063907533] } ] } ] } ] }, { "name": "ANESTH, SURG UPPER ABDOMEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "790", "description": "ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHERWISE SPEC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "271009253" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1263.16, "providers": [{ "billed_charge": 7560.00, "npi": [1881472561] } ] } ] } ] }, { "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: 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"npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 143.82, "providers": [{ "billed_charge": 983.28, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.61, "providers": [{ "billed_charge": 451.50, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9518.92, "providers": [{ "billed_charge": 102308.70, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 406.16, "providers": [{ "billed_charge": 1445.00, "npi": [1174172845] } ] } ] } ] }, { "name": "GENERAL HEALTH PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80050", "description": "GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 127.00, "providers": [{ "billed_charge": 640.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 560.03, "providers": [{ "billed_charge": 2037.54, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 264.06, "providers": [{ "billed_charge": 628.74, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3513.77, "providers": [{ "billed_charge": 26850.00, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 281.84, "providers": [{ "billed_charge": 1105.00, "npi": [1184250524] } ] }, { "allowed_amount": 43.36, "providers": [{ "billed_charge": 170.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4712.10, "providers": [{ "billed_charge": 26400.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 467554.74, "providers": [{ "billed_charge": 1869915.60, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24999.25, "providers": [{ "billed_charge": 148103.67, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 17235.74, "providers": [{ "billed_charge": 183654.47, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1068508.55, "providers": [{ "billed_charge": 4192509.90, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.98, "providers": [{ "billed_charge": 112.80, "npi": [1730617523] } ] }, { "allowed_amount": 10117.18, "providers": [{ "billed_charge": 27184.80, "npi": [1730617523] } ] } ] } ] }, { "name": "ELECTROLYTE PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80051", "description": "ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (BICARBONATE) (82374) CHLORI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 95.67, "providers": [{ "billed_charge": 2040.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.05, "providers": [{ "billed_charge": 64.95, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 474.55, "providers": [{ "billed_charge": 2262.01, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPREHEN METABOLIC PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80053", "description": "COMPREHENSIVE METABOLIC PANEL THIS PANEL 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"823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.56, "providers": [{ "billed_charge": 63.36, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "844939989" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.68, "providers": [{ "billed_charge": 190.08, "npi": [1639791007] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6072.00, "providers": [{ "billed_charge": 24288.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 285421.16, "providers": [{ "billed_charge": 2940849.22, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.68, "providers": [{ "billed_charge": 330.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1020.98, "providers": [{ "billed_charge": 3748.80, "npi": [1730617523] } ] }, { "allowed_amount": 7.19, "providers": [{ "billed_charge": 26.40, "npi": [1730617523] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 348.48, "providers": [{ "billed_charge": 897.60, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.88, "providers": [{ "billed_charge": 180.00, "npi": [1053568014] } ] }, { "allowed_amount": 242.88, "providers": [{ "billed_charge": 690.00, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "752848936" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.36, "providers": [{ "billed_charge": 253.44, "npi": [1295513000] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2148.96, "providers": [{ "billed_charge": 14652.00, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.68, "providers": [{ "billed_charge": 678.00, "npi": [1265493688] } ] }, { "allowed_amount": 6.00, "providers": [{ "billed_charge": 20.00, "npi": [1265493688] } ] }, { "allowed_amount": 8.40, "providers": [{ "billed_charge": 20.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40801.16, "providers": [{ "billed_charge": 644371.98, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 517.44, "providers": [{ "billed_charge": 1372.00, "npi": [1487429874] } ] }, { "allowed_amount": 1034.88, "providers": [{ "billed_charge": 2744.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "760430777" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.68, "providers": [{ "billed_charge": 147.84, "npi": [1780730606] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 828.96, "providers": [{ "billed_charge": 3315.84, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 575.52, "providers": [{ "billed_charge": 3815.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3300.00, "providers": [{ "billed_charge": 49178.70, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 65.27, "providers": [{ "billed_charge": 540.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 227.04, "providers": [{ "billed_charge": 2021.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 415.22, "providers": [{ "billed_charge": 7874.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 47.52, "providers": [{ "billed_charge": 237.60, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1024.32, "providers": [{ "billed_charge": 5005.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 153.12, "providers": [{ "billed_charge": 1015.00, "npi": [1699744144] } ] } ] } ] }, { "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": 3431.70, "providers": [{ "billed_charge": 36854.83, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 508.82, "providers": [{ "billed_charge": 1140.00, "npi": [1689687360] } ] }, { "allowed_amount": 79.66, "providers": [{ "billed_charge": 210.00, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 679.11, "providers": [{ "billed_charge": 2152.63, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1219.40, "providers": [{ "billed_charge": 3094.00, "npi": [1841798667] } ] }, { "allowed_amount": 556.10, "providers": [{ "billed_charge": 1411.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 56.90, "providers": [{ "billed_charge": 550.00, "npi": [1184250524] } ] }, { "allowed_amount": 79.66, "providers": [{ "billed_charge": 770.00, "npi": [1487087144] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 502.50, "providers": [{ "billed_charge": 2008.50, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1651.40, "providers": [{ "billed_charge": 7290.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81260.05, "providers": [{ "billed_charge": 1712049.48, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7859.10, "providers": [{ "billed_charge": 106180.52, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1646.32, "providers": [{ "billed_charge": 15925.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 703.63, "providers": [{ "billed_charge": 2565.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "813193170" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.30, "providers": [{ "billed_charge": 200.00, "npi": [1033524327] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.70, "providers": [{ "billed_charge": 660.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1252.90, "providers": [{ "billed_charge": 6260.76, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 68.06, "providers": [{ "billed_charge": 1288.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1969.80, "providers": [{ "billed_charge": 11172.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15249.20, "providers": [{ "billed_charge": 127820.16, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 357223.58, "providers": [{ "billed_charge": 5732452.94, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3051.85, "providers": [{ "billed_charge": 11215.80, "npi": [1730617523] } ] }, { "allowed_amount": 9.11, "providers": [{ "billed_charge": 33.48, "npi": [1730617523] } ] } ] } ] }, { "name": "RENAL FUNCTION PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80069", "description": "RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM, TOTAL (82310) C", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 604.36, "providers": [{ "billed_charge": 10016.39, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2392.46, "providers": [{ "billed_charge": 36188.57, "npi": [1234567893] } ] } ] } ] }, { "name": "ACUTE HEPATITIS PANEL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80074", "description": "ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 763.14, "providers": [{ "billed_charge": 7140.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.56, "providers": [{ "billed_charge": 762.08, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ 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"payments": [{ "allowed_amount": 4008.03, "providers": [{ "billed_charge": 20630.48, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "853374426" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.14, "providers": [{ "billed_charge": 200.00, "npi": [1245838671] } ] } ] }, { "tin": { "type": "ein", "value": "473204624" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3017.82, "providers": [{ "billed_charge": 6804.00, "npi": [1629301700] } ] }, { "allowed_amount": 1465.05, "providers": [{ "billed_charge": 3780.00, "npi": [1902280019] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6715.04, "providers": [{ "billed_charge": 26595.92, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6300.32, "providers": [{ "billed_charge": 22058.68, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "452215107" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 683.54, "providers": [{ "billed_charge": 4101.24, "npi": [1801226543] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3075.93, "providers": [{ "billed_charge": 14850.00, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 621.40, "providers": [{ "billed_charge": 4729.00, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "830973361" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20754.76, "providers": [{ "billed_charge": 166038.08, "npi": [1447814272] } ] } ] }, { "tin": { "type": "ein", "value": "471489220" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.91, "providers": [{ "billed_charge": 2019.55, "npi": [1861895500] } ] } ] }, { "tin": { "type": "ein", "value": "461242694" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 279.63, "providers": [{ "billed_charge": 675.00, "npi": [1134559685] } ] } ] }, { "tin": { "type": "ein", "value": "854205837" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 994.24, "providers": [{ "billed_charge": 3976.96, "npi": [1164017422] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1833.72, "providers": [{ "billed_charge": 8850.