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"tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2046.09, "providers": [{ "billed_charge": 19728.80, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF CK (CPK)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82550", "description": "CREATINE KINASE (CK), (CPK); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 12.55, "providers": [{ "billed_charge": 135.89, "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 333.50, "providers": [{ "billed_charge": 714.84, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 79.33, "providers": [{ "billed_charge": 996.45, "npi": [1234567893] } ] } ] } ] }, { "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 738.85, "providers": [{ "billed_charge": 1583.40, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 765.79, "providers": [{ "billed_charge": 8755.95, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF ESTRADIOL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82670", "description": "ESTRADIOL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 414.73, "providers": [{ "billed_charge": 4308.52, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF FERRITIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "82728", "description": "FERRITIN", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 572.40, "providers": [{ "billed_charge": 1226.70, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 185.47, "providers": [{ "billed_charge": 2155.55, "npi": [1234567893] } ] } ] } ] }, { "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 329.28, "providers": [{ "billed_charge": 705.60, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 267.29, "providers": [{ "billed_charge": 3093.64, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (FSH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83001", "description": "GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 258.94, "providers": [{ "billed_charge": 2721.82, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF GONADOTROPIN (LH)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83002", "description": "GONADOTROPIN; LUTEINIZING HORMONE (LH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 8.33, "providers": [{ "billed_charge": 81.75, "npi": [1234567893] } ] } ] } ] }, { "name": "GLYCOSYLATED HEMOGLOBIN TEST", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83036", "description": "HEMOGLOBIN; GLYCOSYLATED (A1C)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1929.78, "providers": [{ "billed_charge": 4136.46, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 934.14, "providers": [{ "billed_charge": 11469.14, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 7.64, "providers": [{ "billed_charge": 91.44, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF IRON", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "83540", "description": "IRON", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 190.26, "providers": [{ "billed_charge": 407.61, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 71.98, "providers": [{ "billed_charge": 873.52, "npi": [1234567893] } ] } ] } ] }, { "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 257.04, "providers": [{ "billed_charge": 550.62, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 90.41, "providers": [{ "billed_charge": 999.22, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PROGESTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84144", "description": "PROGESTERONE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 413.78, "providers": [{ "billed_charge": 4393.05, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF PSA, TOTAL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84153", "description": "PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 70.96, "providers": [{ "billed_charge": 648.82, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF SEX HORMONE GLOBUL", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84270", "description": "SEX HORMONE BINDING GLOBULIN (SHBG)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 234.69, "providers": [{ "billed_charge": 1988.31, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF TOTAL TESTOSTERONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84403", "description": "TESTOSTERONE; TOTAL", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 144.52, "providers": [{ "billed_charge": 309.72, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 534.03, "providers": [{ "billed_charge": 6124.29, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY OF FREE THYROXINE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84439", "description": "THYROXINE; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 479.94, "providers": [{ "billed_charge": 1028.28, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 158.36, "providers": [{ "billed_charge": 2568.46, "npi": [1234567893] } ] } ] } ] }, { "name": "ASSAY THYROID STIM HORMONE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84443", "description": "THYROID STIMULATING HORMONE (TSH)", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3245.76, "providers": [{ "billed_charge": 6955.20, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1790.76, "providers": [{ "billed_charge": 16424.97, "npi": [1234567893] } ] } ] } ] }, { "name": "FREE ASSAY (FT-3)", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "84481", "description": "TRIIODOTHYRONINE T3; FREE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 166.04, "providers": [{ "billed_charge": 355.74, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 222.72, "providers": [{ "billed_charge": 2367.54, "npi": [1234567893] } ] } ] } ] }, { "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": 43.91, "providers": [{ "billed_charge": 540.03, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 81.79, "providers": [{ "billed_charge": 1263.43, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 50.30, "providers": [{ "billed_charge": 602.00, "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 2306.56, "providers": [{ "billed_charge": 4941.72, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 893.73, "providers": [{ "billed_charge": 7963.01, "npi": [1234567893] } ] } ] } ] }, { "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 389.58, "providers": [{ "billed_charge": 834.63, "npi": [1811154388] } ] } ] } ] }, { "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": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 3.78, "providers": [{ "billed_charge": 8.10, "npi": [1811154388] } ] } ] } ] }, { "name": "C-REACTIVE PROTEIN", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86140", "description": "C-REACTIVE PROTEIN;", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 101.50, "providers": [{ "billed_charge": 217.56, "npi": [1811154388] } ] } ] } ] }, { "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 31.06, "providers": [{ "billed_charge": 320.20, "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": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 1.43, "providers": [{ "billed_charge": 17.08, "npi": [1234567893] } ] } ] } ] }, { "name": "RUBELLA ANTIBODY", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "86762", "description": "ANTIBODY; RUBELLA", "allowed_amounts": [{ "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 9.62, "providers": [{ "billed_charge": 115.12, "npi": [1234567893] } ] } ] } ] }, { "name": "URINE CULTURE/COLONY COUNT", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87086", "description": "CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE", "allowed_amounts": [{ "tin": { "type": "ein", "value": "610445850" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 418.10, "providers": [{ "billed_charge": 895.77, "npi": [1811154388] } ] } ] }, { "tin": { "type": "ein", "value": "999999999" }, "service_code": ["81"], "billing_class": "professional", "payments": [{ "allowed_amount": 11.01, "providers": [{ "billed_charge": 86.19, "npi": [1234567893] } ] } ] } ] }, { "name": "CANDIDA, DNA, AMP PROBE", "billing_code_type": "CPT", "billing_code_type_version": "2022", "billing_code": "87481", "description": "INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); 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