{"reporting_entity_name": "Oscar Health", "reporting_entity_type": "Health Insurance Issuer", "plan_id": "23818NJ001", "last_updated_on": "2026-03-23", "version": "2.0.0", "out_of_network": [{"name": "Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes", "billing_code_type": "CPT", "billing_code": "97153", "billing_code_type_version": "2022", "description": "ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "271365998"}, "billing_class": "professional", "service_codes": ["12", "11"], "payments": [{"allowed_amount": 69.28, "providers": [{"billed_charge": 250.0, "npi": [1679961205]}]}, {"allowed_amount": 90.0, "providers": [{"billed_charge": 250.0, "npi": [1972327815, 1144552621, 1538564497, 1679961205, 1306276795]}]}, {"allowed_amount": 100.0, "providers": [{"billed_charge": 250.0, "npi": [1538564497]}]}]}, {"tin": {"type": "ein", "value": "811802150"}, "billing_class": "professional", "service_codes": ["12", "99"], "payments": [{"allowed_amount": 62.5, "providers": [{"billed_charge": 75.0, "npi": [1538412762]}]}]}]}, {"name": "Albumin; urine (eg, microalbumin), quantitative", "billing_code_type": "CPT", "billing_code": "82043", "billing_code_type_version": "2022", "description": "URINE ALBUMIN QUANTITATIVE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 23.12, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 23.16, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 65.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 5.78, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 220.0, "npi": [1164701561]}, {"billed_charge": 440.0, "npi": [1164701561]}]}, {"allowed_amount": 5.82, "providers": [{"billed_charge": 220.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 55.51, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 83.64, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 64.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.91, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}]}, {"name": "Ambulance service, basic life support, emergency transport (bls-emergency)", "billing_code_type": "CPT", "billing_code": "A0429", "billing_code_type_version": "2022", "description": "Ambulance service, basic life support, emergency transport (bls-emergency)", "allowed_amounts": [{"tin": {"type": "ein", "value": "111631788"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 798.46, "providers": [{"billed_charge": 995.0, "npi": [1245370717]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 798.46, "providers": [{"billed_charge": 2275.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1204.8, "providers": [{"billed_charge": 2275.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 535.21, "providers": [{"billed_charge": 1385.0, "npi": [1083715460]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 603.75, "providers": [{"billed_charge": 1725.0, "npi": [1346614443]}]}]}, {"tin": {"type": "ein", "value": "203896610"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 510.34, "providers": [{"billed_charge": 1100.0, "npi": [1912926106]}]}]}, {"tin": {"type": "ein", "value": "205015479"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 950.0, "npi": [1912112491]}]}]}, {"tin": {"type": "ein", "value": "210737081"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1650.0, "npi": [1992837363]}]}]}, {"tin": {"type": "ein", "value": "210742613"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1000.0, "npi": [1871691774]}]}]}, {"tin": {"type": "ein", "value": "216000035"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 780.0, "providers": [{"billed_charge": 780.0, "npi": [1659562668]}]}]}, {"tin": {"type": "ein", "value": "216000379"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 800.0, "npi": [1720090491]}]}]}, {"tin": {"type": "ein", "value": "216000541"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 800.0, "npi": [1073509154]}]}]}, {"tin": {"type": "ein", "value": "216000660"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 895.0, "npi": [1770777674]}]}]}, {"tin": {"type": "ein", "value": "216000749"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 800.0, "npi": [1174630172]}]}]}, {"tin": {"type": "ein", "value": "216000784"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 800.0, "npi": [1053307157]}]}]}, {"tin": {"type": "ein", "value": "216000823"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1026.0, "npi": [1639702368]}]}, {"allowed_amount": 790.53, "providers": [{"billed_charge": 1026.0, "npi": [1639702368]}]}]}, {"tin": {"type": "ein", "value": "216000881"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1150.0, "npi": [1255778486]}]}]}, {"tin": {"type": "ein", "value": "216000916"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1326498643]}]}]}, {"tin": {"type": "ein", "value": "221714121"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1245564467]}]}]}, {"tin": {"type": "ein", "value": "221915868"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 750.0, "providers": [{"billed_charge": 