{"reporting_entity_name":"Centene Management Company LLC","reporting_entity_type":"Third Party Administrator","version":"2.0.0","last_updated_on":"2026-10-27","out_of_network":[{"name":"NCNTC R-T FLUOR WND IMG 1ST","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"0598T","description":"NONCONTACT R-T FLUOR WND IMG 1ST ANATOMIC SITE","allowed_amounts":[{"tin":{"type":"ein","value":"823546697"},"service_code":["11","12"],"billing_class":"professional","payments":[{"allowed_amount":30.49,"providers":[{"billed_charge":350.00,"npi":[1306126263]}]},{"allowed_amount":416.42,"providers":[{"billed_charge":4900.00,"npi":[1306126263]}]},{"allowed_amount":380.71,"providers":[{"billed_charge":4550.00,"npi":[1952900581]}]}]}]},{"name":"NCNTC R-T FLUOR WND IMG EA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"0599T","description":"NONCONTACT R-T FLUOR WND IMG EA ADDL ANTMC SITE","allowed_amounts":[{"tin":{"type":"ein","value":"823546697"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":81.32,"providers":[{"billed_charge":500.00,"npi":[1952900581]}]}]}]},{"name":"RESIDENTIAL TREATMENT - CHEM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1002","description":"BEHAVIORAL HEALTH ACCOMMODATIONS - RESIDENTIAL TREATMENT - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"640528487"},"service_code":["56"],"billing_class":"institutional","payments":[{"allowed_amount":13891.50,"providers":[{"billed_charge":17700.00,"npi":[1982610572]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":186984.00,"providers":[{"billed_charge":1272000.00,"npi":[1356703524]}]}]}]},{"name":"DEB SUBQ TISSUE 20 SQ CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"11042","description":"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LE","allowed_amounts":[{"tin":{"type":"ein","value":"823546697"},"service_code":["11","12"],"billing_class":"professional","payments":[{"allowed_amount":728.58,"providers":[{"billed_charge":1772.88,"npi":[1952900581]}]},{"allowed_amount":1517.88,"providers":[{"billed_charge":3841.24,"npi":[1306126263]}]},{"allowed_amount":242.86,"providers":[{"billed_charge":590.96,"npi":[1306126263]}]}]},{"tin":{"type":"ein","value":"646010402"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":411.67,"providers":[{"billed_charge":1330.00,"npi":[1205355765]}]}]},{"tin":{"type":"ein","value":"621519754"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":2081.58,"providers":[{"billed_charge":7037.00,"npi":[1083432025]}]}]},{"tin":{"type":"ein","value":"300852649"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":49.99,"providers":[{"billed_charge":254.00,"npi":[1548885759]}]}]}]},{"name":"PSTAY/PVT","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"114","description":"ROOM AND BOARD - PRIVATE -PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"646001587"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":150535.49,"providers":[{"billed_charge":134389.85,"npi":[1225041809]}]}]}]},{"name":"DETOX/2 BED","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"126","description":"ROOM AND BOARD - SEMI PRIVATE TWO BED -DETOXIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"471052932"},"service_code":["21"],"billing_class":"institutional","payments":[{"allowed_amount":11907.00,"providers":[{"billed_charge":94500.00,"npi":[1356703524]}]}]}]},{"name":"PHARMACY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"250","description":"PHARMACY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":174.75,"providers":[{"billed_charge":582.45,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":200.69,"providers":[{"billed_charge":1621.41,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":818.95,"providers":[{"billed_charge":2729.76,"npi":[1578568481]}]}]}]},{"name":"DRUGS/INCIDNT RAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"255","description":"PHARMACY - DRUGS INCIDENT TO RADIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":390.32,"providers":[{"billed_charge":1301.07,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":506.50,"providers":[{"billed_charge":506.50,"npi":[1912341439]}]}]}]},{"name":"IV SOLUTIONS","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"258","description":"PHARMACY - IV SOLUTIONS","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":91.19,"providers":[{"billed_charge":305.05,"npi":[1386709871]}]},{"allowed_amount":98.08,"providers":[{"billed_charge":326.85,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":546.73,"providers":[{"billed_charge":546.73,"npi":[1912341439]}]}]}]},{"name":"IV THERAPY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"260","description":"IV THERAPY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":5340.60,"providers":[{"billed_charge":9271.00,"npi":[1558365890]}]},{"allowed_amount":802.12,"providers":[{"billed_charge":3068.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6612.09,"providers":[{"billed_charge":29219.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4844.60,"providers":[{"billed_charge":21738.00,"npi":[1366436123]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2000.06,"providers":[{"billed_charge":10892.00,"npi":[1578568481]}]}]}]},{"name":"LABORATORY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"300","description":"LABORATORY - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3.00,"providers":[{"billed_charge":2135.00,"npi":[1558365890]}]},{"allowed_amount":1924.28,"providers":[{"billed_charge":4554.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":4445.73,"providers":[{"billed_charge":7175.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":47.08,"providers":[{"billed_charge":411.75,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"720502505"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":334.97,"providers":[{"billed_charge":664.00,"npi":[1811973100]}]}]},{"tin":{"type":"ein","value":"410695596"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3079.07,"providers":[{"billed_charge":3085.65,"npi":[1043269798]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7254.84,"providers":[{"billed_charge":53912.96,"npi":[1578568481]}]}]}]},{"name":"LAB/CHEMISTRY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"301","description":"LABORATORY - CHEMISTRY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7015.42,"providers":[{"billed_charge":10791.00,"npi":[1558365890]}]},{"allowed_amount":601.98,"providers":[{"billed_charge":663.00,"npi":[1386709871]}]}]},{"tin":{"type":"ein","value":"581790149"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":302.53,"providers":[{"billed_charge":1197.00,"npi":[1801883780]}]}]},{"tin":{"type":"ein","value":"621821558"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":403.67,"providers":[{"billed_charge":3824.11,"npi":[1457321036]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":14648.08,"providers":[{"billed_charge":34053.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":18.22,"providers":[{"billed_charge":4568.25,"npi":[1841394418]}]},{"allowed_amount":194.38,"providers":[{"billed_charge":2102.25,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":114.98,"providers":[{"billed_charge":20769.00,"npi":[1366436123]}]}]},{"tin":{"type":"ein","value":"451834769"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2289.74,"providers":[{"billed_charge":7592.00,"npi":[1144227539]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":5083.89,"providers":[{"billed_charge":20938.00,"npi":[1578568481]}]}]}]},{"name":"LAB/IMMUNOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"302","description":"LABORATORY - IMMUNOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":22.36,"providers":[{"billed_charge":57.00,"npi":[1558365890]}]}]}]},{"name":"LAB/HEMATOLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"305","description":"LABORATORY - HEMATOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":16.00,"providers":[{"billed_charge":16.00,"npi":[1386709871]}]},{"allowed_amount":1785.84,"providers":[{"billed_charge":2943.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":3105.22,"providers":[{"billed_charge":8851.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":601.12,"providers":[{"billed_charge":4810.00,"npi":[1578568481]}]}]}]},{"name":"LAB/BACT-MIRCO","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"306","description":"LABORATORY - BACTERIOLOGY & MICROBIOLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":164.75,"providers":[{"billed_charge":461.00,"npi":[1912341439]}]}]}]},{"name":"LAB/UROLOGY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"307","description":"LABORATORY - UROLOGY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":377.94,"providers":[{"billed_charge":414.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":886.86,"providers":[{"billed_charge":1376.00,"npi":[1912341439]}]}]}]},{"name":"DX X-RAY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"320","description":"RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1060.76,"providers":[{"billed_charge":2332.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":452.22,"providers":[{"billed_charge":3379.00,"npi":[1912341439]}]}]}]},{"name":"DX X-RAY/CHEST","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"324","description":"RADIOLOGY - DIAGNOSTIC - CHEST X-RAY","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":267.77,"providers":[{"billed_charge":464.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2011.27,"providers":[{"billed_charge":10672.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":718.00,"providers":[{"billed_charge":2214.00,"npi":[1578568481]}]}]}]},{"name":"RADIATION RX","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"333","description":"RADIOLOGY--THERAPEUTIC - RADIATION THERAPY","allowed_amounts":[{"tin":{"type":"ein","value":"636000271"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3100.46,"providers":[{"billed_charge":9248.00,"npi":[1841394418]}]}]}]},{"name":"CT SCAN","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"350","description":"CT SCAN - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":6830.13,"providers":[{"billed_charge":27467.00,"npi":[1578568481]}]}]}]},{"name":"CT SCAN/HEAD","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"351","description":"CT SCAN - HEAD SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"640889822"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":3563.92,"providers":[{"billed_charge":31850.00,"npi":[1912341439]}]},{"allowed_amount":98.56,"providers":[{"billed_charge":3394.00,"npi":[1912341439]}]}]}]},{"name":"CT SCAN/BODY","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"352","description":"CT SCAN - BODY SCAN","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7316.28,"providers":[{"billed_charge":24756.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":17985.28,"providers":[{"billed_charge":196172.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":94.20,"providers":[{"billed_charge":2138.00,"npi":[1366436123]}]},{"allowed_amount":316.10,"providers":[{"billed_charge":4771.00,"npi":[1366436123]}]}]}]},{"name":"ROUTINE VENIPUNCTURE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"36415","description":"COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE","allowed_amounts":[{"tin":{"type":"ein","value":"471613586"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.88,"providers":[{"billed_charge":40.00,"npi":[1922767938]}]}]},{"tin":{"type":"ein","value":"621695507"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":4.67,"providers":[{"billed_charge":18.00,"npi":[1942526447]}]},{"allowed_amount":5426.54,"providers":[{"billed_charge":20916.00,"npi":[1942526447]}]}]},{"tin":{"type":"ein","value":"630995963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":55.58,"providers":[{"billed_charge":140.00,"npi":[1700557915]}]},{"allowed_amount":65.38,"providers":[{"billed_charge":140.00,"npi":[1407895725]}]},{"allowed_amount":87.34,"providers":[{"billed_charge":220.00,"npi":[1114395050]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":29.20,"providers":[{"billed_charge":135.00,"npi":[1326650110]}]}]},{"tin":{"type":"ein","value":"934244735"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":58.40,"providers":[{"billed_charge":200.00,"npi":[1922559772]}]}]},{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":43.67,"providers":[{"billed_charge":110.00,"npi":[1114701570]}]}]},{"tin":{"type":"ein","value":"640655662"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":54.56,"providers":[{"billed_charge":264.00,"npi":[1194956755]}]}]},{"tin":{"type":"ein","value":"275099507"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.16,"providers":[{"billed_charge":6.00,"npi":[1518113166]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":46.25,"providers":[{"billed_charge":90.00,"npi":[1629186382]}]}]},{"tin":{"type":"ein","value":"272255038"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":46.72,"providers":[{"billed_charge":200.00,"npi":[1306211164]}]}]},{"tin":{"type":"ein","value":"821078593"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.28,"providers":[{"billed_charge":360.00,"npi":[1295187789]}]}]},{"tin":{"type":"ein","value":"640770155"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":10.28,"providers":[{"billed_charge":16.00,"npi":[1376004150]}]},{"allowed_amount":35.73,"providers":[{"billed_charge":72.00,"npi":[1609323450]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2637.60,"providers":[{"billed_charge":11340.00,"npi":[1234567893]}]}]}]},{"name":"EMERG ROOM","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"450","description":"EMERGENCY ROOM - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":51055.18,"providers":[{"billed_charge":90424.