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "923223356" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 117.46, "providers": [{ "billed_charge": 434.98, "npi": [1609565100] } ] } ] } ] }, { "name": "DRUG SCREEN QUANTALCOHOLS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80320", "description": "ALCOHOLS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21.00, "providers": [{ "billed_charge": 83.88, "npi": [1234567893] } ] } ] } ] }, { "name": "ALCOHOLS BIOMARKERS 1OR 2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80321", "description": "ALCOHOL BIOMARKERS; 1 OR 2", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136.30, "providers": [{ "billed_charge": 545.17, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1152.43, "providers": [{ "billed_charge": 4609.42, "npi": [1234567893] } ] } ] } ] }, { "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": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1731.42, "providers": [{ "billed_charge": 6241.02, "npi": [1982091617] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 405.32, "providers": [{ "billed_charge": 1621.11, "npi": [1234567893] } ] } ] } ] }, { "name": "DRUG SCREEN AMPHETAMINES 1/2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "80324", "description": "AMPHETAMINES; 1 OR 2", "allowed_amounts": [{ "tin": { "type": 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"allowed_amount": 7.88, "providers": [{ "billed_charge": 31.52, "npi": [1234567893] } ] } ] } ] }, { "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": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3652.02, "providers": [{ "billed_charge": 19160.84, "npi": [1982091617] } ] } ] } ] }, { "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": "473588569" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3035.61, "providers": [{ "billed_charge": 14723.50, "npi": [1982091617] } ] } ] } ] }, { "name": 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"allowed_amount": 107.45, "providers": [{ "billed_charge": 816.14, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6940.60, "providers": [{ "billed_charge": 15275.48, "npi": [1234567893] } ] } ] } ] }, { "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": 455.94, "providers": [{ "billed_charge": 9494.95, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.18, "providers": [{ "billed_charge": 25.90, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6398.87, "providers": [{ "billed_charge": 135421.75, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.00, "providers": [{ "billed_charge": 200.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.68, "providers": [{ "billed_charge": 538.72, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 976.43, "providers": [{ "billed_charge": 8177.13, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 634.55, "providers": [{ "billed_charge": 18581.10, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 37053.95, "providers": [{ "billed_charge": 778974.08, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 59.84, "providers": [{ "billed_charge": 220.15, "npi": [1730617523] } ] } ] } ] }, { "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": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.94, "providers": [{ "billed_charge": 616.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 806.19, "providers": [{ "billed_charge": 9006.97, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 527.80, "providers": [{ "billed_charge": 1658.80, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 595.66, "providers": [{ "billed_charge": 5796.23, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13258.25, "providers": [{ "billed_charge": 201493.20, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 233.74, "providers": [{ "billed_charge": 934.96, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 407.16, "providers": [{ "billed_charge": 1026.00, "npi": [1841798667] } ] }, { "allowed_amount": 135.72, "providers": [{ "billed_charge": 342.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1440.14, "providers": [{ "billed_charge": 5670.08, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1983.02, "providers": [{ "billed_charge": 29108.92, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 697.52, "providers": [{ "billed_charge": 2686.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1236.56, "providers": [{ "billed_charge": 6182.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 211.12, "providers": [{ "billed_charge": 1176.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4101.76, "providers": [{ "billed_charge": 34369.92, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77025.59, "providers": [{ "billed_charge": 979953.17, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1241.46, "providers": [{ "billed_charge": 4561.70, "npi": [1730617523] } ] }, { "allowed_amount": 10.26, "providers": [{ "billed_charge": 37.70, "npi": [1730617523] } ] } ] } ] }, { "name": "CYSTATIN C", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82610", "description": "CYSTATIN C", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1146.43, "providers": [{ "billed_charge": 19182.85, "npi": [1234567893] } ] } ] } ] }, { "name": "DEHYDROEPIANDROSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82626", "description": "DEHYDROEPIANDROSTERONE (DHEA)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 164.32, "providers": [{ "billed_charge": 1377.09, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 637.40, "providers": [{ "billed_charge": 8637.04, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 720.39, "providers": [{ "billed_charge": 2400.00, "npi": [1174172845] } ] } ] } ] }, { "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": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 266.88, "providers": [{ "billed_charge": 1333.92, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 155.68, "providers": [{ "billed_charge": 622.44, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.12, "providers": [{ "billed_charge": 64.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 177.92, "providers": [{ "billed_charge": 711.36, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1280.64, "providers": [{ "billed_charge": 23471.04, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 233.52, "providers": [{ "billed_charge": 1957.41, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.12, "providers": [{ "billed_charge": 74.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 55.60, "providers": [{ "billed_charge": 1136.25, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9695.59, "providers": [{ "billed_charge": 127375.77, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.13, "providers": [{ "billed_charge": 55.58, "npi": [1730617523] } ] }, { "allowed_amount": 953.19, "providers": [{ "billed_charge": 3501.54, "npi": 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"82670", "description": "ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 368.60, "providers": [{ "billed_charge": 3457.21, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 474.98, "providers": [{ "billed_charge": 2374.90, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6452.60, "providers": [{ "billed_charge": 98077.48, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 83.88, "providers": [{ "billed_charge": 468.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1075.69, "providers": [{ "billed_charge": 4135.12, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 349.25, "providers": [{ "billed_charge": 2325.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2458.72, "providers": [{ "billed_charge": 20613.12, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 642.62, "providers": [{ "billed_charge": 8666.17, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34489.59, "providers": [{ "billed_charge": 420184.92, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 950.08, "providers": [{ "billed_charge": 3304.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1254.66, "providers": [{ "billed_charge": 4610.10, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF ESTROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82672", "description": "ESTROGENS; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 520.80, "providers": [{ "billed_charge": 8857.80, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4258.43, "providers": [{ "billed_charge": 58483.16, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ESTRONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82679", "description": "ESTRONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 77.65, "providers": [{ "billed_charge": 923.00, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY DIR MEAS FR ESTRADIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82681", "description": "ASSAY OF DIRECT MEASUREMENT FREE ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 202.52, "providers": [{ "billed_charge": 1782.06, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", 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"billing_class": "professional", "payments": [{ "allowed_amount": 34.10, "providers": [{ "billed_charge": 305.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 761.13, "providers": [{ "billed_charge": 15416.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 320.54, "providers": [{ "billed_charge": 1601.76, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6.82, "providers": [{ "billed_charge": 38.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1063.92, "providers": [{ "billed_charge": 8906.04, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62143.84, "providers": [{ "billed_charge": 691601.61, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 491.31, "providers": [{ "billed_charge": 1806.24, "npi": [1730617523] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 296.09, "providers": [{ "billed_charge": 3218.06, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 139.65, "providers": [{ "billed_charge": 338.10, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1675.80, "providers": [{ "billed_charge": 18761.18, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 147.00, "providers": [{ "billed_charge": 588.00, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 882.00, "providers": [{ "billed_charge": 3439.80, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.45, "providers": [{ "billed_charge": 133.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7144.20, "providers": [{ "billed_charge": 109211.36, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1315.65, "providers": [{ "billed_charge": 17280.63, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 658.75, "providers": [{ "billed_charge": 2584.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 492.45, "providers": [{ "billed_charge": 2462.25, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 143.52, "providers": [{ "billed_charge": 780.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3160.50, "providers": [{ "billed_charge": 26496.60, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 44982.56, "providers": [{ "billed_charge": 566698.85, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 810.81, "providers": [{ "billed_charge": 2976.75, "npi": [1730617523] } ] }, { "allowed_amount": 10.01, "providers": [{ "billed_charge": 36.75, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF FOLIC ACID, RBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82747", "description": "FOLIC ACID; RBC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 194.26, "providers": [{ "billed_charge": 776.60, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 620.90, "providers": [{ "billed_charge": 10369.39, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY IGA/IGD/IGG/IGM EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82784", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1071.36, "providers": [{ "billed_charge": 13445.06, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5406.76, "providers": [{ "billed_charge": 66637.13, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF IGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82785", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 592.80, "providers": [{ "billed_charge": 6647.27, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 74.07, "providers": [{ "billed_charge": 621.27, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3408.23, "providers": [{ "billed_charge": 37442.18, "npi": [1234567893] } ] } ] } ] }, { "name": "IGG 1 2 3 OR 4 EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82787", "description": "GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 138.72, "providers": [{ "billed_charge": 3335.37, "npi": [1234567893] } ] } ] } ] }, { "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": 10.42, "providers": [{ "billed_charge": 21.61, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 137.90, "providers": [{ "billed_charge": 1218.22, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.72, "providers": [{ "billed_charge": 735.09, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5297.57, "providers": [{ "billed_charge": 14246.18, "npi": [1234567893] } ] } ] } ] }, { "name": "REAGENT STRIP/BLOOD GLUCOSE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82948", "description": "GLUCOSE; BLOOD, REAGENT STRIP", "allowed_amounts": [{ "tin": { "type": "ein", "value": "742882192" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 148.68, "providers": [{ "billed_charge": 1180.00, "npi": [1033370176] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 143.38, "providers": [{ "billed_charge": 335.00, "npi": [1538526702] } ] }, { "allowed_amount": 98.44, "providers": [{ "billed_charge": 230.00, "npi": [1669082723] } ] }, { "allowed_amount": 263.22, "providers": [{ "billed_charge": 615.00, "npi": [1003273731] } ] }, { "allowed_amount": 12.60, "providers": [{ "billed_charge": 25.00, "npi": [1255596342] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.60, "providers": [{ "billed_charge": 3071.54, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.46, "providers": [{ "billed_charge": 272.