750.0, "npi": [1831349380]}]}]}, {"tin": {"type": "ein", "value": "222319642"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1200.0, "npi": [1588401707]}]}]}, {"tin": {"type": "ein", "value": "222442017"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 700.0, "npi": [1215916440]}]}]}, {"tin": {"type": "ein", "value": "222581178"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1000.0, "npi": [1316493596]}]}]}, {"tin": {"type": "ein", "value": "222940768"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1100.0, "npi": [1821231721]}]}]}, {"tin": {"type": "ein", "value": "223097062"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 950.0, "npi": [1184118457]}]}]}, {"tin": {"type": "ein", "value": "223257717"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1100.0, "npi": [1275664823]}]}]}, {"tin": {"type": "ein", "value": "223385668"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1250.0, "npi": [1326141771]}]}]}, {"tin": {"type": "ein", "value": "223472557"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1578.0, "npi": [1144543653]}]}]}, {"tin": {"type": "ein", "value": "223655842"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 809.46, "providers": [{"billed_charge": 1500.0, "npi": [1033769849]}]}]}, {"tin": {"type": "ein", "value": "223702071"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 809.46, "providers": [{"billed_charge": 1245.0, "npi": [1811949779]}]}]}, {"tin": {"type": "ein", "value": "225002051"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 850.0, "npi": [1154651990]}]}]}, {"tin": {"type": "ein", "value": "226001739"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1689653883]}]}]}, {"tin": {"type": "ein", "value": "226001742"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1200.0, "npi": [1588937908]}]}]}, {"tin": {"type": "ein", "value": "226001772"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1922267004]}]}]}, {"tin": {"type": "ein", "value": "226001779"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 637.0, "providers": [{"billed_charge": 637.0, "npi": [1366435745]}]}]}, {"tin": {"type": "ein", "value": "226002036"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1400.0, "npi": [1083061402]}]}]}, {"tin": {"type": "ein", "value": "226002052"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1200.0, "npi": [1770338329]}]}]}, {"tin": {"type": "ein", "value": "226002092"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 950.0, "npi": [1730182627]}]}]}, {"tin": {"type": "ein", "value": "226002115"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 750.0, "providers": [{"billed_charge": 750.0, "npi": [1225024334]}]}]}, {"tin": {"type": "ein", "value": "226002151"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1500.0, "npi": [1962498063]}]}]}, {"tin": {"type": "ein", "value": "226002186"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 950.0, "npi": [1265656805]}]}]}, {"tin": {"type": "ein", "value": "226002190"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.93, "providers": [{"billed_charge": 1000.0, "npi": [1962481101]}]}]}, {"tin": {"type": "ein", "value": "226002200"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.93, "providers": [{"billed_charge": 950.0, "npi": [1174519292]}]}, {"allowed_amount": 790.53, "providers": [{"billed_charge": 950.0, "npi": [1174519292]}]}]}, {"tin": {"type": "ein", "value": "226002394"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 800.0, "npi": [1467699785]}]}]}, {"tin": {"type": "ein", "value": "226002416"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1500.0, "npi": [1326175191]}]}]}, {"tin": {"type": "ein", "value": "226002426"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1300.0, "npi": [1639878432]}]}]}, {"tin": {"type": "ein", "value": "226002481"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 850.0, "npi": [1861784266]}]}]}, {"tin": {"type": "ein", "value": "226043859"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1950.0, "npi": [1023097268]}]}]}, {"tin": {"type": "ein", "value": "226064813"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1100.0, "npi": [1548394786]}]}]}, {"tin": {"type": "ein", "value": "226208273"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 510.34, "providers": [{"billed_charge": 900.0, "npi": [1750560975]}, {"billed_charge": 975.0, "npi": [1750560975]}]}]}, {"tin": {"type": "ein", "value": "236003047"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 492.73, "providers": [{"billed_charge": 950.0, "npi": [1255468435]}]}]}, {"tin": {"type": "ein", "value": "237000760"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1288.0, "npi": [1295715357]}]}]}, {"tin": {"type": "ein", "value": "237102800"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1200.0, "npi": [1598923781]}]}]}, {"tin": {"type": "ein", "value": "237107761"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.93, "providers": [{"billed_charge": 