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"621821558"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1939.94,"providers":[{"billed_charge":23086.46,"npi":[1457321036]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":36871.49,"providers":[{"billed_charge":270818.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":45946.28,"providers":[{"billed_charge":48839.00,"npi":[1366436123]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":52238.61,"providers":[{"billed_charge":69802.00,"npi":[1578568481]}]}]}]},{"name":"AMBUL SURG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"490","description":"AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"621826300"},"service_code":["24"],"billing_class":"institutional","payments":[{"allowed_amount":255.46,"providers":[{"billed_charge":8943.39,"npi":[1720001928]}]}]}]},{"name":"RURAL/CLINIC","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"521","description":"FREE-STANDING CLINIC - RURAL HEALTH-CLINIC","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["50"],"billing_class":"institutional","payments":[{"allowed_amount":14284.60,"providers":[{"billed_charge":26120.09,"npi":[1234567893]}]}]}]},{"name":"DRUG/DETAIL CODE","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"636","description":"DRUGS REQ SPEC IDENTIFICATION - DRUGS REQ DETAILED CODING*","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1889.42,"providers":[{"billed_charge":5338.19,"npi":[1386709871]}]},{"allowed_amount":9784.50,"providers":[{"billed_charge":48293.00,"npi":[1558365890]}]},{"allowed_amount":505.69,"providers":[{"billed_charge":1541.71,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":7550.75,"providers":[{"billed_charge":23452.89,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"463123178"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2.50,"providers":[{"billed_charge":561.32,"npi":[1093140600]}]}]},{"tin":{"type":"ein","value":"636000271"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":1.58,"providers":[{"billed_charge":819.60,"npi":[1841394418]}]},{"allowed_amount":0.68,"providers":[{"billed_charge":2786.97,"npi":[1841394418]}]}]},{"tin":{"type":"ein","value":"720423651"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":130.80,"providers":[{"billed_charge":7531.20,"npi":[1366436123]}]}]},{"tin":{"type":"ein","value":"451834769"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1141.27,"providers":[{"billed_charge":3804.21,"npi":[1144227539]}]}]},{"tin":{"type":"ein","value":"410695596"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":793.43,"providers":[{"billed_charge":2644.77,"npi":[1043269798]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":10656.30,"providers":[{"billed_charge":35520.80,"npi":[1578568481]}]}]},{"tin":{"type":"ein","value":"720502505"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":52.23,"providers":[{"billed_charge":174.10,"npi":[1811973100]}]}]},{"tin":{"type":"ein","value":"432035443"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":930.30,"providers":[{"billed_charge":3101.00,"npi":[1457347239]}]}]},{"tin":{"type":"ein","value":"720685044"},"service_code":["22","23"],"billing_class":"institutional","payments":[{"allowed_amount":24621.78,"providers":[{"billed_charge":181588.60,"npi":[1356399539]}]},{"allowed_amount":1.80,"providers":[{"billed_charge":6.00,"npi":[1356399539]}]}]}]},{"name":"HOSPICE/RTN HOME","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"651","description":"HOSPICE SERVICES - ROUTINE HOME CARE","allowed_amounts":[{"tin":{"type":"ein","value":"640899562"},"service_code":["34"],"billing_class":"institutional","payments":[{"allowed_amount":25428.00,"providers":[{"billed_charge":32600.00,"npi":[1518219773]}]}]}]},{"name":"CT HEAD/BRAIN W/O DYE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"70450","description":"COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL","allowed_amounts":[{"tin":{"type":"ein","value":"933793422"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":195.06,"providers":[{"billed_charge":450.00,"npi":[1437577517]}]}]},{"tin":{"type":"ein","value":"640409419"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":338.22,"providers":[{"billed_charge":1782.00,"npi":[1497312664]}]},{"allowed_amount":112.74,"providers":[{"billed_charge":594.00,"npi":[1497312664]}]},{"allowed_amount":150.32,"providers":[{"billed_charge":792.00,"npi":[1497312664]}]}]}]},{"name":"X-RAY EXAM CHEST 1 VIEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71045","description":"RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW","allowed_amounts":[{"tin":{"type":"ein","value":"640409419"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":15.96,"providers":[{"billed_charge":68.00,"npi":[1497312664]}]},{"allowed_amount":63.84,"providers":[{"billed_charge":272.00,"npi":[1497312664]}]},{"allowed_amount":7.98,"providers":[{"billed_charge":34.00,"npi":[1497312664]}]}]},{"tin":{"type":"ein","value":"640863698"},"service_code":["22","23","21"],"billing_class":"professional","payments":[{"allowed_amount":23.94,"providers":[{"billed_charge":105.00,"npi":[1306993282]}]},{"allowed_amount":71.82,"providers":[{"billed_charge":315.00,"npi":[1366479115]}]},{"allowed_amount":39.90,"providers":[{"billed_charge":175.00,"npi":[1306993282,1366479115]}]},{"allowed_amount":31.92,"providers":[{"billed_charge":140.00,"npi":[1306993282]}]}]}]},{"name":"X-RAY EXAM CHEST 2 VIEWS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"71046","description":"RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS","allowed_amounts":[{"tin":{"type":"ein","value":"640409419"},"service_code":["22","11","23","21"],"billing_class":"professional","payments":[{"allowed_amount":38.24,"providers":[{"billed_charge":164.00,"npi":[1497312664]}]},{"allowed_amount":47.80,"providers":[{"billed_charge":205.00,"npi":[1497312664]}]},{"allowed_amount":19.12,"providers":[{"billed_charge":82.00,"npi":[1497312664]}]},{"allowed_amount":9.56,"providers":[{"billed_charge":41.00,"npi":[1497312664]}]}]}]},{"name":"EKG/ECG","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"730","description":"EKG/ECG - GENERAL CLASSIFICATION","allowed_amounts":[{"tin":{"type":"ein","value":"620479367"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":640.60,"providers":[{"billed_charge":1508.00,"npi":[1558365890]}]}]},{"tin":{"type":"ein","value":"640889822"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":2823.20,"providers":[{"billed_charge":15080.00,"npi":[1912341439]}]}]},{"tin":{"type":"ein","value":"726014895"},"service_code":["23"],"billing_class":"institutional","payments":[{"allowed_amount":1426.18,"providers":[{"billed_charge":3654.00,"npi":[1578568481]}]}]}]},{"name":"CT ABD & PELV W/CONTRAST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"74177","description":"COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S)","allowed_amounts":[{"tin":{"type":"ein","value":"933793422"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":138.32,"providers":[{"billed_charge":384.00,"npi":[1437577517]}]}]}]},{"name":"FETAL BIOPHYS PROFIL W/O NST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76819","description":"FETAL BIOPHYSICAL PROFILE; WITHOUT NON-STRESS TESTING","allowed_amounts":[{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":567.90,"providers":[{"billed_charge":2025.00,"npi":[1013930122]}]}]}]},{"name":"TRANSVAGINAL US, NON-OB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"76830","description":"ULTRASOUND, TRANSVAGINAL","allowed_amounts":[{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":212.34,"providers":[{"billed_charge":630.00,"npi":[1396306957]}]},{"allowed_amount":83.28,"providers":[{"billed_charge":210.00,"npi":[1013930122]}]}]}]},{"name":"BREAST TOMOSYNTHESIS BI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77063","description":"SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P","allowed_amounts":[{"tin":{"type":"ein","value":"412007905"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":641.52,"providers":[{"billed_charge":2664.00,"npi":[1477930162]}]}]},{"tin":{"type":"ein","value":"200289504"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1678.05,"providers":[{"billed_charge":5625.00,"npi":[1336187947]}]}]}]},{"name":"SCR MAMMO BI INCL CAD","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77067","description":"SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (","allowed_amounts":[{"tin":{"type":"ein","value":"412007905"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":819.41,"providers":[{"billed_charge":3525.00,"npi":[1477930162]}]}]},{"tin":{"type":"ein","value":"200289504"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4298.40,"providers":[{"billed_charge":15936.00,"npi":[1336187947]}]}]}]},{"name":"GUIDANCE FOR RADIAJ TX DLVR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77387","description":"GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR DELIVERY OF RADIATION TREATMENT DELIVERY, INCLUDES IN","allowed_amounts":[{"tin":{"type":"ein","value":"640586958"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":215.47,"providers":[{"billed_charge":880.00,"npi":[1699777854]}]}]}]},{"name":"RADIATION TREATMENT DELIVERY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"77407","description":"RADIATION TREATMENT DELIVERY, =>1 MEV; INTERMEDIATE","allowed_amounts":[{"tin":{"type":"ein","value":"621526296"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1349.60,"providers":[{"billed_charge":6047.82,"npi":[1285869362]}]}]}]},{"name":"METABOLIC PANEL TOTAL CA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80048","description":"BASIC METABOLIC PANEL (CALCIUM, TOTAL) THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM, TOTAL (82310)","allowed_amounts":[{"tin":{"type":"ein","value":"620846885"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":4.44,"providers":[{"billed_charge":28.00,"npi":[1053725564]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":800.10,"providers":[{"billed_charge":7550.86,"npi":[1234567893]}]}]}]},{"name":"COMPREHEN METABOLIC PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80053","description":"COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTA","allowed_amounts":[{"tin":{"type":"ein","value":"646001350"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":34.86,"providers":[{"billed_charge":760.92,"npi":[1629186382]}]}]},{"tin":{"type":"ein","value":"640770155"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":26.94,"providers":[{"billed_charge":228.00,"npi":[1609323450]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":14796.25,"providers":[{"billed_charge":150693.41,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"640655662"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":33.66,"providers":[{"billed_charge":264.00,"npi":[1194956755]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13338.36,"providers":[{"billed_charge":142701.59,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":105.57,"providers":[{"billed_charge":972.