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1830.08, "providers": [{ "billed_charge": 22206.96, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE TOLERANCE TEST (GTT)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82951", "description": "GLUCOSE; TOLERANCE TEST (GTT), 3 SPECIMENS (INCLUDES GLUCOSE)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.44, "providers": [{ "billed_charge": 260.82, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1058.12, "providers": [{ "billed_charge": 14129.26, "npi": [1234567893] } ] } ] } ] }, { "name": "GTT-ADDED SAMPLES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82952", "description": "GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND 3 SPECIMENS (LIST SEPARATELY IN ADDITION TO CODE FOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 283.56, "providers": [{ "billed_charge": 3272.03, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF G6PD ENZYME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82955", "description": "GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 439.08, "providers": [{ "billed_charge": 6088.12, "npi": [1234567893] } ] } ] } ] }, { "name": "GLUCOSE BLOOD TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82962", "description": "GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752354465" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.10, "providers": [{ "billed_charge": 7.00, "npi": [1144282989] } ] }, { "allowed_amount": 199.50, "providers": [{ "billed_charge": 665.00, "npi": [1144282989] } ] }, { "allowed_amount": 4.90, "providers": [{ "billed_charge": 14.00, "npi": [1144282989] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.76, "providers": [{ "billed_charge": 135.00, "npi": [1982050241] } ] }, { "allowed_amount": 34.44, "providers": [{ "billed_charge": 315.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.88, "providers": [{ "billed_charge": 64.00, "npi": [1326017872] } ] }, { "allowed_amount": 43.68, "providers": [{ "billed_charge": 104.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.73, "providers": [{ "billed_charge": 105.07, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.00, "providers": [{ "billed_charge": 375.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.84, "providers": [{ "billed_charge": 186.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GGT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82977", "description": "GLUTAMYLTRANSFERASE, GAMMA (GGT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 85.00, "providers": [{ "billed_charge": 571.73, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 254.88, "providers": [{ "billed_charge": 3416.69, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 108.00, "providers": [{ "billed_charge": 905.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 10.80, "providers": [{ "billed_charge": 146.71, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9189.12, "providers": [{ "billed_charge": 63124.59, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 480.40, "providers": [{ "billed_charge": 1920.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF GLYCATED PROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82985", "description": "GLYCATED PROTEIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.44, "providers": [{ "billed_charge": 245.70, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (FSH)", 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[{ "billed_charge": 130.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5140.15, "providers": [{ "billed_charge": 71248.44, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 130.06, "providers": [{ "billed_charge": 520.24, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 353.02, "providers": [{ "billed_charge": 2356.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2703.39, "providers": [{ "billed_charge": 22671.81, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 380.89, "providers": [{ "billed_charge": 4945.46, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26638.81, "providers": [{ "billed_charge": 314039.14, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1148.51, "providers": [{ "billed_charge": 4644.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.65, "providers": [{ "billed_charge": 46.45, "npi": [1730617523] } ] }, { "allowed_amount": 506.00, "providers": [{ "billed_charge": 1858.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (LH)", 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"billed_charge": 55523.78, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 212.98, "providers": [{ "billed_charge": 851.92, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2537.24, "providers": [{ "billed_charge": 21273.36, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 101.86, "providers": [{ "billed_charge": 682.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 175.94, "providers": [{ "billed_charge": 1969.25, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 22557.69, "providers": [{ "billed_charge": 265707.64, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1069.86, "providers": [{ "billed_charge": 4158.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 844.20, "providers": [{ "billed_charge": 3102.10, "npi": [1730617523] } ] }, { "allowed_amount": 12.60, "providers": [{ "billed_charge": 46.30, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY, GROWTH HORMONE (HGH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83003", "description": "GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 208.50, "providers": [{ "billed_charge": 1042.00, "npi": [1740715333] } ] } ] } ] }, { "name": "ASSAY OF HAPTOGLOBIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83010", "description": "HAPTOGLOBIN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.55, "providers": [{ "billed_charge": 132.19, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 687.06, "providers": [{ "billed_charge": 11306.58, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI (C-13), BREATH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83013", "description": "HELICOBACTER PYLORI; BREATH TEST ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE (EG, C-13)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13257.76, "providers": [{ "billed_charge": 85097.38, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7780.08, "providers": [{ "billed_charge": 65218.23, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 707.28, "providers": [{ "billed_charge": 6825.00, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 57917.56, "providers": [{ "billed_charge": 381126.75, "npi": [1234567893] } ] } ] } ] }, { "name": "H PYLORI DRUG ADMIN", 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"value": "743001674" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 420.00, "npi": [1972819589] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 2550.14, "providers": [{ "billed_charge": 23580.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 588.51, "providers": [{ "billed_charge": 2140.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11255.76, "providers": [{ "billed_charge": 94214.88, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 238702.85, "providers": [{ "billed_charge": 3080153.36, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1758.26, "providers": [{ "billed_charge": 6458.48, "npi": [1730617523] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.55, "providers": [{ "billed_charge": 133.20, "npi": [1689687360] } ] }, { "allowed_amount": 57.75, "providers": [{ "billed_charge": 186.48, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 422.82, "providers": [{ "billed_charge": 1272.01, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "462456505" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.43, "providers": [{ "billed_charge": 440.00, "npi": [1487087144] } ] }, { "allowed_amount": 74.34, "providers": [{ "billed_charge": 720.00, "npi": [1184250524] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 51869.51, "providers": [{ "billed_charge": 755520.40, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.38, "providers": [{ "billed_charge": 1611.86, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 393.66, "providers": [{ "billed_charge": 1053.00, "npi": [1487429874] } ] }, { "allowed_amount": 738.72, "providers": [{ "billed_charge": 1976.00, "npi": [1841798667] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 860.22, "providers": [{ "billed_charge": 4425.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "760622208" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 43.74, "providers": [{ "billed_charge": 668.25, "npi": [1609603836] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4996.08, "providers": [{ "billed_charge": 84107.24, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "813193170" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.99, "providers": [{ "billed_charge": 75.00, "npi": [1033524327] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 34.02, "providers": [{ "billed_charge": 308.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "760009637" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.18, "providers": [{ "billed_charge": 962.00, "npi": [1982050241] } ] }, { "allowed_amount": 43.74, "providers": [{ "billed_charge": 666.00, "npi": [1417335571] } ] }, { "allowed_amount": 121.50, "providers": [{ "billed_charge": 1850.00, "npi": [1942400601] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 865.08, "providers": [{ "billed_charge": 4321.84, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.30, "providers": [{ "billed_charge": 585.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1411.83, "providers": [{ "billed_charge": 6972.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 204.12, "providers": [{ "billed_charge": 1344.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "751414940" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 170.10, "providers": [{ "billed_charge": 665.00, "npi": [1578897765] } ] } ] }, { "tin": { "type": "ein", "value": "300198705" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.86, "providers": [{ "billed_charge": 25.00, "npi": [1255596342] } ] }, { "allowed_amount": 210.63, "providers": [{ "billed_charge": 1275.00, "npi": [1003273731] } ] }, { "allowed_amount": 90.86, "providers": [{ "billed_charge": 550.00, "npi": [1669082723] } ] }, { "allowed_amount": 173.46, "providers": [{ "billed_charge": 1050.00, "npi": [1538526702] } ] } ] } ] }, { "name": "ASSAY OF HOMOCYSTINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83090", "description": "HOMOCYSTEINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.75, "providers": [{ "billed_charge": 1299.70, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 753.46, "providers": [{ "billed_charge": 18131.16, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 215.04, "providers": [{ "billed_charge": 720.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE 17-D", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83498", "description": "HYDROXYPROGESTERONE, 17-D", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 195.60, "providers": [{ "billed_charge": 2285.52, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4191.42, "providers": [{ "billed_charge": 40962.72, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83516", "description": "IMMUNOASSAY FOR ANALYTE OTH THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 249.12, "providers": [{ "billed_charge": 3990.88, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 461.41, "providers": [{ "billed_charge": 15680.