900.0, "npi": [1982603544]}]}]}, {"tin": {"type": "ein", "value": "237113915"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.93, "providers": [{"billed_charge": 1500.0, "npi": [1316359706]}]}]}, {"tin": {"type": "ein", "value": "237125570"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1730564436]}]}]}, {"tin": {"type": "ein", "value": "237140015"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 836.04, "providers": [{"billed_charge": 900.0, "npi": [1184600454]}]}]}, {"tin": {"type": "ein", "value": "260058225"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1200.0, "npi": [1952588352]}]}]}, {"tin": {"type": "ein", "value": "262220917"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 1375.0, "npi": [1194986083]}]}]}, {"tin": {"type": "ein", "value": "270294681"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1580.0, "npi": [1457680001]}]}]}, {"tin": {"type": "ein", "value": "452401199"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1598000648]}]}]}, {"tin": {"type": "ein", "value": "465462438"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1538566138]}]}]}, {"tin": {"type": "ein", "value": "475029024"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1750.0, "npi": [1780138826]}]}]}, {"tin": {"type": "ein", "value": "591395439"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 641.17, "providers": [{"billed_charge": 988.42, "npi": [1598715716]}]}]}, {"tin": {"type": "ein", "value": "810565795"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1346229572]}]}]}, {"tin": {"type": "ein", "value": "830812803"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1530.0, "npi": [1740774504]}]}]}, {"tin": {"type": "ein", "value": "873690973"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1000.0, "npi": [1780339051]}]}]}, {"tin": {"type": "ein", "value": "920682174"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 790.53, "providers": [{"billed_charge": 1900.0, "npi": [1639955354]}]}]}, {"tin": {"type": "ein", "value": "992723575"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 762.52, "providers": [{"billed_charge": 2388.05, "npi": [1134959604]}]}, {"allowed_amount": 809.46, "providers": [{"billed_charge": 2388.05, "npi": [1134959604]}]}]}]}, {"name": "Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified", "billing_code_type": "CPT", "billing_code": "00811", "billing_code_type_version": "2022", "description": "ANESTHESIA LOWER INTST ENDOSCOPIC PX NOS", "allowed_amounts": [{"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 443.7, "billing_code_modifier": ["QX"], "providers": [{"billed_charge": 595.0, "npi": [1740899509]}]}, {"allowed_amount": 463.28, "billing_code_modifier": ["P3,QX"], "providers": [{"billed_charge": 510.0, "npi": [1609201268]}]}, {"allowed_amount": 595.0, "billing_code_modifier": ["QX"], "providers": [{"billed_charge": 595.0, "npi": [1912657487]}]}]}, {"tin": {"type": "ein", "value": "223342098"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 1265.85, "billing_code_modifier": ["AA,P3"], "providers": [{"billed_charge": 3300.0, "npi": [1730314972]}]}]}, {"tin": {"type": "ein", "value": "471880700"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 345.83, "billing_code_modifier": ["QK", "QX"], "providers": [{"billed_charge": 1000.0, "npi": [1417933649, 1346293503]}]}, {"allowed_amount": 358.88, "billing_code_modifier": ["QX"], "providers": [{"billed_charge": 1200.0, "npi": [1417933649]}]}, {"allowed_amount": 463.28, "billing_code_modifier": ["QK", "QX"], "providers": [{"billed_charge": 1400.0, "npi": [1386642361, 1497024343]}]}]}, {"tin": {"type": "ein", "value": "873838698"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 665.55, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1800.0, "npi": [1477510873]}]}]}, {"tin": {"type": "ein", "value": "882558602"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 717.75, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1851365217]}]}, {"allowed_amount": 783.0, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1093726119]}]}, {"allowed_amount": 796.05, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3500.0, "npi": [1457442162]}]}, {"allowed_amount": 809.1, "billing_code_modifier": ["AA,P3"], "providers": [{"billed_charge": 3500.0, "npi": [1659325074]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 274.25, "billing_code_modifier": ["QY"], "providers": [{"billed_charge": 274.25, "npi": [1467765149, 1164605663]}]}, {"allowed_amount": 329.1, "billing_code_modifier": ["QY"], "providers": [{"billed_charge": 329.1, "npi": [1104828193]}]}, {"allowed_amount": 332.78, "billing_code_modifier": ["QX"], "providers": [{"billed_charge": 548.5, "npi": [1164754990, 1497883623]}]}, {"allowed_amount": 358.88, "billing_code_modifier": ["QX"], "providers": [{"billed_charge": 658.2, "npi": [1497883623]}]}]}]}, {"name": "Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy", "billing_code_type": "CPT", "billing_code": "00812", "billing_code_type_version": "2022", "description": "ANESTHESIA LOWER INTST ENDOSCOPIC PX SCR