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":407.17,"providers":[{"billed_charge":5700.00,"npi":[1234567893]}]}]}]},{"name":"HEPATIC FUNCTION PANEL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80076","description":"HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (8224","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":99.36,"providers":[{"billed_charge":1036.80,"npi":[1234567893]}]}]}]},{"name":"DRUG SCRN QUAN LEVETIRACETAM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80177","description":"LEVETIRACETAM","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5.96,"providers":[{"billed_charge":75.00,"npi":[1234567893]}]}]}]},{"name":"DRUG TEST PRSMV DIR OPT OBS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80305","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; CAPABLE ","allowed_amounts":[{"tin":{"type":"ein","value":"815000928"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":899.68,"providers":[{"billed_charge":1584.00,"npi":[1770367716]}]}]}]},{"name":"DRUG TEST PRSMV INSTRMNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80306","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; READ BY ","allowed_amounts":[{"tin":{"type":"ein","value":"811097331"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":148.25,"providers":[{"billed_charge":280.00,"npi":[1689781007]}]}]}]},{"name":"DRUG TEST PRSMV CHEM ANLYZR","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"80307","description":"DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES; BY INSTR","allowed_amounts":[{"tin":{"type":"ein","value":"421633186"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":66.02,"providers":[{"billed_charge":158.00,"npi":[1376814533]}]}]},{"tin":{"type":"ein","value":"201236503"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":248.56,"providers":[{"billed_charge":1491.36,"npi":[1225110497]}]}]},{"tin":{"type":"ein","value":"473479587"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1400.79,"providers":[{"billed_charge":11013.78,"npi":[1891182812]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2938.92,"providers":[{"billed_charge":15845.35,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS AUTO W/SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81001","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":316.03,"providers":[{"billed_charge":5304.00,"npi":[1234567893]}]}]}]},{"name":"URINALYSIS AUTO W/O SCOPE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81003","description":"URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, ","allowed_amounts":[{"tin":{"type":"ein","value":"630995963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.84,"providers":[{"billed_charge":40.00,"npi":[1700557915]}]},{"allowed_amount":14.40,"providers":[{"billed_charge":150.00,"npi":[1114395050]}]}]},{"tin":{"type":"ein","value":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.96,"providers":[{"billed_charge":21.00,"npi":[1336981836]}]}]}]},{"name":"URINE PREGNANCY TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81025","description":"URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS","allowed_amounts":[{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":94.82,"providers":[{"billed_charge":572.00,"npi":[1013930122]}]},{"allowed_amount":124.44,"providers":[{"billed_charge":884.00,"npi":[1396306957]}]}]}]},{"name":"NFCT DS BV RNA VAG FLU ALG","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"81513","description":"NFCT DS BACTERAL VAGINOSIS RNA VAGINAL-FLUID ALG","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4279.20,"providers":[{"billed_charge":21394.80,"npi":[1093753303]}]}]}]},{"name":"ASSAY OF ACTH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82024","description":"ADRENOCORTICOTROPIC HORMONE (ACTH)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":17.38,"providers":[{"billed_charge":180.00,"npi":[1234567893]}]}]}]},{"name":"MICROALBUMIN, QUANTITATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82043","description":"ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE","allowed_amounts":[{"tin":{"type":"ein","value":"646001350"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":3.18,"providers":[{"billed_charge":63.79,"npi":[1629186382]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1027.00,"providers":[{"billed_charge":16665.05,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF AMYLASE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82150","description":"AMYLASE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":143.08,"providers":[{"billed_charge":1927.78,"npi":[1234567893]}]}]}]},{"name":"BILIRUBIN, DIRECT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82248","description":"BILIRUBIN; DIRECT","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":113.00,"providers":[{"billed_charge":714.19,"npi":[1234567893]}]}]}]},{"name":"VITAMIN D 25 HYDROXY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82306","description":"VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13679.64,"providers":[{"billed_charge":37999.00,"npi":[1234567893]}]}]}]},{"name":"CARCINOEMBRYONIC ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82378","description":"CARCINOEMBRYONIC ANTIGEN (CEA)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":59.71,"providers":[{"billed_charge":672.00,"npi":[1234567893]}]}]}]},{"name":"TOTAL CORTISOL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"82533","description":"CORTISOL; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":234.88,"providers":[{"billed_charge":2760.00,"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":111.34,"providers":[{"billed_charge":1368.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":964.62,"providers":[{"billed_charge":15633.78,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3761.66,"providers":[{"billed_charge":50153.25,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":10.00,"providers":[{"billed_charge":120.00,"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":2074.05,"providers":[{"billed_charge":21780.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2452.00,"providers":[{"billed_charge":28577.44,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":2330.24,"providers":[{"billed_charge":31385.60,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":63.27,"providers":[{"billed_charge":865.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":19.47,"providers":[{"billed_charge":330.00,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12.96,"providers":[{"billed_charge":144.00,"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":769.12,"providers":[{"billed_charge":8377.65,"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":383.18,"providers":[{"billed_charge":4353.00,"npi":[1234567893]}]}]}]},{"name":"HEMOGLOBIN ELECTROPHORESIS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83020","description":"HEMOGLOBIN FRACTIONATION AND QUANTITATION; ELECTROPHORESIS (EG, A2, S, C, AND/OR F)","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":68.24,"providers":[{"billed_charge":287.04,"npi":[1942526447]}]}]}]},{"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":"320439952"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":20.64,"providers":[{"billed_charge":136.00,"npi":[1285332064]}]}]},{"tin":{"type":"ein","value":"640612902"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":61.95,"providers":[{"billed_charge":795.00,"npi":[1609576529]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":42.72,"providers":[{"billed_charge":200.00,"npi":[1629186382]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8093.24,"providers":[{"billed_charge":111071.65,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":130.41,"providers":[{"billed_charge":1839.20,"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":118.22,"providers":[{"billed_charge":1614.46,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1420.08,"providers":[{"billed_charge":12475.12,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1737.06,"providers":[{"billed_charge":14554.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":220.10,"providers":[{"billed_charge":2948.27,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":25.76,"providers":[{"billed_charge":422.40,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF MAGNESIUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83735","description":"MAGNESIUM","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":815.40,"providers":[{"billed_charge":11340.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":777.48,"providers":[{"billed_charge":7040.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PARATHORMONE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"83970","description":"PARATHORMONE (PARATHYROID HORMONE)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":371.60,"providers":[{"billed_charge":3400.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PHOSPHORUS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84100","description":"PHOSPHORUS INORGANIC (PHOSPHATE);","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":21.30,"providers":[{"billed_charge":294.65,"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":488.28,"providers":[{"billed_charge":5200.00,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF PROLACTIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84146","description":"PROLACTIN","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":366.24,"providers":[{"billed_charge":4032.00,"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":1937.52,"providers":[{"billed_charge":18190.80,"npi":[1234567893]}]}]}]},{"name":"PROTEIN E-PHORESIS, SERUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84165","description":"PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION, SERUM","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":59.08,"providers":[{"billed_charge":469.35,"npi":[1720289127]}]},{"allowed_amount":51.18,"providers":[{"billed_charge":402.30,"npi":[1942526447]}]}]}]},{"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":958.44,"providers":[{"billed_charge":9383.75,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3157.92,"providers":[{"billed_charge":33245.13,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF TOTAL THYROXINE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84436","description":"THYROXINE; TOTAL","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":179.22,"providers":[{"billed_charge":2072.27,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1311.38,"providers":[{"billed_charge":23233.45,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12572.28,"providers":[{"billed_charge":139306.78,"npi":[1234567893]}]}]}]},{"name":"ASSAY OF THYROID (T3 OR T4)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84479","description":"THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":93.12,"providers":[{"billed_charge":1119.46,"npi":[1234567893]}]}]}]},{"name":"ASSAY, TRIIODOTHYRONINE (T3)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"84480","description":"TRIIODOTHYRONINE T3; TOTAL (TT-3)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":197.78,"providers":[{"billed_charge":2232.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1097.28,"providers":[{"billed_charge":17280.00,"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":225.33,"providers":[{"billed_charge":3303.96,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":102.96,"providers":[{"billed_charge":1122.00,"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":142.17,"providers":[{"billed_charge":1575.00,"npi":[1234567893]}]}]}]},{"name":"BL SMEAR W/DIFF WBC COUNT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85007","description":"BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITH MANUAL DIFFERENTIAL WBC COUNT","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":107.73,"providers":[{"billed_charge":756.00,"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":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":4.86,"providers":[{"billed_charge":15.00,"npi":[1326650110]}]}]},{"tin":{"type":"ein","value":"620846885"},"service_code":["23","21"],"billing_class":"professional","payments":[{"allowed_amount":12.24,"providers":[{"billed_charge":39.00,"npi":[1053725564]}]},{"allowed_amount":4.08,"providers":[{"billed_charge":13.00,"npi":[1053725564]}]}]},{"tin":{"type":"ein","value":"824404269"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":31.08,"providers":[{"billed_charge":100.00,"npi":[1841076403]}]}]},{"tin":{"type":"ein","value":"204193593"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.30,"providers":[{"billed_charge":28.00,"npi":[1447144365]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5729.50,"providers":[{"billed_charge":58785.92,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":207.90,"providers":[{"billed_charge":1071.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"208339281"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":23.31,"providers":[{"billed_charge":75.00,"npi":[1841799616]}]}]},{"tin":{"type":"ein","value":"640655662"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.30,"providers":[{"billed_charge":360.00,"npi":[1194956755]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1245.48,"providers":[{"billed_charge":13536.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":79.20,"providers":[{"billed_charge":1584.