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.65, "providers": [{ "billed_charge": 6018.54, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2088.96, "providers": [{ "billed_charge": 39476.73, "npi": [1234567893] } ] } ] } ] }, { "name": "RIA NONANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83519", "description": "IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 108.56, "providers": [{ "billed_charge": 2911.06, "npi": [1234567893] } ] } ] } ] }, { "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": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 172.80, "providers": [{ "billed_charge": 863.60, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2051.28, "providers": [{ "billed_charge": 27804.35, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7936.25, "providers": [{ "billed_charge": 103529.23, "npi": [1234567893] } ] } ] } ] }, { "name": "IG LIGHT CHAINS FREE EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83521", "description": "IMMUNOGLOBULIN LIGHT CHAINS FREE EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 124.32, "providers": [{ "billed_charge": 2308.62, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3340.57, "providers": [{ "billed_charge": 53089.23, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF INSULIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83525", "description": "INSULIN; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 111.16, "providers": [{ "billed_charge": 1532.48, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1173.06, "providers": [{ "billed_charge": 6929.93, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 245.96, "providers": [{ "billed_charge": 982.98, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1767.48, "providers": [{ "billed_charge": 14813.46, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 97.24, "providers": [{ "billed_charge": 1943.10, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13452.51, "providers": [{ "billed_charge": 151702.87, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 697.23, "providers": [{ "billed_charge": 2484.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 497.92, "providers": [{ "billed_charge": 1829.12, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF IRON", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83540", "description": "IRON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 162.15, "providers": [{ "billed_charge": 968.02, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 213.84, "providers": [{ "billed_charge": 692.29, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 793.80, "providers": [{ "billed_charge": 10775.10, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 116.62, "providers": [{ "billed_charge": 427.02, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4487.29, "providers": [{ "billed_charge": 51223.53, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 84.24, "providers": [{ "billed_charge": 336.44, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.16, "providers": [{ "billed_charge": 6642.24, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 232.00, "providers": [{ "billed_charge": 900.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.24, "providers": [{ "billed_charge": 29.00, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 459.81, "providers": [{ "billed_charge": 9126.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 401.76, "providers": [{ "billed_charge": 2006.32, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.80, "providers": [{ "billed_charge": 400.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 421.20, "providers": [{ "billed_charge": 3529.50, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26031.24, "providers": [{ "billed_charge": 222658.37, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 176.40, "providers": [{ "billed_charge": 647.20, "npi": [1730617523] } ] }, { "allowed_amount": 92.61, "providers": [{ "billed_charge": 339.78, "npi": [1730617523] } ] } ] } ] }, { "name": "IRON BINDING TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83550", "description": "IRON BINDING CAPACITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 121.40, "providers": [{ "billed_charge": 906.70, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1070.65, "providers": [{ "billed_charge": 14557.90, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5441.85, "providers": [{ "billed_charge": 60859.66, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 113.62, "providers": [{ "billed_charge": 454.48, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.19, "providers": [{ "billed_charge": 12.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.37, "providers": [{ "billed_charge": 11.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 450.11, "providers": [{ "billed_charge": 6804.55, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28544.77, "providers": [{ "billed_charge": 277887.74, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 178.50, "providers": [{ "billed_charge": 655.50, "npi": [1730617523] } ] } ] } ] }, { "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": 4.97, "providers": [{ "billed_charge": 4.97, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 39.26, "providers": [{ "billed_charge": 598.00, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 238.92, "providers": [{ "billed_charge": 3906.54, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 33.22, "providers": [{ "billed_charge": 220.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5021.88, "providers": [{ "billed_charge": 24709.47, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 405.60, "providers": [{ "billed_charge": 1560.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LDH ENZYMES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83625", "description": "LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 179.72, "providers": [{ "billed_charge": 2221.53, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LEAD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83655", "description": "LEAD", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 588.87, "providers": [{ "billed_charge": 9026.92, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2623.14, "providers": [{ "billed_charge": 34559.36, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LIPASE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83690", "description": "LIPASE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.60, "providers": [{ "billed_charge": 137.84, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 805.35, "providers": [{ "billed_charge": 14552.85, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 162.15, "providers": [{ "billed_charge": 3554.07, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3904.63, "providers": [{ "billed_charge": 61250.70, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 365.62, "providers": [{ "billed_charge": 1470.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN(A)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83695", "description": "LIPOPROTEIN (A)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 895.00, "providers": [{ "billed_charge": 7500.00, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2237.94, "providers": [{ "billed_charge": 23910.56, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY LIPOPROTEIN PLA2", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83698", "description": "LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 (LP-PLA2)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 166.74, "providers": [{ "billed_charge": 343.20, "npi": [1234567893] } ] } ] } ] }, { "name": "LIPOPROTEIN BLD QUAN PART", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83704", "description": "LIPOPROTEIN, BLOOD; QUANTITATION OF LIPOPROTEIN PARTICLE NUMBER(S) (EG, BY NUCLEAR MAGNETIC RESONANC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 605.80, "providers": [{ "billed_charge": 2206.94, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF LIPOPROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83718", "description": "LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 94.29, "providers": [{ "billed_charge": 418.00, "npi": [1174172845] } ] } ] } ] }, { "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": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.60, "providers": [{ "billed_charge": 118.98, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 229.11, "providers": [{ "billed_charge": 2408.76, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 199.50, "providers": [{ "billed_charge": 735.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF MAGNESIUM", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83735", "description": "MAGNESIUM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 115.17, "providers": [{ "billed_charge": 1092.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.95, "providers": [{ "billed_charge": 116.55, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 22.80, "providers": [{ "billed_charge": 59.64, "npi": [1053568014] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 194.30, "providers": [{ "billed_charge": 636.50, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.10, "providers": [{ "billed_charge": 234.00, "npi": [1265493688] } ] }, { "allowed_amount": 15.60, "providers": [{ "billed_charge": 52.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 26.80, "providers": [{ "billed_charge": 107.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.00, "providers": [{ "billed_charge": 800.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1881.36, "providers": [{ "billed_charge": 29921.78, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 150.75, "providers": [{ "billed_charge": 3624.52, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 103.85, "providers": [{ "billed_charge": 279.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 368.50, "providers": [{ "billed_charge": 1842.50, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 105.53, "providers": [{ "billed_charge": 2025.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.35, "providers": [{ "billed_charge": 589.68, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11307.36, "providers": [{ "billed_charge": 132046.18, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF METANEPHRINES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83835", "description": "METANEPHRINES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.00, "providers": [{ "billed_charge": 1627.56, "npi": [1234567893] } ] } ] } ] }, { "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": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 98.15, "providers": [{ "billed_charge": 392.60, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1342.92, "providers": [{ "billed_charge": 12488.94, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 137.41, "providers": [{ "billed_charge": 1225.00, "npi": [1194769497] } ] } ] }, { "tin": { 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"value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 285.60, "providers": [{ "billed_charge": 564.40, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 403.20, "providers": [{ "billed_charge": 1008.00, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 672.00, "providers": [{ "billed_charge": 2688.00, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 134.40, "providers": [{ "billed_charge": 569.60, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 949.20, "providers": [{ "billed_charge": 2373.00, "npi": [1841798667] } ] }, { "allowed_amount": 445.20, "providers": [{ "billed_charge": 1113.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 21772.80, "providers": [{ "billed_charge": 322444.80, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1201.20, "providers": [{ "billed_charge": 14444.74, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1092.40, "providers": [{ "billed_charge": 3876.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2163.00, "providers": [{ "billed_charge": 12360.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2788.80, "providers": [{ "billed_charge": 23376.12, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 705.60, "providers": [{ "billed_charge": 4704.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 203876.17, "providers": [{ "billed_charge": 2224530.93, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 549.12, "providers": [{ "billed_charge": 2016.00, "npi": [1730617523] } ] } ] } ] }, { "name": "ASSAY OF TSI 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901.23, "providers": [{ "billed_charge": 18018.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 191.40, "providers": [{ "billed_charge": 765.60, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 580.58, "providers": [{ "billed_charge": 4793.88, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 694.96, "providers": [{ "billed_charge": 9114.76, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 438.32, "providers": [{ "billed_charge": 1710.