COLSC", "allowed_amounts": [{"tin": {"type": "ein", "value": "223342098"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 844.8, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1650.0, "npi": [1356319016]}]}, {"allowed_amount": 895.49, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1980.0, "npi": [1467089540, 1174977276]}]}, {"allowed_amount": 963.07, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1980.0, "npi": [1386087344, 1609403674]}]}]}, {"tin": {"type": "ein", "value": "223624559"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 400.0, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 400.0, "npi": [1841384757]}]}]}, {"tin": {"type": "ein", "value": "462656846"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 912.38, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1000.0, "npi": [1619053741]}]}, {"allowed_amount": 929.28, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1000.0, "npi": [1619053741]}]}, {"allowed_amount": 1000.0, "billing_code_modifier": ["AA,P3"], "providers": [{"billed_charge": 1000.0, "npi": [1235132440]}]}, {"allowed_amount": 1064.45, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1200.0, "npi": [1619053741]}]}]}, {"tin": {"type": "ein", "value": "471880700"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 515.33, "billing_code_modifier": ["QK", "QX"], "providers": [{"billed_charge": 1200.0, "npi": [1154563336, 1386642361]}]}]}, {"tin": {"type": "ein", "value": "873838698"}, "billing_class": "professional", "service_codes": ["24", "22"], "payments": [{"allowed_amount": 979.97, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 1800.0, "npi": [1992841548]}]}, {"allowed_amount": 1064.45, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 2100.0, "npi": [1457524092, 1467419325]}]}, {"allowed_amount": 1081.34, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 2100.0, "npi": [1841633864]}]}]}, {"tin": {"type": "ein", "value": "882558602"}, "billing_class": "professional", "service_codes": ["24", "11"], "payments": [{"allowed_amount": 861.7, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1659325074]}]}, {"allowed_amount": 878.59, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1396137683]}]}, {"allowed_amount": 895.49, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1386986842]}]}, {"allowed_amount": 929.28, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1083889174]}]}, {"allowed_amount": 946.18, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1093726119]}]}, {"allowed_amount": 963.07, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3000.0, "npi": [1093726119]}]}, {"allowed_amount": 979.97, "billing_code_modifier": ["AA,P3"], "providers": [{"billed_charge": 3000.0, "npi": [1164898698]}]}, {"allowed_amount": 1064.45, "billing_code_modifier": ["AA"], "providers": [{"billed_charge": 3500.0, "npi": [1457442162]}]}]}]}, {"name": "Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)", "billing_code_type": "CPT", "billing_code": "80048", "billing_code_type_version": "2022", "description": "BASIC METABOLIC PANEL CALCIUM TOTAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "050258905"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.19, "providers": [{"billed_charge": 242.9, "npi": [1487649430]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.02, "providers": [{"billed_charge": 96.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 26.78, "providers": [{"billed_charge": 26.78, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.93, "providers": [{"billed_charge": 130.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 62.61, "providers": [{"billed_charge": 178.89, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.19, "providers": [{"billed_charge": 14.05, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.36, "providers": [{"billed_charge": 263.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.19, "providers": [{"billed_charge": 8.46, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 46.0, "providers": [{"billed_charge": 868.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.19, "providers": [{"billed_charge": 42.3, "npi": [1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.19, "providers": [{"billed_charge": 59.22, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 54.72, "providers": [{"billed_charge": 111.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 92.28, "providers": [{"billed_charge": 510.