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":61.76,"providers":[{"billed_charge":796.26,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":180.56,"providers":[{"billed_charge":4440.00,"npi":[1234567893]}]}]}]},{"name":"THROMBOPLASTIN TIME, PARTIAL","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"85730","description":"THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":16.20,"providers":[{"billed_charge":216.00,"npi":[1234567893]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86038","description":"ANTINUCLEAR ANTIBODIES (ANA);","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":756.16,"providers":[{"billed_charge":10010.72,"npi":[1234567893]}]}]}]},{"name":"ANTINUCLEAR ANTIBODIES (ANA)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86039","description":"ANTINUCLEAR ANTIBODIES (ANA); TITER","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":105.42,"providers":[{"billed_charge":1386.00,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":326.20,"providers":[{"billed_charge":6720.00,"npi":[1234567893]}]}]}]},{"name":"CCP ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86200","description":"CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":192.39,"providers":[{"billed_charge":2296.80,"npi":[1234567893]}]}]}]},{"name":"DNA ANTIBODY NATIVE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86225","description":"DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":74.16,"providers":[{"billed_charge":960.31,"npi":[1234567893]}]}]}]},{"name":"NUCLEAR ANTIGEN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86235","description":"EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EA","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":669.70,"providers":[{"billed_charge":8868.40,"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":74.26,"providers":[{"billed_charge":1845.60,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":425.75,"providers":[{"billed_charge":6233.92,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":226.95,"providers":[{"billed_charge":3731.05,"npi":[1234567893]}]}]}]},{"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":502.02,"providers":[{"billed_charge":4579.20,"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":470.40,"providers":[{"billed_charge":8776.53,"npi":[1234567893]}]}]}]},{"name":"HERPES SIMPLEX TYPE 1 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86695","description":"ANTIBODY; HERPES SIMPLEX, TYPE 1","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":487.08,"providers":[{"billed_charge":6333.62,"npi":[1234567893]}]}]}]},{"name":"HERPES SIMPLEX TYPE 2 TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86696","description":"ANTIBODY; HERPES SIMPLEX, TYPE 2","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":740.35,"providers":[{"billed_charge":9549.36,"npi":[1234567893]}]}]}]},{"name":"HEP B SURFACE ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86706","description":"HEPATITIS B SURFACE ANTIBODY (HBSAB)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":38.64,"providers":[{"billed_charge":720.00,"npi":[1234567893]}]}]}]},{"name":"TREPONEMA PALLIDUM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86780","description":"ANTIBODY; TREPONEMA PALLIDUM","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":71.52,"providers":[{"billed_charge":1310.00,"npi":[1234567893]}]}]}]},{"name":"THYROGLOBULIN ANTIBODY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86800","description":"THYROGLOBULIN ANTIBODY","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":229.12,"providers":[{"billed_charge":3500.85,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS C AB TEST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86803","description":"HEPATITIS C ANTIBODY;","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":751.14,"providers":[{"billed_charge":11232.00,"npi":[1234567893]}]}]}]},{"name":"RBC ANTIBODY SCREEN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86850","description":"ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.80,"providers":[{"billed_charge":98.40,"npi":[1234567893]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC ABO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86900","description":"BLOOD TYPING, SEROLOGIC; ABO","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.10,"providers":[{"billed_charge":270.00,"npi":[1234567893]}]}]}]},{"name":"BLOOD TYPING SEROLOGIC RH(D)","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"86901","description":"BLOOD TYPING, SEROLOGIC; RH (D)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":8.10,"providers":[{"billed_charge":180.00,"npi":[1234567893]}]}]}]},{"name":"CULTURE OTHR SPECIMN AEROBIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87070","description":"CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESU","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":112.52,"providers":[{"billed_charge":2999.60,"npi":[1234567893]}]}]}]},{"name":"CULTURE AEROBIC IDENTIFY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87077","description":"CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EACH","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":756.88,"providers":[{"billed_charge":12480.00,"npi":[1234567893]}]}]}]},{"name":"CULTURE SCREEN ONLY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87081","description":"CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY;","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":32.78,"providers":[{"billed_charge":472.00,"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":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1713.36,"providers":[{"billed_charge":28320.00,"npi":[1234567893]}]}]}]},{"name":"CULTURE TYPE IMMUNOLOGIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87147","description":"CULTURE, TYPING; IMMUNOLOGIC METHOD, OTHER THAN IMMUNOFLUORESCENCE (EG, AGGLUTINATION GROUPING), PER","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":9.32,"providers":[{"billed_charge":240.00,"npi":[1234567893]}]}]}]},{"name":"MICROBE SUSCEPTIBLE MIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87186","description":"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CONC","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":478.47,"providers":[{"billed_charge":3690.00,"npi":[1234567893]}]}]}]},{"name":"SMEAR, GRAM STAIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87205","description":"SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":46.08,"providers":[{"billed_charge":864.00,"npi":[1234567893]}]}]}]},{"name":"HEPATITIS B SURFACE AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87340","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HEPATITIS B SURFACE ANTIGEN (HBSAG); (E","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":186.00,"providers":[{"billed_charge":2400.00,"npi":[1234567893]}]}]}]},{"name":"HIV-1 AG W/HIV-1 & HIV-2 AB","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87389","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN(S), W HIV-1 AND HIV-2 ANT","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":3479.64,"providers":[{"billed_charge":26964.00,"npi":[1234567893]}]}]}]},{"name":"CORONAVIRUS AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":15.02,"providers":[{"billed_charge":50.00,"npi":[1114701570]}]}]}]},{"name":"SARSCOV & INF VIR A&B AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","allowed_amounts":[{"tin":{"type":"ein","value":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":89.61,"providers":[{"billed_charge":225.00,"npi":[1336981836]}]}]}]},{"name":"STREP A AG IA","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87430","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, STREPTOCOCCUS, GROUP A; (EG, ENZYME IMM","allowed_amounts":[{"tin":{"type":"ein","value":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":46.25,"providers":[{"billed_charge":175.00,"npi":[1659775732]}]}]}]},{"name":"AG DETECT POLYVAL IA MULT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87451","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE; MULTIPLE STEP METHOD, EACH POLYVALENT A","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":558.14,"providers":[{"billed_charge":4720.00,"npi":[1234567893]}]}]}]},{"name":"CANDIDA, DNA, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87480","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CANDIDA SPECIES, DIRECT PROBE TECHNIQUE","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1136.52,"providers":[{"billed_charge":8568.00,"npi":[1234567893]}]}]}]},{"name":"M. GENITALIUM AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87563","description":"IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":175.50,"providers":[{"billed_charge":1052.70,"npi":[1093753303]}]}]}]},{"name":"HPV HIGH-RISK TYPES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87624","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4826.25,"providers":[{"billed_charge":30250.00,"npi":[1093753303]}]},{"allowed_amount":684.45,"providers":[{"billed_charge":4290.00,"npi":[1942526447]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1894.80,"providers":[{"billed_charge":20040.00,"npi":[1234567893]}]}]}]},{"name":"STREP B, DNA, AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87653","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":544.05,"providers":[{"billed_charge":3062.18,"npi":[1942526447]}]}]}]},{"name":"TRICHOMONAS VAGIN, DIR PROBE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87660","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, DIRECT PROBE TECHNIQ","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":414.92,"providers":[{"billed_charge":3128.00,"npi":[1234567893]}]}]}]},{"name":"DETECT AGNT MULT, DNA, AMPLI","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87801","description":"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5300.10,"providers":[{"billed_charge":57542.57,"npi":[1942526447]}]},{"allowed_amount":23727.60,"providers":[{"billed_charge":293685.04,"npi":[1093753303]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":13299.39,"providers":[{"billed_charge":140106.00,"npi":[1234567893]}]}]}]},{"name":"INFLUENZA ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87804","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA","allowed_amounts":[{"tin":{"type":"ein","value":"822818022"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":7.03,"providers":[{"billed_charge":41.00,"npi":[1316829252]}]}]},{"tin":{"type":"ein","value":"455454264"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":379.62,"providers":[{"billed_charge":1682.64,"npi":[1730774290]}]},{"allowed_amount":21.09,"providers":[{"billed_charge":93.48,"npi":[1730774290]}]}]}]},{"name":"SARS-COV-2 COVID19 W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87811","description":"IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS","allowed_amounts":[{"tin":{"type":"ein","value":"455454264"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":316.62,"providers":[{"billed_charge":3618.00,"npi":[1730774290]}]},{"allowed_amount":17.59,"providers":[{"billed_charge":201.00,"npi":[1730774290]}]}]}]},{"name":"Infectious Agent Antigen Detection","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87812","description":"infectious agent antigen detection of SARS-CoV-2 (COVID-19) and influenza virus types A and B using a single, visually read (direct optical observation) multiplex test","allowed_amounts":[{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":601.35,"providers":[{"billed_charge":2280.00,"npi":[1174980478]}]}]}]},{"name":"STREP A ASSAY W/OPTIC","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"87880","description":"INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GR","allowed_amounts":[{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.27,"providers":[{"billed_charge":225.00,"npi":[1114701570]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":63.27,"providers":[{"billed_charge":306.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"455454264"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":7.03,"providers":[{"billed_charge":31.16,"npi":[1730774290]}]},{"allowed_amount":84.36,"providers":[{"billed_charge":373.92,"npi":[1730774290]}]}]}]},{"name":"CYTOPATH, C/V, INTERPRET","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88141","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), REQUIRING INTERPRETATION BY PHYSICIAN","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":481.18,"providers":[{"billed_charge":3430.00,"npi":[1234567893]}]}]}]},{"name":"CYTOPATH C/V THIN LAYER","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88142","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":30.39,"providers":[{"billed_charge":219.00,"npi":[1093753303]}]}]}]},{"name":"CYTOPATH C/V AUTO FLUID REDO","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88175","description":"CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY RPTNG SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED TH","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["11","81"],"billing_class":"professional","payments":[{"allowed_amount":13.31,"providers":[{"billed_charge":94.00,"npi":[1942526447]}]},{"allowed_amount":5883.02,"providers":[{"billed_charge":41548.00,"npi":[1093753303]}]},{"allowed_amount":1064.80,"providers":[{"billed_charge":7520.00,"npi":[1942526447]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":5829.39,"providers":[{"billed_charge":57466.00,"npi":[1234567893]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88304","description":"LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION, INDUCED ABSCESS ANEURYSM","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":37.00,"providers":[{"billed_charge":222.42,"npi":[1720405814]}]},{"allowed_amount":28.75,"providers":[{"billed_charge":171.63,"npi":[1447331897]}]}]},{"tin":{"type":"ein","value":"640523321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":49.20,"providers":[{"billed_charge":1000.00,"npi":[1861464760]}]}]}]},{"name":"TISSUE EXAM BY PATHOLOGIST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88305","description":"LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION ABORTION - SPONTANEOUS/MISSED ARTER","allowed_amounts":[{"tin":{"type":"ein","value":"621695507"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":1354.13,"providers":[{"billed_charge":10369.90,"npi":[1720405814]}]},{"allowed_amount":1149.93,"providers":[{"billed_charge":9417.40,"npi":[1447331897]}]},{"allowed_amount":218.03,"providers":[{"billed_charge":1324.70,"npi":[1619107091]}]},{"allowed_amount":725.07,"providers":[{"billed_charge":4862.50,"npi":[1598898967]}]},{"allowed_amount":81.60,"providers":[{"billed_charge":635.80,"npi":[1205279270]}]},{"allowed_amount":522.51,"providers":[{"billed_charge":4060.70,"npi":[1821206962]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":172.00,"providers":[{"billed_charge":1368.