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF 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[1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1219.68, "providers": [{ "billed_charge": 6098.40, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 29.68, "providers": [{ "billed_charge": 168.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.76, "providers": [{ "billed_charge": 448.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 618.31, "providers": [{ "billed_charge": 5183.73, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 43705.44, "providers": [{ "billed_charge": 979828.13, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1210.65, "providers": [{ "billed_charge": 4446.75, "npi": [1730617523] } ] }, { "allowed_amount": 11.53, "providers": [{ "billed_charge": 42.35, "npi": [1730617523] } ] } ] } ] }, { "name": "T3 REVERSE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84482", "description": "TRIIODOTHYRONINE T3; REVERSE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 234.42, "providers": [{ "billed_charge": 7005.72, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TROPONIN, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84484", "description": "TROPONIN, QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 498.54, "providers": [{ "billed_charge": 10531.24, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF UREA NITROGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84520", "description": "UREA NITROGEN; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.30, "providers": [{ "billed_charge": 14.73, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 172.23, "providers": [{ "billed_charge": 3504.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.77, "providers": [{ "billed_charge": 168.64, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5764.60, "providers": [{ "billed_charge": 7807.62, "npi": [1234567893] } ] } ] } ] }, { "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": 116.63, "providers": [{ "billed_charge": 1119.99, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.36, "providers": [{ "billed_charge": 406.80, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.42, "providers": [{ "billed_charge": 170.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.03, "providers": [{ "billed_charge": 224.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1901.12, "providers": [{ "billed_charge": 34125.22, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 406.80, "providers": [{ "billed_charge": 3407.40, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 216.96, "providers": [{ "billed_charge": 4104.00, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 13488.02, "providers": [{ "billed_charge": 149042.60, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.08, "providers": [{ "billed_charge": 572.00, "npi": [1174172845] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN A", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84590", "description": "VITAMIN A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 357.88, "providers": [{ "billed_charge": 7693.95, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF VITAMIN K", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84597", "description": "VITAMIN K", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1180.85, "providers": [{ "billed_charge": 29890.26, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ZINC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84630", "description": "ZINC", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 551.27, "providers": [{ "billed_charge": 7037.96, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF C-PEPTIDE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84681", "description": "C-PEPTIDE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1211.53, "providers": [{ "billed_charge": 7899.59, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3050.13, "providers": [{ "billed_charge": 25552.53, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 5529.21, "providers": [{ "billed_charge": 40570.49, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84702", "description": "GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2492.28, "providers": [{ "billed_charge": 46253.23, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.24, "providers": [{ "billed_charge": 401.52, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 67.77, "providers": [{ "billed_charge": 451.71, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 45.18, "providers": [{ "billed_charge": 873.00, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11517.88, "providers": [{ "billed_charge": 175867.97, "npi": [1234567893] } ] } ] } ] }, { "name": "CHORIONIC GONADOTROPIN ASSAY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84703", "description": "GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 275.11, "providers": [{ "billed_charge": 4945.88, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1284.78, "providers": [{ "billed_charge": 24753.90, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED DIFF WBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85004", "description": "BLOOD COUNT; AUTOMATED DIFFERENTIAL WBC COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.32, "providers": [{ "billed_charge": 264.30, "npi": [1234567893] } ] } ] } ] }, { "name": "BL SMEAR W/O DIFF WBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85008", "description": "BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITHOUT MANUAL DIFFERENTIAL WBC COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.12, "providers": [{ "billed_charge": 92.68, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMATOCRIT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85014", "description": "BLOOD COUNT; HEMATOCRIT (HCT)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 145.66, "providers": [{ "billed_charge": 2900.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 69.58, "providers": [{ "billed_charge": 484.59, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 382.44, "providers": [{ "billed_charge": 3082.31, "npi": [1234567893] } ] } ] } ] }, { "name": "HEMOGLOBIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85018", "description": "BLOOD COUNT; HEMOGLOBIN (HGB)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 163.61, "providers": [{ "billed_charge": 3306.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 76.68, "providers": [{ "billed_charge": 520.75, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 414.72, "providers": [{ "billed_charge": 3539.26, "npi": [1234567893] } ] } ] } ] }, { "name": "COMPLETE CBC W/AUTO DIFF WBC", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85025", "description": "BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "541882269" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.60, "providers": [{ "billed_charge": 330.00, "npi": [1912903717] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1789.48, "providers": [{ "billed_charge": 11250.03, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] }, { "allowed_amount": 40.80, "providers": [{ "billed_charge": 102.00, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "474075276" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.89, "providers": [{ "billed_charge": 11.66, "npi": [1629454053] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 547.82, "providers": [{ "billed_charge": 1905.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "823021953" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.90, "providers": [{ "billed_charge": 233.10, "npi": [1447760814] } ] } ] }, { "tin": { "type": "ein", "value": "844939989" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.02, "providers": [{ "billed_charge": 419.58, "npi": [1639791007] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3360.96, "providers": [{ "billed_charge": 13392.74, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 136888.74, "providers": [{ "billed_charge": 1078360.24, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 58.35, "providers": [{ "billed_charge": 540.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 35.01, "providers": [{ "billed_charge": 495.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 507.84, "providers": [{ "billed_charge": 1865.28, "npi": [1730617523] } ] }, { "allowed_amount": 5.29, "providers": [{ "billed_charge": 19.43, "npi": [1730617523] } ] } ] }, { "tin": { "type": "ein", "value": "822312224" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 108.78, "providers": [{ "billed_charge": 268.52, "npi": [1689687360] } ] } ] }, { "tin": { "type": "ein", "value": "851486076" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 221.73, "providers": [{ "billed_charge": 567.21, "npi": [1972117349] } ] } ] }, { "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 894.70, "providers": [{ "billed_charge": 6921.61, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "752848936" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 46.68, "providers": [{ "billed_charge": 186.48, "npi": [1295513000] } ] } ] }, { "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.70, "providers": [{ "billed_charge": 39.00, "npi": [1518254309] } ] }, { "allowed_amount": 3.90, "providers": [{ "billed_charge": 13.00, "npi": [1518254309] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["81", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.23, "providers": [{ "billed_charge": 329.00, "npi": [1265493688] } ] }, { "allowed_amount": 4.50, "providers": [{ "billed_charge": 15.00, "npi": [1265493688] } ] } ] }, { "tin": { "type": "ein", "value": "822704194" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 688.53, "providers": [{ "billed_charge": 1770.00, "npi": [1841798667] } ] }, { "allowed_amount": 342.32, "providers": [{ "billed_charge": 880.00, "npi": [1487429874] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15764.96, "providers": [{ "billed_charge": 175615.93, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 420.12, "providers": [{ "billed_charge": 3780.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 662.70, "providers": [{ "billed_charge": 2641.80, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "760430777" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.91, "providers": [{ "billed_charge": 271.95, "npi": [1780730606] } ] } ] }, { "tin": { "type": "ein", "value": "760182737" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.45, "providers": [{ "billed_charge": 38.85, "npi": [1104839380] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1548.22, "providers": [{ "billed_charge": 16448.47, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 40.30, "providers": [{ "billed_charge": 330.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "208015163" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 229.51, "providers": [{ "billed_charge": 2039.32, "npi": [1649459744] } ] } ] }, { "tin": { "type": "ein", "value": "710892430" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 48.60, "providers": [{ "billed_charge": 180.00, "npi": [1154379907] } ] } ] }, { "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.45, "providers": [{ "billed_charge": 97.15, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 563.71, "providers": [{ "billed_charge": 11186.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1206.69, "providers": [{ "billed_charge": 6190.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 287.86, "providers": [{ "billed_charge": 2294.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "742934350" }, "service_code": ["23"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.00, "providers": [{ "billed_charge": 30.00, "npi": [1104034164] } ] } ] } ] }, { "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": 17.96, "providers": [{ "billed_charge": 129.56, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 114.24, "providers": [{ "billed_charge": 285.60, "npi": [1821077728] } ] }, { "allowed_amount": 4.08, "providers": [{ "billed_charge": 10.20, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "756002868" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.22, "providers": [{ "billed_charge": 91.00, "npi": [1326017872] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.96, "providers": [{ "billed_charge": 80.