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"640867628"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":33.54,"providers":[{"billed_charge":400.00,"npi":[1164525309]}]},{"allowed_amount":419.26,"providers":[{"billed_charge":5000.00,"npi":[1164525309]}]}]},{"tin":{"type":"ein","value":"352037910"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":218.36,"providers":[{"billed_charge":610.00,"npi":[1659574127]}]}]},{"tin":{"type":"ein","value":"640523321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":4374.14,"providers":[{"billed_charge":44109.00,"npi":[1861464760]}]}]},{"tin":{"type":"ein","value":"640678600"},"service_code":["11","22","21"],"billing_class":"professional","payments":[{"allowed_amount":1572.50,"providers":[{"billed_charge":15375.00,"npi":[1790777142]}]},{"allowed_amount":20.97,"providers":[{"billed_charge":205.00,"npi":[1790777142]}]},{"allowed_amount":278.69,"providers":[{"billed_charge":1435.00,"npi":[1790777142]}]}]}]},{"name":"SPECIAL STAINS GROUP 1","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88312","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN","allowed_amounts":[{"tin":{"type":"ein","value":"640523321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":899.45,"providers":[{"billed_charge":5550.00,"npi":[1861464760]}]}]}]},{"name":"SPECIAL STAINS GROUP 2","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"88313","description":"SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT","allowed_amounts":[{"tin":{"type":"ein","value":"640523321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":361.86,"providers":[{"billed_charge":3752.00,"npi":[1861464760]}]}]}]},{"name":"BH/INTENS OP/PSYCH","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"905","description":"INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC","allowed_amounts":[{"tin":{"type":"ein","value":"863916163"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":735.24,"providers":[{"billed_charge":15000.00,"npi":[1023688157]}]}]}]},{"name":"BH/INTENS OP/CHEM DEP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"906","description":"INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY","allowed_amounts":[{"tin":{"type":"ein","value":"901035381"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3133.10,"providers":[{"billed_charge":38000.00,"npi":[1164811121]}]}]},{"tin":{"type":"ein","value":"861790384"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1056.00,"providers":[{"billed_charge":30492.00,"npi":[1912670068]}]}]},{"tin":{"type":"ein","value":"883984612"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":667.59,"providers":[{"billed_charge":22365.00,"npi":[1376254755]}]}]},{"tin":{"type":"ein","value":"800966827"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":11210.00,"providers":[{"billed_charge":118000.00,"npi":[1104212794]}]}]},{"tin":{"type":"ein","value":"882656603"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2160.00,"providers":[{"billed_charge":7200.00,"npi":[1114655834]}]}]}]},{"name":"PSYCH DIAGNOSTIC EVALUATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90791","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":346.70,"providers":[{"billed_charge":832.00,"npi":[1234567893]}]}]}]},{"name":"PSYCH DIAG EVAL W/MED SRVCS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90792","description":"PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":17088.78,"providers":[{"billed_charge":36268.00,"npi":[1234567893]}]}]}]},{"name":"PSYTX W PT 30 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90832","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"646008520"},"service_code":["22","10"],"billing_class":"professional","payments":[{"allowed_amount":128.96,"providers":[{"billed_charge":175.00,"npi":[1194030239]}]},{"allowed_amount":1031.70,"providers":[{"billed_charge":1050.00,"npi":[1326468679]}]}]},{"tin":{"type":"ein","value":"853165427"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":51.59,"providers":[{"billed_charge":170.00,"npi":[1023876166]}]},{"allowed_amount":154.77,"providers":[{"billed_charge":510.00,"npi":[1023876166]}]}]}]},{"name":"PSYTX W PT W E/M 30 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90833","description":"PSYCHOTHERAPY, 30 MINUTES WITH PATIENT WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE","allowed_amounts":[{"tin":{"type":"ein","value":"874345955"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":649.35,"providers":[{"billed_charge":1650.00,"npi":[1396383501]}]}]},{"tin":{"type":"ein","value":"815000928"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":396.90,"providers":[{"billed_charge":1080.00,"npi":[1770367716]}]},{"allowed_amount":54.66,"providers":[{"billed_charge":320.00,"npi":[1770367716]}]},{"allowed_amount":2512.20,"providers":[{"billed_charge":14720.00,"npi":[1770367716]}]}]}]},{"name":"PSYTX W PT 45 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90834","description":"PSYCHOTHERAPY, 45 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"474591265"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":5638.05,"providers":[{"billed_charge":12414.51,"npi":[1235569443]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":61498.38,"providers":[{"billed_charge":180524.55,"npi":[1234567893]}]}]}]},{"name":"PSYTX W PT 60 MINUTES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90837","description":"PSYCHOTHERAPY, 60 MINUTES WITH PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"646029322"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":3189.82,"providers":[{"billed_charge":5682.88,"npi":[1346084092]}]}]},{"tin":{"type":"ein","value":"854131067"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":100.45,"providers":[{"billed_charge":240.00,"npi":[1912531005]}]},{"allowed_amount":3966.44,"providers":[{"billed_charge":7920.00,"npi":[1912531005]}]}]},{"tin":{"type":"ein","value":"384013585"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":100.45,"providers":[{"billed_charge":190.00,"npi":[1306085253]}]},{"allowed_amount":483.76,"providers":[{"billed_charge":760.00,"npi":[1306085253]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":14028.00,"providers":[{"billed_charge":30888.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"640770155"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":3991.02,"providers":[{"billed_charge":10560.00,"npi":[1811682099]}]}]}]},{"name":"GROUP PSYCHOTHERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"90853","description":"GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)","allowed_amounts":[{"tin":{"type":"ein","value":"646029322"},"service_code":["53"],"billing_class":"professional","payments":[{"allowed_amount":126.35,"providers":[{"billed_charge":294.00,"npi":[1740800432]}]}]}]},{"name":"PSTAY/PARTIAL HOSP","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"912","description":"PSYCHIATRIC/PSYCHOLOGICAL SERVICES - PARTIAL HOSPITALIZATION","allowed_amounts":[{"tin":{"type":"ein","value":"901035381"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":3977.00,"providers":[{"billed_charge":29000.00,"npi":[1164811121]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":55245.96,"providers":[{"billed_charge":435600.00,"npi":[1356703524]}]}]},{"tin":{"type":"ein","value":"800966827"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":2968.00,"providers":[{"billed_charge":23200.00,"npi":[1104212794]}]}]}]},{"name":"PSYCHIATRIC CARE INTENSIVE 4","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"913","description":"PSYCHIATRIC CARE INTENSIVE 4-6 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"863916163"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":1177.92,"providers":[{"billed_charge":28000.00,"npi":[1023688157]}]}]},{"tin":{"type":"ein","value":"833494125"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":22040.00,"providers":[{"billed_charge":173710.00,"npi":[1609409762]}]}]},{"tin":{"type":"ein","value":"883984612"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":460.02,"providers":[{"billed_charge":7190.00,"npi":[1376254755]}]}]},{"tin":{"type":"ein","value":"461281853"},"service_code":["22"],"billing_class":"institutional","payments":[{"allowed_amount":315.00,"providers":[{"billed_charge":3995.00,"npi":[1417392762]}]}]}]},{"name":"SPEECH/HEARING THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"92507","description":"TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER; INDIVIDUAL","allowed_amounts":[{"tin":{"type":"ein","value":"832176650"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2347.25,"providers":[{"billed_charge":4100.00,"npi":[1538879994]}]}]}]},{"name":"ELECTROCARDIOGRAM REPORT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93010","description":"ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY","allowed_amounts":[{"tin":{"type":"ein","value":"264253264"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":7.42,"providers":[{"billed_charge":45.00,"npi":[1154356764]}]},{"allowed_amount":14.84,"providers":[{"billed_charge":90.00,"npi":[1154356764]}]}]},{"tin":{"type":"ein","value":"646008520"},"service_code":["22","11","23","21"],"billing_class":"professional","payments":[{"allowed_amount":794.00,"providers":[{"billed_charge":3600.00,"npi":[1982801858]}]},{"allowed_amount":238.20,"providers":[{"billed_charge":1016.00,"npi":[1982801858]}]},{"allowed_amount":198.50,"providers":[{"billed_charge":836.00,"npi":[1982801858]}]},{"allowed_amount":714.60,"providers":[{"billed_charge":3240.00,"npi":[1982801858]}]}]},{"tin":{"type":"ein","value":"640682111"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":194.56,"providers":[{"billed_charge":1248.00,"npi":[1962507061]}]},{"allowed_amount":60.75,"providers":[{"billed_charge":390.00,"npi":[1962507061]}]}]}]},{"name":"ILR DEVICE INTERROGAT REMOTE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"93298","description":"INTERROGATION DEVICE EVALUATION(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE LOOP RECORDER SYSTEM, INCLUD","allowed_amounts":[{"tin":{"type":"ein","value":"646008520"},"service_code":["19"],"billing_class":"professional","payments":[{"allowed_amount":627.00,"providers":[{"billed_charge":627.00,"npi":[1982801858]}]}]}]},{"name":"GLUC MONITOR, CONT, PHYS I&R","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"95251","description":"AMBULATORY CONTINUOUS GLUCOSE MONITORING OF INTERSTITIAL TISSUE FLUID VIA A SUBCUTANEOUS SENSOR FOR ","allowed_amounts":[{"tin":{"type":"ein","value":"646001350"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":255.22,"providers":[{"billed_charge":700.00,"npi":[1629186382]}]}]}]},{"name":"BRIEF EMOTIONAL/BEHAV ASSMT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96127","description":"BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT (EG, DEPRESSION INVENTORY, ATTENTION-DEFICIT/HYPERACTIVITY DIS","allowed_amounts":[{"tin":{"type":"ein","value":"821078593"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":27.33,"providers":[{"billed_charge":240.00,"npi":[1295187789]}]}]},{"tin":{"type":"ein","value":"640937314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":21.78,"providers":[{"billed_charge":60.00,"npi":[1033643432]}]}]}]},{"name":"THER/PROPH/DIAG INJ SC/IM","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"96372","description":"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION (SPECIFY SUBSTANCE OR DRUG); SUBCUTANEOUS OR INTR","allowed_amounts":[{"tin":{"type":"ein","value":"474987773"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":157.97,"providers":[{"billed_charge":407.44,"npi":[1497301915]}]}]},{"tin":{"type":"ein","value":"813504372"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":193.34,"providers":[{"billed_charge":363.44,"npi":[1811221401]}]}]},{"tin":{"type":"ein","value":"640907721"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":22.10,"providers":[{"billed_charge":80.00,"npi":[1023687910]}]}]},{"tin":{"type":"ein","value":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":647.50,"providers":[{"billed_charge":2090.00,"npi":[1336981836]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":246.08,"providers":[{"billed_charge":608.00,"npi":[1659775732]}]},{"allowed_amount":158.38,"providers":[{"billed_charge":418.00,"npi":[1598865362]}]}]},{"tin":{"type":"ein","value":"462950767"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":276.25,"providers":[{"billed_charge":1500.00,"npi":[1861277964]}]}]},{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":55.25,"providers":[{"billed_charge":175.00,"npi":[1114701570]}]}]},{"tin":{"type":"ein","value":"272255038"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":139.76,"providers":[{"billed_charge":221.28,"npi":[1306211164]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":185.65,"providers":[{"billed_charge":629.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"822133878"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":519.26,"providers":[{"billed_charge":1330.00,"npi":[1275216467]}]}]}]},{"name":"MECHANICAL TRACTION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97012","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; TRACTION, MECHANICAL","allowed_amounts":[{"tin":{"type":"ein","value":"455088386"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":784.75,"providers":[{"billed_charge":1825.00,"npi":[1629154968]}]}]},{"tin":{"type":"ein","value":"453806985"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":247.25,"providers":[{"billed_charge":897.00,"npi":[1639822422]}]}]}]},{"name":"ELECTRIC STIMULATION THERAPY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97014","description":"APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED)","allowed_amounts":[{"tin":{"type":"ein","value":"200338259"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":338.40,"providers":[{"billed_charge":609.00,"npi":[1588759955]}]}]},{"tin":{"type":"ein","value":"274681891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.76,"providers":[{"billed_charge":850.00,"npi":[1881475911]}]}]},{"tin":{"type":"ein","value":"263078685"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":68.84,"providers":[{"billed_charge":330.00,"npi":[1477719847]}]}]},{"tin":{"type":"ein","value":"201677707"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.72,"providers":[{"billed_charge":40.00,"npi":[1790449932]}]}]},{"tin":{"type":"ein","value":"640943837"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":58.60,"providers":[{"billed_charge":105.00,"npi":[1871685552]}]}]}]},{"name":"THERAPEUTIC EXERCISES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97110","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP STRENGTH A","allowed_amounts":[{"tin":{"type":"ein","value":"455088386"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1602.10,"providers":[{"billed_charge":2960.00,"npi":[1629154968]}]}]},{"tin":{"type":"ein","value":"640887209"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.05,"providers":[{"billed_charge":1400.00,"npi":[1679982078]}]}]},{"tin":{"type":"ein","value":"271878561"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":243.63,"providers":[{"billed_charge":360.00,"npi":[1750435301]}]}]},{"tin":{"type":"ein","value":"274681891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1327.78,"providers":[{"billed_charge":3520.00,"npi":[1881475911]}]}]},{"tin":{"type":"ein","value":"201677707"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":973.47,"providers":[{"billed_charge":2300.00,"npi":[1790449932]}]}]},{"tin":{"type":"ein","value":"883757810"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":729.76,"providers":[{"billed_charge":1928.50,"npi":[1104593599]}]}]},{"tin":{"type":"ein","value":"640867459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":235.09,"providers":[{"billed_charge":440.00,"npi":[1831942416]}]}]},{"tin":{"type":"ein","value":"464053647"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":64.96,"providers":[{"billed_charge":267.00,"npi":[1295353514]}]}]},{"tin":{"type":"ein","value":"640906618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":730.86,"providers":[{"billed_charge":4500.00,"npi":[1053207787]}]}]},{"tin":{"type":"ein","value":"271412557"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1117.31,"providers":[{"billed_charge":3180.00,"npi":[1568767242]}]}]},{"tin":{"type":"ein","value":"932831546"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":753.66,"providers":[{"billed_charge":2700.00,"npi":[1811870900]}]}]}]},{"name":"NEUROMUSCULAR REEDUCATION","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97112","description":"THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALA","allowed_amounts":[{"tin":{"type":"ein","value":"640887209"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":234.66,"providers":[{"billed_charge":1540.00,"npi":[1679982078]}]}]},{"tin":{"type":"ein","value":"201677707"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":410.89,"providers":[{"billed_charge":1260.00,"npi":[1790449932]}]}]},{"tin":{"type":"ein","value":"464053647"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":48.74,"providers":[{"billed_charge":198.00,"npi":[1295353514]}]}]},{"tin":{"type":"ein","value":"932831546"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":991.83,"providers":[{"billed_charge":3150.00,"npi":[1811870900]}]}]}]},{"name":"MANUAL THERAPY 1/> REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97140","description":"MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTIO","allowed_amounts":[{"tin":{"type":"ein","value":"640887209"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":180.32,"providers":[{"billed_charge":1300.00,"npi":[1679982078]}]}]},{"tin":{"type":"ein","value":"464053647"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":41.32,"providers":[{"billed_charge":168.00,"npi":[1295353514]}]}]},{"tin":{"type":"ein","value":"932831546"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":97.08,"providers":[{"billed_charge":375.00,"npi":[1811870900]}]}]}]},{"name":"ADAPTIVE BEHAVIOR TX BY TECH","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97153","description":"ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"883979874"},"service_code":["99","12"],"billing_class":"professional","payments":[{"allowed_amount":17354.19,"providers":[{"billed_charge":241500.00,"npi":[1780064949]}]},{"allowed_amount":11785.04,"providers":[{"billed_charge":164000.00,"npi":[1780064949]}]}]}]},{"name":"ADAPT BEHAVIOR TX PHYS/QHP","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97155","description":"ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN","allowed_amounts":[{"tin":{"type":"ein","value":"883979874"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1221.62,"providers":[{"billed_charge":17000.00,"npi":[1780064949]}]},{"allowed_amount":1113.83,"providers":[{"billed_charge":15500.00,"npi":[1780064949]}]}]}]},{"name":"THERAPEUTIC ACTIVITIES","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97530","description":"THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FU","allowed_amounts":[{"tin":{"type":"ein","value":"640887209"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":414.99,"providers":[{"billed_charge":2700.00,"npi":[1679982078]}]}]},{"tin":{"type":"ein","value":"274681891"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":610.50,"providers":[{"billed_charge":1320.00,"npi":[1881475911]}]}]},{"tin":{"type":"ein","value":"201677707"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1936.29,"providers":[{"billed_charge":5320.00,"npi":[1790449932]}]}]},{"tin":{"type":"ein","value":"883757810"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":566.72,"providers":[{"billed_charge":1500.40,"npi":[1104593599]}]}]},{"tin":{"type":"ein","value":"814311713"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":953.12,"providers":[{"billed_charge":3330.00,"npi":[1699251512]}]}]},{"tin":{"type":"ein","value":"464053647"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":77.28,"providers":[{"billed_charge":321.00,"npi":[1295353514]}]}]},{"tin":{"type":"ein","value":"640906618"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":558.98,"providers":[{"billed_charge":3300.00,"npi":[1053207787]}]}]}]},{"name":"RMVL DEVITAL TIS 20 CM/<","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"97597","description":"DEBRIDEMENT (EG, HIGH PRESSURE WATERJET W/WOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT W SCISSORS, SCAL","allowed_amounts":[{"tin":{"type":"ein","value":"300852649"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":219.26,"providers":[{"billed_charge":1760.00,"npi":[1548885759]}]}]}]},{"name":"CHIROPRACT MANJ 1-2 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98940","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 1-2 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"640943837"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.24,"providers":[{"billed_charge":180.00,"npi":[1871685552]}]}]},{"tin":{"type":"ein","value":"640931880"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2173.20,"providers":[{"billed_charge":2800.00,"npi":[1881781631]}]}]}]},{"name":"CHIROPRACT MANJ 3-4 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98941","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"200338259"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":235.90,"providers":[{"billed_charge":329.00,"npi":[1588759955]}]}]},{"tin":{"type":"ein","value":"455088386"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2460.10,"providers":[{"billed_charge":3650.00,"npi":[1629154968]}]}]},{"tin":{"type":"ein","value":"271878561"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1856.89,"providers":[{"billed_charge":2460.00,"npi":[1750435301]}]}]},{"tin":{"type":"ein","value":"263078685"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":202.20,"providers":[{"billed_charge":390.00,"npi":[1477719847]}]}]},{"tin":{"type":"ein","value":"453806985"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":674.00,"providers":[{"billed_charge":1200.00,"npi":[1639822422]}]}]},{"tin":{"type":"ein","value":"264741370"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":452.90,"providers":[{"billed_charge":600.00,"npi":[1063452092]}]}]},{"tin":{"type":"ein","value":"640867459"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":168.50,"providers":[{"billed_charge":250.00,"npi":[1831942416]}]}]}]},{"name":"CHIROPRACTIC MANJ 5 REGIONS","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98942","description":"CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS","allowed_amounts":[{"tin":{"type":"ein","value":"464657769"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":330.19,"providers":[{"billed_charge":525.00,"npi":[1083042170]}]}]},{"tin":{"type":"ein","value":"200338259"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":343.42,"providers":[{"billed_charge":496.00,"npi":[1588759955]}]}]}]},{"name":"HC PRO PHONE CALL 5-10 MIN","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"98966","description":"TELEPHONE ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A QUAL NONPHYS HEALTH CARE PROF TO AN ESTABL","allowed_amounts":[{"tin":{"type":"ein","value":"810965592"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":11850.00,"providers":[{"billed_charge":11850.00,"npi":[1538480686]}]}]}]},{"name":"MED SERV EVE/WKEND/HOLIDAY","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99051","description":"SERVICE(S) PROVIDED IN THE OFFICE DURING REGULARLY SCHEDULED EVENING, WEEKEND, OR HOLIDAY OFFICE HOU","allowed_amounts":[{"tin":{"type":"ein","value":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":153.36,"providers":[{"billed_charge":280.00,"npi":[1659775732]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT NEW","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99204","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH","allowed_amounts":[{"tin":{"type":"ein","value":"640574599"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3898.44,"providers":[{"billed_charge":4200.00,"npi":[1093344699]}]}]},{"tin":{"type":"ein","value":"455454264"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":556.92,"providers":[{"billed_charge":1239.20,"npi":[1730774290]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99213","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1117.35,"providers":[{"billed_charge":1899.75,"npi":[1114701570]}]}]},{"tin":{"type":"ein","value":"861149236"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":74.49,"providers":[{"billed_charge":170.00,"npi":[1326556184]}]}]},{"tin":{"type":"ein","value":"208339281"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":8847.36,"providers":[{"billed_charge":8880.00,"npi":[1841799616]}]}]},{"tin":{"type":"ein","value":"813504372"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1303.54,"providers":[{"billed_charge":2364.04,"npi":[1811221401]}]}]},{"tin":{"type":"ein","value":"923527145"},"service_code":["02","10"],"billing_class":"professional","payments":[{"allowed_amount":1405.92,"providers":[{"billed_charge":2160.00,"npi":[1619211992]}]},{"allowed_amount":47.37,"providers":[{"billed_charge":90.00,"npi":[1619211992]}]}]},{"tin":{"type":"ein","value":"510466372"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":93.11,"providers":[{"billed_charge":150.00,"npi":[1518521145]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2795.31,"providers":[{"billed_charge":4814.00,"npi":[1659775732]}]},{"allowed_amount":1927.80,"providers":[{"billed_charge":3320.00,"npi":[1598865362]}]}]},{"tin":{"type":"ein","value":"640911702"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":60.75,"providers":[{"billed_charge":141.00,"npi":[1477135267]}]}]},{"tin":{"type":"ein","value":"824404269"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":25989.12,"providers":[{"billed_charge":28200.00,"npi":[1841076403]}]}]},{"tin":{"type":"ein","value":"272255038"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1424.02,"providers":[{"billed_charge":2249.00,"npi":[1306211164]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1331.85,"providers":[{"billed_charge":3006.