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4535.72, "providers": [{ "billed_charge": 45084.00, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "760611317" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 64.80, "providers": [{ "billed_charge": 440.00, "npi": [1699744144] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.44, "providers": [{ "billed_charge": 840.72, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 116.64, "providers": [{ "billed_charge": 1368.00, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16026.94, "providers": [{ "billed_charge": 145353.68, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED RBC COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85041", "description": "BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 52.49, "providers": [{ "billed_charge": 312.47, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 192.98, "providers": [{ "billed_charge": 1417.42, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED RETICULOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85045", "description": "BLOOD COUNT; RETICULOCYTE, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "943357013" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 132.80, "providers": [{ "billed_charge": 2496.00, "npi": [1982606992] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 88.43, "providers": [{ "billed_charge": 2471.60, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1922.40, "providers": [{ "billed_charge": 28171.89, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "260834681" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.00, "providers": [{ "billed_charge": 384.00, "npi": [1033290077] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 281.88, "providers": [{ "billed_charge": 1008.00, "npi": [1174172845] } ] } ] } ] }, { "name": "RETICYTE/HGB CONCENTRATE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85046", "description": "BLOOD COUNT; RETICULOCYTES, AUTOMATED, INCLUDING 1 OR MORE CELLULAR PARAMETERS (EG, RETICULOCYTE HEM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.80, "providers": [{ "billed_charge": 400.00, "npi": [1134585946] } ] } ] } ] }, { "name": "AUTOMATED LEUKOCYTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85048", "description": "BLOOD COUNT; LEUKOCYTE (WBC), AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.36, "providers": [{ "billed_charge": 113.19, "npi": [1234567893] } ] } ] } ] }, { "name": "AUTOMATED PLATELET COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85049", "description": "BLOOD COUNT; PLATELET, AUTOMATED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.69, "providers": [{ "billed_charge": 11.45, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 354.22, "providers": [{ "billed_charge": 2487.55, "npi": [1234567893] } ] } ] } ] }, { "name": "BLOOD SMEAR INTERPRETATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85060", "description": "BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741761309" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.63, "providers": [{ "billed_charge": 91.00, "npi": [1366964470] } ] } ] }, { "tin": { "type": "ein", "value": "863024305" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.00, "providers": [{ "billed_charge": 125.00, "npi": [1285664755] } ] } ] } ] }, { "name": "CCPD/COMPOSITE", "billing_code_type": "RC", "billing_code_type_version": "2022", "billing_code": "851", "description": "CCPD - OUTPT OR HOME - CCPD/COMPOSITE RATE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "853224374" }, "service_code": ["12"], "billing_class": "institutional", "payments": [{ "allowed_amount": 15123.38, "providers": [{ "billed_charge": 428570.10, "npi": [1609473941] } ] } ] } ] }, { "name": "CLOT FACTOR VIII AHG 1 STAGE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85240", "description": "CLOTTING; FACTOR VIII (AHG), 1-STAGE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 388.96, "providers": [{ "billed_charge": 9526.34, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW RISTOCTN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85245", "description": "CLOTTING; FACTOR VIII, VW FACTOR, RISTOCETIN COFACTOR", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 330.51, "providers": [{ "billed_charge": 5382.41, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT FACTOR VIII VW ANTIGEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85246", "description": "CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 374.54, "providers": [{ "billed_charge": 6738.33, "npi": [1234567893] } ] } ] } ] }, { "name": "ANTITHROMBIN III ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85300", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 123.11, "providers": [{ "billed_charge": 5141.61, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT C ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85303", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 205.40, "providers": [{ "billed_charge": 5605.64, "npi": [1234567893] } ] } ] } ] }, { "name": "CLOT INHIBIT PROT S FREE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85306", "description": "CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 302.41, "providers": [{ "billed_charge": 8595.23, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRIN DEGRADATION, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85379", "description": "FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 109.98, "providers": [{ "billed_charge": 2872.26, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 696.46, "providers": [{ "billed_charge": 20840.78, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRINOGEN ACTIVITY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85384", "description": "FIBRINOGEN; ACTIVITY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.66, "providers": [{ "billed_charge": 131.26, "npi": [1234567893] } ] } ] } ] }, { "name": "FIBRINOLYSINS SCREEN I&R", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85390", "description": "FIBRINOLYSINS OR COAGULOPATHY SCREEN, INTERPRETATION AND REPORT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 1379.34, "providers": [{ "billed_charge": 8558.00, "npi": [1518254309] } ] }, { "allowed_amount": 3596.76, "providers": [{ "billed_charge": 22426.00, "npi": [1518254309] } ] } ] } ] }, { "name": "CLOTTING ASSAY WHOLE BLOOD", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85396", "description": "COAGULATION/FIBRINOLYSIS ASSAY, WHOLE BLOOD (EG, VISCOELASTIC CLOT ASSESSMENT), INCLUDING USE OF ANY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "751664109" }, "service_code": ["22", "23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 100.85, "providers": [{ "billed_charge": 340.00, "npi": [1821077728] } ] }, { "allowed_amount": 80.68, "providers": [{ "billed_charge": 272.00, "npi": [1821077728] } ] }, { "allowed_amount": 584.93, "providers": [{ "billed_charge": 1972.00, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.88, "providers": [{ "billed_charge": 108.00, "npi": [1457609190] }, { "billed_charge": 156.00, "npi": [1457609190] } ] } ] } ] }, { "name": "BLOOD PLATELET AGGREGATION", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85576", "description": "PLATELET, AGGREGATION (IN VITRO), EACH AGENT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741720245" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 750.78, "providers": [{ "billed_charge": 7182.00, "npi": [1518254309] } ] }, { "allowed_amount": 42.14, "providers": [{ "billed_charge": 420.00, "npi": [1699734053] } ] }, { "allowed_amount": 8.73, "providers": [{ "billed_charge": 84.00, "npi": [1003132663] } ] }, { "allowed_amount": 43.65, "providers": [{ "billed_charge": 420.00, "npi": [1003132663] } ] }, { "allowed_amount": 2426.93, "providers": [{ "billed_charge": 23256.00, "npi": [1518254309] } ] } ] }, { "tin": { "type": "ein", "value": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 941.00, "providers": [{ "billed_charge": 941.00, "npi": [1346207214] } ] }, { "allowed_amount": 131.74, "providers": [{ "billed_charge": 131.74, "npi": [1346207214] } ] } ] }, { "tin": { "type": "ein", "value": "203304074" }, "service_code": ["23", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 126.42, "providers": [{ "billed_charge": 2250.00, "npi": [1679580849] } ] }, { "allowed_amount": 177.53, "providers": [{ "billed_charge": 1350.00, "npi": [1679580849] } ] } ] }, { "tin": { "type": "ein", "value": "863024305" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 39.00, "providers": [{ "billed_charge": 192.00, "npi": [1699161356] } ] } ] } ] }, { "name": "PHOSPHOLIPID PLTLT NEUTRALIZ", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85597", "description": "PHOSPHOLIPID NEUTRALIZATION; PLATELET", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 80.60, "providers": [{ "billed_charge": 986.12, "npi": [1234567893] } ] } ] } ] }, { "name": "HEXAGNAL PHOSPH PLTLT NEUTRL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85598", "description": "PHOSPHOLIPID NEUTRALIZATION; HEXAGONAL PHOSPHOLIPID", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 186.16, "providers": [{ "billed_charge": 2445.34, "npi": [1234567893] } ] } ] } ] }, { "name": "PROTHROMBIN TIME", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85610", "description": "PROTHROMBIN TIME;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "810740765" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 20.41, "providers": [{ "billed_charge": 180.00, "npi": [1528514221] } ] } ] }, { "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2.73, "providers": [{ "billed_charge": 43.62, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "751664109" }, "service_code": ["21"], "billing_class": "professional", "payments": [{ "allowed_amount": 60.30, "providers": [{ "billed_charge": 150.75, "npi": [1821077728] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 657.92, "providers": [{ "billed_charge": 11458.54, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.35, "providers": [{ "billed_charge": 274.40, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3226.90, "providers": [{ "billed_charge": 53633.04, "npi": [1234567893] } ] } ] } ] }, { "name": "RUSSELL VIPER VENOM, DILUTED", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "85613", "description": "RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 28.75, "providers": [{ "billed_charge": 502.22, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 454.60, "providers": [{ "billed_charge": 7282.79, "npi": [1234567893] } ] } ] } ] }, { "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": 7.52, "providers": [{ "billed_charge": 152.83, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "752848936" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.30, "providers": [{ "billed_charge": 194.40, "npi": [1295513000] } ] }, { "allowed_amount": 6.75, "providers": [{ "billed_charge": 54.00, "npi": [1770586703] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.10, "providers": [{ "billed_charge": 60.00, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1158.30, "providers": [{ "billed_charge": 30358.90, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.46, "providers": [{ "billed_charge": 165.