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":10863.20,"providers":[{"billed_charge":23817.01,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"471613586"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1108.38,"providers":[{"billed_charge":1950.00,"npi":[1922767938]}]}]},{"tin":{"type":"ein","value":"630995963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":670.41,"providers":[{"billed_charge":738.00,"npi":[1114395050]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":219.08,"providers":[{"billed_charge":336.00,"npi":[1326650110]}]}]},{"tin":{"type":"ein","value":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3268.59,"providers":[{"billed_charge":7436.00,"npi":[1336981836]}]}]},{"tin":{"type":"ein","value":"640650533"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":1489.71,"providers":[{"billed_charge":2040.00,"npi":[1538178777]}]}]},{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1173.90,"providers":[{"billed_charge":1840.00,"npi":[1396306957]}]}]},{"tin":{"type":"ein","value":"464128425"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":223.47,"providers":[{"billed_charge":750.00,"npi":[1396297453]}]}]},{"tin":{"type":"ein","value":"461590861"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":328.62,"providers":[{"billed_charge":474.00,"npi":[1548754211]}]},{"allowed_amount":344.60,"providers":[{"billed_charge":790.00,"npi":[1548754211]}]}]},{"tin":{"type":"ein","value":"640394192"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":670.41,"providers":[{"billed_charge":1237.50,"npi":[1801372685]}]}]},{"tin":{"type":"ein","value":"815000928"},"service_code":["11","02"],"billing_class":"professional","payments":[{"allowed_amount":187.44,"providers":[{"billed_charge":660.00,"npi":[1770367716]}]},{"allowed_amount":2905.11,"providers":[{"billed_charge":6435.00,"npi":[1770367716]}]}]},{"tin":{"type":"ein","value":"462950767"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1787.76,"providers":[{"billed_charge":3072.00,"npi":[1861277964]}]}]},{"tin":{"type":"ein","value":"471052932"},"service_code":["22","02"],"billing_class":"professional","payments":[{"allowed_amount":308.82,"providers":[{"billed_charge":900.00,"npi":[1164083747]}]},{"allowed_amount":926.46,"providers":[{"billed_charge":2700.00,"npi":[1164083747]}]}]},{"tin":{"type":"ein","value":"640770155"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":1769.82,"providers":[{"billed_charge":2616.00,"npi":[1609323450]}]},{"allowed_amount":1542.24,"providers":[{"billed_charge":1744.00,"npi":[1376004150]}]}]}]},{"name":"OFFICE/OUTPATIENT VISIT EST","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99214","description":"OFFICE OR OTH OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE","allowed_amounts":[{"tin":{"type":"ein","value":"640507572"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1590.82,"providers":[{"billed_charge":2090.00,"npi":[1427591627]}]}]},{"tin":{"type":"ein","value":"320439952"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7825.79,"providers":[{"billed_charge":20074.00,"npi":[1285332064]}]},{"allowed_amount":4104.03,"providers":[{"billed_charge":10442.00,"npi":[1043974678]}]}]},{"tin":{"type":"ein","value":"923893466"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":156.38,"providers":[{"billed_charge":200.00,"npi":[1902815566]}]}]},{"tin":{"type":"ein","value":"473740923"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":116.97,"providers":[{"billed_charge":237.00,"npi":[1639824543]}]}]},{"tin":{"type":"ein","value":"851351435"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2445.82,"providers":[{"billed_charge":4147.59,"npi":[1114701570]}]}]},{"tin":{"type":"ein","value":"640586958"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5004.16,"providers":[{"billed_charge":6528.00,"npi":[1598382640]}]}]},{"tin":{"type":"ein","value":"822133878"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":6829.39,"providers":[{"billed_charge":7800.00,"npi":[1275216467]}]}]},{"tin":{"type":"ein","value":"640937314"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":957.06,"providers":[{"billed_charge":1350.00,"npi":[1033643432]}]}]},{"tin":{"type":"ein","value":"640655662"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1993.80,"providers":[{"billed_charge":3375.00,"npi":[1194956755]}]}]},{"tin":{"type":"ein","value":"813504372"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":172.34,"providers":[{"billed_charge":480.88,"npi":[1811221401]}]},{"allowed_amount":14970.49,"providers":[{"billed_charge":27169.72,"npi":[1811221401]}]}]},{"tin":{"type":"ein","value":"510466372"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1063.36,"providers":[{"billed_charge":1600.00,"npi":[1518521145]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":137.61,"providers":[{"billed_charge":151.00,"npi":[1659775732]}]},{"allowed_amount":825.66,"providers":[{"billed_charge":957.00,"npi":[1629186382]}]}]},{"tin":{"type":"ein","value":"646008520"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":1750.00,"providers":[{"billed_charge":1750.00,"npi":[1316524838]}]},{"allowed_amount":202.75,"providers":[{"billed_charge":250.00,"npi":[1316524838]}]}]},{"tin":{"type":"ein","value":"461561484"},"service_code":["11","72"],"billing_class":"professional","payments":[{"allowed_amount":16828.92,"providers":[{"billed_charge":30210.00,"npi":[1568089977]}]},{"allowed_amount":531.70,"providers":[{"billed_charge":950.00,"npi":[1568089977]}]}]},{"tin":{"type":"ein","value":"821078593"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3572.35,"providers":[{"billed_charge":7425.00,"npi":[1295187789]}]}]},{"tin":{"type":"ein","value":"999999999"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":3485.18,"providers":[{"billed_charge":7852.00,"npi":[1234567893]}]},{"allowed_amount":566.73,"providers":[{"billed_charge":673.00,"npi":[1234567893]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":2751.65,"providers":[{"billed_charge":6162.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"834721464"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":3987.60,"providers":[{"billed_charge":8550.00,"npi":[1588141725]}]}]},{"tin":{"type":"ein","value":"471613586"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":638.04,"providers":[{"billed_charge":1020.00,"npi":[1922767938]}]}]},{"tin":{"type":"ein","value":"630995963"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":620.00,"providers":[{"billed_charge":620.00,"npi":[1407895725]}]}]},{"tin":{"type":"ein","value":"874345955"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3815.05,"providers":[{"billed_charge":7200.00,"npi":[1396383501]}]}]},{"tin":{"type":"ein","value":"464786388"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":938.28,"providers":[{"billed_charge":1440.00,"npi":[1326650110]}]}]},{"tin":{"type":"ein","value":"883800094"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":2027.50,"providers":[{"billed_charge":5975.00,"npi":[1154827079]}]},{"allowed_amount":1581.91,"providers":[{"billed_charge":3585.00,"npi":[1336981836]}]},{"allowed_amount":243.30,"providers":[{"billed_charge":717.00,"npi":[1154827079]}]}]},{"tin":{"type":"ein","value":"934244735"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":33896.00,"providers":[{"billed_charge":33896.00,"npi":[1922559772]}]}]},{"tin":{"type":"ein","value":"204193593"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":425.36,"providers":[{"billed_charge":584.00,"npi":[1447144365]}]}]},{"tin":{"type":"ein","value":"720993441"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":2929.61,"providers":[{"billed_charge":3420.00,"npi":[1174346613]}]}]},{"tin":{"type":"ein","value":"841927794"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":125.10,"providers":[{"billed_charge":325.19,"npi":[1578183802]}]}]},{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":735.08,"providers":[{"billed_charge":900.00,"npi":[1013930122]}]}]},{"tin":{"type":"ein","value":"640907721"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":106.34,"providers":[{"billed_charge":175.00,"npi":[1023687910]}]}]},{"tin":{"type":"ein","value":"421633186"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":1595.04,"providers":[{"billed_charge":2208.00,"npi":[1376814533]}]}]},{"tin":{"type":"ein","value":"275099507"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":138.24,"providers":[{"billed_charge":200.18,"npi":[1518113166]}]}]},{"tin":{"type":"ein","value":"815000928"},"service_code":["11","02","10"],"billing_class":"professional","payments":[{"allowed_amount":3981.33,"providers":[{"billed_charge":14720.50,"npi":[1770367716]}]},{"allowed_amount":68.94,"providers":[{"billed_charge":252.10,"npi":[1770367716]}]},{"allowed_amount":4147.26,"providers":[{"billed_charge":6435.00,"npi":[1770367716]}]}]},{"tin":{"type":"ein","value":"461590861"},"service_code":["11","10"],"billing_class":"professional","payments":[{"allowed_amount":994.40,"providers":[{"billed_charge":1680.00,"npi":[1548754211]}]},{"allowed_amount":1563.80,"providers":[{"billed_charge":1680.00,"npi":[1548754211]}]}]},{"tin":{"type":"ein","value":"640362400"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":187.65,"providers":[{"billed_charge":202.00,"npi":[1629365853]}]}]},{"tin":{"type":"ein","value":"640770155"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":744.38,"providers":[{"billed_charge":1176.00,"npi":[1609323450]}]},{"allowed_amount":550.44,"providers":[{"billed_charge":672.00,"npi":[1376004150]}]}]},{"tin":{"type":"ein","value":"646001347"},"service_code":["72"],"billing_class":"professional","payments":[{"allowed_amount":265.84,"providers":[{"billed_charge":304.00,"npi":[1538582531]}]}]},{"tin":{"type":"ein","value":"923892417"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":734.95,"providers":[{"billed_charge":3528.00,"npi":[1790548311]}]}]},{"tin":{"type":"ein","value":"455454264"},"service_code":["11","72","20"],"billing_class":"professional","payments":[{"allowed_amount":106.34,"providers":[{"billed_charge":202.84,"npi":[1760216543]}]},{"allowed_amount":4147.26,"providers":[{"billed_charge":7910.76,"npi":[1730774290]}]},{"allowed_amount":93.87,"providers":[{"billed_charge":202.84,"npi":[1760216543]}]},{"allowed_amount":531.70,"providers":[{"billed_charge":1014.20,"npi":[1760216543]}]}]}]},{"name":"INITIAL HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99222","description":"INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE","allowed_amounts":[{"tin":{"type":"ein","value":"233044435"},"service_code":["51"],"billing_class":"professional","payments":[{"allowed_amount":873.66,"providers":[{"billed_charge":2520.00,"npi":[1699975425]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99231","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"436457002"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1387.27,"providers":[{"billed_charge":3360.00,"npi":[1104024769]}]}]},{"tin":{"type":"ein","value":"880747037"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":315.04,"providers":[{"billed_charge":600.00,"npi":[1346069960]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99232","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"823546697"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":550.16,"providers":[{"billed_charge":1351.44,"npi":[1558688416]}]}]},{"tin":{"type":"ein","value":"55823824"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":686.20,"providers":[{"billed_charge":1770.00,"npi":[1679517411]}]}]},{"tin":{"type":"ein","value":"932472974"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":523.65,"providers":[{"billed_charge":930.00,"npi":[1114214038]}]},{"allowed_amount":104.73,"providers":[{"billed_charge":186.00,"npi":[1669851846]}]}]},{"tin":{"type":"ein","value":"428398848"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":1578.61,"providers":[{"billed_charge":4071.00,"npi":[1033129440]}]}]},{"tin":{"type":"ein","value":"646008520"},"service_code":["22","21"],"billing_class":"professional","payments":[{"allowed_amount":337.86,"providers":[{"billed_charge":386.00,"npi":[1568036184]}]},{"allowed_amount":1351.44,"providers":[{"billed_charge":1544.00,"npi":[1568036184]}]}]},{"tin":{"type":"ein","value":"211727924"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":2799.78,"providers":[{"billed_charge":6018.00,"npi":[1447662861]}]}]}]},{"name":"SUBSEQUENT HOSPITAL CARE","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99233","description":"SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT","allowed_amounts":[{"tin":{"type":"ein","value":"450573649"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":301.14,"providers":[{"billed_charge":301.14,"npi":[1235234808]}]}]},{"tin":{"type":"ein","value":"640735747"},"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":512.16,"providers":[{"billed_charge":620.00,"npi":[1326335902]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99283","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"646001549"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":913.44,"providers":[{"billed_charge":1514.92,"npi":[1124117171]}]},{"allowed_amount":415.20,"providers":[{"billed_charge":688.60,"npi":[1255946018]}]}]},{"tin":{"type":"ein","value":"646008276"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1270.75,"providers":[{"billed_charge":1470.50,"npi":[1043396591]}]}]},{"tin":{"type":"ein","value":"640911702"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":448.50,"providers":[{"billed_charge":750.00,"npi":[1609416544]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99284","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"646001549"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":539.44,"providers":[{"billed_charge":1049.72,"npi":[1255946018]}]}]},{"tin":{"type":"ein","value":"842925284"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":791.70,"providers":[{"billed_charge":6335.00,"npi":[1730709627]}]}]},{"tin":{"type":"ein","value":"834216310"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":508.96,"providers":[{"billed_charge":3162.00,"npi":[1902938624]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2968.42,"providers":[{"billed_charge":8141.00,"npi":[1770848434]}]},{"allowed_amount":2120.30,"providers":[{"billed_charge":5815.00,"npi":[1831076751,1225547185]}]},{"allowed_amount":6360.90,"providers":[{"billed_charge":17445.00,"npi":[1699290460]}]}]},{"tin":{"type":"ein","value":"811218105"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2035.80,"providers":[{"billed_charge":16290.00,"npi":[1033797550]}]}]},{"tin":{"type":"ein","value":"561997592"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2035.84,"providers":[{"billed_charge":12648.00,"npi":[1295974988]}]}]},{"tin":{"type":"ein","value":"934108863"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2940.60,"providers":[{"billed_charge":23530.00,"npi":[1639581739]}]}]}]},{"name":"EMERGENCY DEPT VISIT","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99285","description":"EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KE","allowed_amounts":[{"tin":{"type":"ein","value":"842925284"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":328.28,"providers":[{"billed_charge":2626.00,"npi":[1730709627]}]}]},{"tin":{"type":"ein","value":"621266047"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":5562.27,"providers":[{"billed_charge":15561.00,"npi":[1124078944]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99308","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"811665429"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":980.64,"providers":[{"billed_charge":1512.00,"npi":[1083488043]}]}]}]},{"name":"NURSING FAC CARE SUBSEQ","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99309","description":"SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQ","allowed_amounts":[{"tin":{"type":"ein","value":"811665429"},"service_code":["31"],"billing_class":"professional","payments":[{"allowed_amount":1636.82,"providers":[{"billed_charge":2562.00,"npi":[1376264697]}]}]}]},{"name":"Under Other Evaluation and Management Services","billing_code_type":"CPT","billing_code_type_version":"2022","billing_code":"99459","description":"Under Other Evaluation and Management Services","allowed_amounts":[{"tin":{"type":"ein","value":"800885134"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":266.91,"providers":[{"billed_charge":630.00,"npi":[1396306957]}]}]}]},{"name":"GRND MLGE PER STATUTE MILE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"GROUND MILEAGE, PER STATUTE MILE","allowed_amounts":[{"tin":{"type":"ein","value":"721275309"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":15700.24,"providers":[{"billed_charge":15700.24,"npi":[1619071941]}]}]},{"tin":{"type":"ein","value":"760796521"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":93682.23,"providers":[{"billed_charge":168300.00,"npi":[1316047392]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":117601.48,"providers":[{"billed_charge":835306.62,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"43171173"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":27461.29,"providers":[{"billed_charge":22714.21,"npi":[1366492910]}]}]},{"tin":{"type":"ein","value":"465007345"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":2908.44,"providers":[{"billed_charge":2261.00,"npi":[1528596814]}]},{"allowed_amount":14236.03,"providers":[{"billed_charge":11067.00,"npi":[1760831630]}]}]},{"tin":{"type":"ein","value":"646001540"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":47683.22,"providers":[{"billed_charge":46542.00,"npi":[1629058094]}]}]},{"tin":{"type":"ein","value":"640868008"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":147459.56,"providers":[{"billed_charge":114303.36,"npi":[1770533176]}]}]},{"tin":{"type":"ein","value":"720701964"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":80271.41,"providers":[{"billed_charge":127039.98,"npi":[1316943566]}]}]},{"tin":{"type":"ein","value":"640466231"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":190481.34,"providers":[{"billed_charge":200293.00,"npi":[1003829375]}]}]},{"tin":{"type":"ein","value":"872889138"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":620853.27,"providers":[{"billed_charge":628281.50,"npi":[1932821063]}]}]}]},{"name":"AMB SVC ALS NON ER TRSPRT L1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0426","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NONEMERGENCY TRANSPORT, LEVEL 1 (ALS 1)","allowed_amounts":[{"tin":{"type":"ein","value":"640868008"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":6223.35,"providers":[{"billed_charge":5575.89,"npi":[1770533176]}]}]}]},{"name":"AMB SVC ALS ER TRNSPRT LVL1","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS 1 - EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"721275309"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":54982.84,"providers":[{"billed_charge":54982.84,"npi":[1619071941]}]}]},{"tin":{"type":"ein","value":"760796521"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":135392.92,"providers":[{"billed_charge":202980.00,"npi":[1316047392]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":145396.36,"providers":[{"billed_charge":1688476.09,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"465007345"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":32675.60,"providers":[{"billed_charge":26302.42,"npi":[1760831630]}]}]},{"tin":{"type":"ein","value":"43171173"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20256.48,"providers":[{"billed_charge":20242.90,"npi":[1366492910]}]}]},{"tin":{"type":"ein","value":"646001540"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":80171.44,"providers":[{"billed_charge":78550.00,"npi":[1629058094]}]}]},{"tin":{"type":"ein","value":"640868008"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":227165.75,"providers":[{"billed_charge":164506.15,"npi":[1770533176]}]}]},{"tin":{"type":"ein","value":"720701964"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":156221.09,"providers":[{"billed_charge":288224.00,"npi":[1316943566]}]}]},{"tin":{"type":"ein","value":"640466231"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":347308.29,"providers":[{"billed_charge":361100.00,"npi":[1003829375]}]}]},{"tin":{"type":"ein","value":"872889138"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":1092703.22,"providers":[{"billed_charge":1101980.00,"npi":[1932821063]}]}]}]},{"name":"AMB SERVICE BLS NONEMERG TRA","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0428","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NONEMERGENCY TRANSPORT, (BLS)","allowed_amounts":[{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3815.64,"providers":[{"billed_charge":62208.36,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"43171173"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":3683.71,"providers":[{"billed_charge":3683.71,"npi":[1366492910]}]}]},{"tin":{"type":"ein","value":"872889138"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":154045.88,"providers":[{"billed_charge":154970.00,"npi":[1932821063]}]}]}]},{"name":"AMB SERVICE BLS EMERGENCY TR","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0429","description":"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS, EMERGENCY)","allowed_amounts":[{"tin":{"type":"ein","value":"760796521"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26099.92,"providers":[{"billed_charge":44990.00,"npi":[1316047392]}]}]},{"tin":{"type":"ein","value":"454506713"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":31542.81,"providers":[{"billed_charge":458989.77,"npi":[1356761589]}]}]},{"tin":{"type":"ein","value":"43171173"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":20658.42,"providers":[{"billed_charge":20358.39,"npi":[1366492910]}]}]},{"tin":{"type":"ein","value":"646001540"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":13757.90,"providers":[{"billed_charge":13500.00,"npi":[1629058094]}]}]},{"tin":{"type":"ein","value":"640466231"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":133499.17,"providers":[{"billed_charge":137400.00,"npi":[1003829375]}]}]},{"tin":{"type":"ein","value":"720701964"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":30803.64,"providers":[{"billed_charge":58165.00,"npi":[1316943566]}]}]},{"tin":{"type":"ein","value":"872889138"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":313658.50,"providers":[{"billed_charge":322290.00,"npi":[1932821063]}]}]}]},{"name":"AMB RSPN&TREATMENT NO TRNSPT","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0998","description":"AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT","allowed_amounts":[{"tin":{"type":"ein","value":"872889138"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":33000.00,"providers":[{"billed_charge":33000.00,"npi":[1932821063]}]}]}]},{"name":"monthly supply allowance for a non-adjunctive, non-implanted continuous glucose monitor (CGM)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4239","description":"monthly supply allowance for a non-adjunctive, non-implanted continuous glucose monitor (CGM)","allowed_amounts":[{"tin":{"type":"ein","value":"999999999"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":9018.24,"providers":[{"billed_charge":26524.08,"npi":[1234567893]}]}]}]},{"name":"CONTINUOUS POS AIRWAY PRESSU","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"E0601","description":"CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE","allowed_amounts":[{"tin":{"type":"ein","value":"640616376"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":1008.42,"providers":[{"billed_charge":2100.00,"npi":[1467415414]}]}]},{"tin":{"type":"ein","value":"640936379"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":882.42,"providers":[{"billed_charge":2380.00,"npi":[1811708019]}]},{"allowed_amount":405.18,"providers":[{"billed_charge":1020.00,"npi":[1245936681]}]}]},{"tin":{"type":"ein","value":"640715328"},"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":576.24,"providers":[{"billed_charge":1600.00,"npi":[1538102900]}]}]}]},{"name":"FQHC VISIT ESTABLISHED PATIE","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0467","description":"FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, ESTABLISHED PATIENT","allowed_amounts":[{"tin":{"type":"ein","value":"640829371"},"service_code":["50"],"billing_class":"professional","payments":[{"allowed_amount":294.00,"providers":[{"billed_charge":980.00,"npi":[1295296408]}]}]}]},{"name":"DR TST DEFIN DR ID M P D 1-7","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUG","allowed_amounts":[{"tin":{"type":"ein","value":"473479587"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":4453.17,"providers":[{"billed_charge":39530.40,"npi":[1891182812]}]}]}]},{"name":"ALCOHL&/RX SRVC; INTENSV OP;","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"H0015","description":"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS","allowed_amounts":[{"tin":{"type":"ein","value":"923029503"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":14375.00,"providers":[{"billed_charge":57500.00,"npi":[1124635354]}]}]}]},{"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":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.94,"providers":[{"billed_charge":79.50,"npi":[1659775732]}]}]},{"tin":{"type":"ein","value":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.00,"providers":[{"billed_charge":520.00,"npi":[1336981836]}]}]},{"tin":{"type":"ein","value":"822133878"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":19.61,"providers":[{"billed_charge":420.00,"npi":[1275216467]}]}]}]},{"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":"883800094"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.87,"providers":[{"billed_charge":144.00,"npi":[1336981836]}]}]},{"tin":{"type":"ein","value":"646001350"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":0.12,"providers":[{"billed_charge":26.00,"npi":[1598865362]}]},{"allowed_amount":0.64,"providers":[{"billed_charge":156.00,"npi":[1659775732]}]}]},{"tin":{"type":"ein","value":"462950767"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":3.60,"providers":[{"billed_charge":129.00,"npi":[1861277964]}]}]},{"tin":{"type":"ein","value":"852620842"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":1.14,"providers":[{"billed_charge":63.00,"npi":[1174980478]}]}]},{"tin":{"type":"ein","value":"822133878"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":10.80,"providers":[{"billed_charge":325.00,"npi":[1275216467]}]}]}]},{"name":"GLBAL FEE URGNT CARE CENTERS","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"S9083","description":"GLOBAL FEE URGENT CARE CENTERS","allowed_amounts":[{"tin":{"type":"ein","value":"640914383"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":14000.00,"providers":[{"billed_charge":15470.00,"npi":[1013524495]}]}]}]}]}