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 128.25, "providers": [{ "billed_charge": 2992.50, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": 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"ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 272.74, "providers": [{ "billed_charge": 4523.74, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 15-3", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86300", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "222405059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 603.49, "providers": [{ "billed_charge": 6391.60, "npi": [1316322035] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 274.71, "providers": [{ "billed_charge": 4251.86, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3673.24, "providers": [{ "billed_charge": 45055.41, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 19-9", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86301", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 24.98, "providers": [{ "billed_charge": 334.56, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1115.84, "providers": [{ "billed_charge": 14509.22, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY, TUMOR, CA 125", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86304", "description": "IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 524.58, "providers": [{ "billed_charge": 9187.50, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 62.46, "providers": [{ "billed_charge": 249.72, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3973.47, "providers": [{ "billed_charge": 55375.63, "npi": [1234567893] } ] } ] } ] }, { "name": "HETEROPHILE ANTIBODY SCREEN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86308", "description": "HETEROPHILE ANTIBODIES; SCREENING", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.87, "providers": [{ "billed_charge": 780.70, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNOASSAY INFECTIOUS AGENT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86317", "description": "IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT OTHERWISE SPECIFIED", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1555.27, "providers": [{ "billed_charge": 19244.90, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8036.81, "providers": [{ "billed_charge": 82285.30, "npi": [1234567893] } ] } ] } ] }, { "name": "IA INFECTIOUS AGENT ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86318", "description": "IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 63.35, "providers": [{ "billed_charge": 280.00, "npi": [1336758952] } ] } ] } ] }, { "name": "IA NFCT AB SARSCOV2 COVID19", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86328", "description": "IA INFECTIOUS AGT ANTIBODY SARS-COV-2 COVID-19", "allowed_amounts": [{ "tin": { "type": "ein", "value": "993118014" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 19.24, "providers": [{ "billed_charge": 50.00, "npi": [1750747226] } ] } ] } ] }, { "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": "760421006" }, "service_code": ["22", "21"], "billing_class": "professional", "payments": [{ "allowed_amount": 171.18, "providers": [{ "billed_charge": 171.18, "npi": [1346207214] } ] }, { "allowed_amount": 57.06, "providers": [{ "billed_charge": 57.06, "npi": [1346207214] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 495.80, "providers": [{ "billed_charge": 8602.17, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3101.86, "providers": [{ "billed_charge": 49193.06, "npi": [1234567893] } ] } ] } ] }, { "name": "IMMUNFIX E-PHORSIS/URINE/CSF", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86335", "description": "IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS WITH CONCENTRATION (EG, URINE, CSF)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 636.73, "providers": [{ "billed_charge": 7754.12, "npi": [1234567893] } ] } ] } ] }, { "name": "INHIBIN A", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86336", "description": "INHIBIN A", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.49, "providers": [{ "billed_charge": 643.36, "npi": [1234567893] } ] } ] } ] }, { "name": "INSULIN ANTIBODIES", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86337", "description": "INSULIN ANTIBODIES", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 490.15, "providers": [{ "billed_charge": 7743.88, "npi": [1234567893] } ] } ] } ] }, { "name": "ISLET CELL ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86341", "description": "ISLET CELL ANTIBODY", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1539.71, "providers": [{ "billed_charge": 26114.50, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELLS, TOTAL COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86359", "description": "T CELLS; TOTAL COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 207.32, "providers": [{ "billed_charge": 1893.84, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT/RATIO", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86360", "description": "T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 930.27, "providers": [{ "billed_charge": 13663.65, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 15046.71, "providers": [{ "billed_charge": 172853.91, "npi": [1234567893] } ] } ] } ] }, { "name": "T CELL, ABSOLUTE COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86361", "description": "T CELLS; ABSOLUTE CD4 COUNT", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 224.98, "providers": [{ "billed_charge": 2918.58, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4202.58, "providers": [{ "billed_charge": 43539.07, "npi": [1234567893] } ] } ] } ] }, { "name": "TISS TRNSGLTMNASE EA IG CLAS", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86364", "description": "TISSUE TRANSGLUTAMINASE EA IMMUNOGLOBULIN CLASS", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 491.32, "providers": [{ "billed_charge": 13796.08, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1647.94, "providers": [{ "billed_charge": 43411.75, "npi": [1234567893] } ] } ] } ] }, { "name": "MICROSOMAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86376", "description": "MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 131.43, "providers": [{ "billed_charge": 1274.59, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "812244474" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 14.56, "providers": [{ "billed_charge": 58.20, "npi": [1558717827] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2898.36, "providers": [{ "billed_charge": 46712.54, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "843731229" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 538.70, "providers": [{ "billed_charge": 2066.10, "npi": [1336758952] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 356.72, "providers": [{ "billed_charge": 2988.51, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 385.84, "providers": [{ "billed_charge": 5285.48, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 18363.21, "providers": [{ "billed_charge": 238089.02, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 434.34, "providers": [{ "billed_charge": 1700.00, "npi": [1174172845] } ] } ] }, { "tin": { "type": "ein", "value": "821606706" }, "service_code": ["11", "81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.90, "providers": [{ "billed_charge": 36.38, "npi": [1730617523] } ] }, { "allowed_amount": 920.70, "providers": [{ "billed_charge": 3383.34, "npi": [1730617523] } ] } ] } ] }, { "name": "MITOCHONDRIAL ANTIBODY EACH", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86381", "description": "MITOCHONDRIAL ANTIBODY EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 794.04, "providers": [{ "billed_charge": 7622.12, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3266.02, "providers": [{ "billed_charge": 31641.52, "npi": [1234567893] } ] } ] } ] }, { "name": "RHEUMATOID FACTOR, QUANT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86431", "description": "RHEUMATOID FACTOR; QUANTITATIVE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "814697090" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 85.20, "providers": [{ "billed_charge": 425.40, "npi": [1740715333] } ] } ] }, { "tin": { "type": "ein", "value": "473968494" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.66, "providers": [{ "billed_charge": 230.00, "npi": [1134585946] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1553.80, "providers": [{ "billed_charge": 30579.21, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "810576059" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 73.84, "providers": [{ "billed_charge": 618.54, "npi": [1235186800] } ] } ] }, { "tin": { "type": "ein", "value": "742554159" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 133.48, "providers": [{ "billed_charge": 2838.77, "npi": [1194769497] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7603.34, "providers": [{ "billed_charge": 126800.42, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "842769317" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 238.11, "providers": [{ "billed_charge": 792.00, "npi": [1174172845] } ] } ] } ] }, { "name": "TB TEST CELL IMMUN MEASURE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86480", "description": "TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 16772.69, "providers": [{ "billed_charge": 173531.27, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": 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"professional", "payments": [{ "allowed_amount": 1920.00, "providers": [{ "billed_charge": 10799.36, "npi": [1790721538] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 6060.00, "providers": [{ "billed_charge": 34085.48, "npi": [1234567893] } ] } ] } ] }, { "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": "840611484" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 89.10, "providers": [{ "billed_charge": 1351.20, "npi": [1881679751] } ] } ] }, { "tin": { "type": "ein", "value": "382084239" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 4774.50, "providers": [{ 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}, { "tin": { "type": "ein", "value": "746002544" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 390.00, "providers": [{ "billed_charge": 975.00, "npi": [1073588612] } ] } ] }, { "tin": { "type": "ein", "value": "741772120" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 2050.00, "providers": [{ "billed_charge": 5125.00, "npi": [1437218062] } ] } ] }, { "tin": { "type": "ein", "value": "760133493" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1876.16, "providers": [{ "billed_charge": 4690.40, "npi": [1760033526] } ] } ] }, { "tin": { "type": "ein", "value": "746000574" }, "service_code": ["41"], "billing_class": "professional", "payments": [{ "allowed_amount": 1730.46, "providers": [{ "billed_charge": 4326.22, "npi": [1972609337] } ] } ] } ] }, { "name": "INFUS SPL EXT RX INFUS PUMP", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", 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"service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 234.00, "providers": [{ "billed_charge": 900.00, "npi": [1234567893] } ] } ] } ] }, { "name": "OST SKN BARRIER 4X4 EXT W/O", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4385", "description": "OSTOMY SKIN BARRIER, SOLID 4 X 4 OR EQUIVALENT, EXTENDED WEAR, WITHOUT BUILT-IN CONVEXITY, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 884.56, "providers": [{ "billed_charge": 3079.20, "npi": [1234567893] } ] } ] } ] }, { "name": "OSTOMY DEODORANT W/WO LUB PE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4394", "description": "OSTOMY DEODORANT, WITH OR WITHOUT LUBRICANT, FOR USE IN OSTOMY POUCH, PER FL OZ", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 309.81, "providers": [{ "billed_charge": 1265.36, "npi": [1234567893] } ] } ] } ] }, { "name": "ADHESIVE REMOVER, WIPES, ANY", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4456", "description": "ADHESIVE REMOVER, WIPES, ANY TYPE, EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 42.00, "providers": [{ "billed_charge": 300.00, "npi": [1234567893] } ] } ] } ] }, { "name": "INCONTNCE GARMENT ANY TYPE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "A4520", "description": "INCONTINENCE GARMENT, ANY TYPE, (E.G., BRIEF, DIAPER), EACH", "allowed_amounts": [{ "tin": { "type": "ein", "value": "202087851" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2610.76, "providers": [{ "billed_charge": 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"professional", "payments": [{ "allowed_amount": 50360.38, "providers": [{ "billed_charge": 247575.00, "npi": [1144275355] } ] }, { "allowed_amount": 15.25, "providers": [{ "billed_charge": 75.00, "npi": [1619940475] } ] }, { "allowed_amount": 137.25, "providers": [{ "billed_charge": 675.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "811830612" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 61.00, "providers": [{ "billed_charge": 64.16, "npi": [1316044050] } ] } ] }, { "tin": { "type": "ein", "value": "824771503" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1164.35, "providers": [{ "billed_charge": 1460.00, "npi": [1598990772] } ] } ] }, { "tin": { "type": "ein", "value": "208439006" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1529.28, "providers": [{ "billed_charge": 2360.00, "npi": [1649648759] } ] } ] }, { "tin": { "type": "ein", "value": "824472878" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1761.10, "providers": [{ "billed_charge": 2750.00, "npi": [1477916708] } ] } ] }, { "tin": { "type": "ein", "value": "202798379" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 346.58, "providers": [{ "billed_charge": 1052.70, "npi": [1598129702] } ] }, { "allowed_amount": 255.20, "providers": [{ "billed_charge": 765.60, "npi": [1093212821] } ] } ] }, { "tin": { "type": "ein", "value": "752600873" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 709.28, "providers": [{ "billed_charge": 992.00, "npi": [1295350999] } ] } ] }, { "tin": { "type": "ein", "value": "473112502" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.59, "providers": [{ "billed_charge": 49.00, "npi": [1922211697] } ] } ] }, { "tin": { "type": "ein", "value": "741282696" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 620.86, "providers": [{ "billed_charge": 1480.00, "npi": [1679953749] } ] } ] }, { "tin": { "type": "ein", "value": "921381983" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 152.50, "providers": [{ "billed_charge": 500.00, "npi": [1619394756] } ] } ] }, { "tin": { "type": "ein", "value": "461105510" }, "service_code": ["22", "11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1451.52, "providers": [{ "billed_charge": 5600.00, "npi": [1942947593] } ] }, { "allowed_amount": 1218.24, "providers": [{ "billed_charge": 4700.00, "npi": [1184991564] } ] }, { "allowed_amount": 129.60, "providers": [{ "billed_charge": 500.00, "npi": [1184991564] } ] }, { "allowed_amount": 77.76, "providers": [{ "billed_charge": 300.00, "npi": [1942947593] } ] } ] }, { "tin": { "type": "ein", "value": "263275773" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 492.48, "providers": [{ "billed_charge": 3800.00, "npi": [1467182865] } ] }, { "allowed_amount": 289.75, "providers": [{ "billed_charge": 1900.00, "npi": [1326509761] } ] } ] } ] }, { "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": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 5787.90, "providers": [{ "billed_charge": 37583.00, "npi": [1508390816] } ] } ] } ] }, { "name": "RT D 3/> S TX AR CSTM BLK;6-", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6012", "description": "RADIATION TRTMNT DELIVERY, 3 OR MORE SEPARATE TRTMNT AREAS, CUST BLOCKING, TANGENTIAL PORTS, WEDGES,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 13741.92, "providers": [{ "billed_charge": 33600.00, "npi": [1508390816] } ] } ] } ] }, { "name": "RT D 3/> S TX AR CSTM BLK;11", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6013", "description": "RADIATION TRTMNT DELIVERY, 3 OR MORE SEPARATE TRTMNT AREAS, CUST BLOCKING, TANGENTIAL PORTS, WEDGES,", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3163.27, "providers": [{ "billed_charge": 7700.00, "npi": [1508390816] } ] } ] } ] }, { "name": "INTENS MOD TX DEL 1/MX FLDS", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "G6015", "description": "INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS, VIA NARROW SPATIALLY AND TEM", "allowed_amounts": [{ "tin": { "type": "ein", "value": "752512142" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3972.42, "providers": [{ "billed_charge": 10755.00, "npi": [1700220183] } ] } ] }, { "tin": { "type": "ein", "value": "752131429" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 68733.28, "providers": [{ "billed_charge": 425348.00, "npi": [1508390816] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC; GRP CNSL CL", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0005", "description": "ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIAN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760549240" }, "service_code": ["50"], "billing_class": "professional", "payments": [{ "allowed_amount": 459.00, "providers": [{ "billed_charge": 2720.00, "npi": [1962056614] } ] } ] } ] }, { "name": "ALCOHL&/RX SRVC;METHDONE ADM", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0020", "description": "ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG BY A LI", "allowed_amounts": [{ "tin": { "type": "ein", "value": "274250532" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 53.10, "providers": [{ "billed_charge": 113.88, "npi": [1083931562] } ] }, { "allowed_amount": 1193.40, "providers": [{ "billed_charge": 2502.00, "npi": [1770781106] } ] } ] }, { "tin": { "type": "ein", "value": "852856491" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 34308.00, "providers": [{ "billed_charge": 52049.00, "npi": [1205582822] } ] } ] } ] }, { "name": "ORAL MEDADMIN DIR OBSERV", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0033", "description": "ORAL MEDICATION ADMINISTRATION, DIRECT OBSERVATION", "allowed_amounts": [{ "tin": { "type": "ein", "value": "741547909" }, "service_code": ["57"], "billing_class": "professional", "payments": [{ "allowed_amount": 1877.25, "providers": [{ "billed_charge": 7509.00, "npi": [1245769223] } ] } ] } ] }, { "name": "ALCOHOL &/OR DRUG SCREENING", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "H0049", "description": "ALCOHOL AND/OR DRUG SCREENING", "allowed_amounts": [{ "tin": { "type": "ein", "value": "760537608" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 570.00, "providers": [{ "billed_charge": 1425.00, "npi": [1770583411] } ] } ] } ] }, { "name": "INJ CEFTRIAXONE SODM PER 250", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0696", "description": "INJECTION, CEFTRIAXONE SODIUM, PER 250 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 32.21, "providers": [{ "billed_charge": 1376.92, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 54.91, "providers": [{ "billed_charge": 705.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.69, "providers": [{ "billed_charge": 180.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.64, "providers": [{ "billed_charge": 360.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12", "20"], "billing_class": "professional", "payments": [{ "allowed_amount": 953.28, "providers": [{ "billed_charge": 81994.03, "npi": [1234567893] } ] }, { "allowed_amount": 0.98, "providers": [{ "billed_charge": 56.00, "npi": [1234567893] } ] } ] }, { "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 51.60, "providers": [{ "billed_charge": 129.60, "npi": [1447747860] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 182.40, "providers": [{ "billed_charge": 9725.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 149.99, "providers": [{ "billed_charge": 25520.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.84, "providers": [{ "billed_charge": 80.00, "npi": [1316188725] } ] } ] } ] }, { "name": "njection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0872", "description": "njection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2475.00, "providers": [{ "billed_charge": 198114.00, "npi": [1234567893] } ] } ] } ] }, { "name": "INJECTION DAPTOMYCIN 1 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J0878", "description": "INJECTION, DAPTOMYCIN, 1 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "932967816" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 723.00, "providers": [{ "billed_charge": 1687.00, "npi": [1447747860] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 240.00, "providers": [{ "billed_charge": 29934.24, "npi": [1234567893] } ] } ] } ] }, { "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": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.94, "providers": [{ "billed_charge": 2805.80, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "271271893" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 23.70, "providers": [{ "billed_charge": 2640.00, "npi": [1942832191] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 49.69, "providers": [{ "billed_charge": 1608.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "824472878" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.83, "providers": [{ "billed_charge": 255.00, "npi": [1659617827] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.80, "providers": [{ "billed_charge": 700.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "813564692" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 5.10, "providers": [{ "billed_charge": 250.00, "npi": [1972823169] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.45, "providers": [{ "billed_charge": 147.46, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 25.02, "providers": [{ "billed_charge": 6030.00, "npi": [1093920399] } ] } ] }, { "tin": { "type": "ein", "value": "812369811" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 18.36, "providers": [{ "billed_charge": 2700.00, "npi": [1316188725] } ] } ] } ] }, { "name": "INJ ERTAPENEM SODIUM 500MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1335", "description": "INJECTION, ERTAPENEM SODIUM, 500 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 2875.44, "providers": [{ "billed_charge": 82264.01, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ KETOROLAC TROMETHAMINE", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J1885", "description": "INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 27.60, "providers": [{ "billed_charge": 1185.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "824472878" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 13.43, "providers": [{ "billed_charge": 190.00, "npi": [1659617827] } ] } ] }, { "tin": { "type": "ein", "value": "832666588" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 78.63, "providers": [{ "billed_charge": 1285.00, "npi": [1063072734] } ] } ] }, { "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 37.35, "providers": [{ "billed_charge": 1572.00, "npi": [1114210416] } ] } ] }, { "tin": { "type": "ein", "value": "464725163" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.57, "providers": [{ "billed_charge": 24.12, "npi": [1942535828] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 336.50, "providers": [{ "billed_charge": 9110.00, "npi": [1144275355] } ] } ] }, { "tin": { "type": "ein", "value": "843627265" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.35, "providers": [{ "billed_charge": 2550.00, "npi": [1093920399] } ] } ] } ] }, { "name": "INJECTION MEROPENEM 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2185", "description": "INJECTION, MEROPENEM, 100 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 1659.00, "providers": [{ "billed_charge": 47914.65, "npi": [1234567893] } ] } ] } ] }, { "name": "INJ MILRINONE LACTATE 5 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2260", "description": "INJECTION, MILRINONE LACTATE, 5 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "61639157" }, "service_code": ["12"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.51, "providers": [{ "billed_charge": 2955.03, "npi": [1952429219] } ] } ] } ] }, { "name": "INJ PROMETHAZINE HCL UPTO 50", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2550", "description": "INJECTION, PROMETHAZINE HCL, UP TO 50 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 41.14, "providers": [{ "billed_charge": 280.00, "npi": [1144275355] } ] } ] } ] }, { "name": "Injection, methylprednisolone sodium succinate, 5 mg", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J2919", "description": "Injection, methylprednisolone sodium succinate, 5 mg", "allowed_amounts": [{ "tin": { "type": "ein", "value": "921457580" }, "service_code": ["20"], "billing_class": "professional", "payments": [{ "allowed_amount": 245.51, "providers": [{ "billed_charge": 2342.40, "npi": [1114210416] } ] } ] } ] }, { "name": "INJ TRIAMCINOLON ACETONID NO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3301", "description": "INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.43, "providers": [{ "billed_charge": 90.00, "npi": [1841497393] } ] } ] } ] }, { "name": "INJ PYRIDOXINE HCL 100 MG", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3415", "description": "INJECTION, PYRIDOXINE HCL, 100 MG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "815097602" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 297.91, "providers": [{ "billed_charge": 2125.00, "npi": [1649235490] } ] } ] } ] }, { "name": "INJ VIT B-12 CYNOCOBLMN TO", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": "J3420", "description": "INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1,000 MCG", "allowed_amounts": [{ "tin": { "type": "ein", "value": "833128725" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 15.77, "providers": [{ "billed_charge": 290.00, "npi": [1841497393] } ] } ] }, { "tin": { "type": "ein", "value": "470874059" }, "service_code": ["11"], "billing_class": "professional", "payments": [{ "allowed_amount": 38.66, "providers": [{ "billed_charge": 600.00, "npi": [1144275355] } ] } ] } ] }, { "name": "INFUS NORMAL SALINE SOL 1000", "billing_code_type": "HCPCS", "billing_code_type_version": "2022", "billing_code": 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