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 155.84, "providers": [{"billed_charge": 572.75, "npi": [1730132234]}, {"billed_charge": 669.5, "npi": [1982666111]}]}]}, {"tin": {"type": "ein", "value": "811723202"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 54.72, "providers": [{"billed_charge": 181.0, "npi": [1063968196]}]}]}, {"tin": {"type": "ein", "value": "812857619"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 66.81, "providers": [{"billed_charge": 100.0, "npi": [1710491253]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.42, "providers": [{"billed_charge": 79.0, "npi": [1598315574]}]}]}]}, {"name": "Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)", "billing_code_type": "CPT", "billing_code": "85027", "billing_code_type_version": "2022", "description": "BLOOD COUNT COMPLETE AUTOMATED", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 45.29, "npi": [1124024922]}]}, {"allowed_amount": 6.2, "providers": [{"billed_charge": 45.29, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "050258905"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 10.99, "providers": [{"billed_charge": 48.0, "npi": [1487649430]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 85.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.69, "providers": [{"billed_charge": 67.68, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 9.45, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 16.18, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 35.66, "providers": [{"billed_charge": 245.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.25, "providers": [{"billed_charge": 75.5, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "561398929"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 35.65, "npi": [1811005150]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 63.86, "providers": [{"billed_charge": 326.0, "npi": [1710931522]}, {"billed_charge": 903.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 76.72, "providers": [{"billed_charge": 901.0, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.2, "providers": [{"billed_charge": 79.0, "npi": [1598315574]}]}]}]}, {"name": "Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count", "billing_code_type": "CPT", "billing_code": "85025", "billing_code_type_version": "2022", "description": "BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC", "allowed_amounts": [{"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 52.05, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 31.08, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.41, "providers": [{"billed_charge": 58.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.83, "providers": [{"billed_charge": 19.42, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.51, "providers": [{"billed_charge": 128.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.51, "providers": [{"billed_charge": 125.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.58, "providers": [{"billed_charge": 32.58, "npi": [1073535027, 1467469023]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.51, "providers": [{"billed_charge": 93.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 48.51, "providers": [{"billed_charge": 138.61, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "141338586"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.41, "providers": [{"billed_charge": 33.0, "npi": [1740233899]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.0, "providers": [{"billed_charge": 125.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 150.0, "npi": [1215038310]}]}, {"allowed_amount": 7.83, "providers": [{"billed_charge": 150.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 23.31, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 14.04, "npi": [1093749087]}]}, {"allowed_amount": 6.81, "providers": [{"billed_charge": 14.04, "npi": [1093749087]}]}, {"allowed_amount": 7.91, "providers": [{"billed_charge": 14.04, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.26, "providers": [{"billed_charge": 273.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 48.65, "providers": [{"billed_charge": 51.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "231996150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 39.22, "providers": [{"billed_charge": 159.0, "npi": [1174822068]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 37.21, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 7.77, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.46, "providers": [{"billed_charge": 245.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.73, "providers": [{"billed_charge": 87.5, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 47.54, "providers": [{"billed_charge": 861.62, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "382084239"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 52.05, "npi": [1518903350]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 50.88, "providers": [{"billed_charge": 861.62, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 47.54, "providers": [{"billed_charge": 861.62, "npi": [1043475668]}]}, {"allowed_amount": 48.8, "providers": [{"billed_charge": 861.62, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452497248"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 92.51, "providers": [{"billed_charge": 706.0, "npi": [1114473329]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 57.2, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "461653414"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 23.0, "npi": [1558609008]}]}, {"allowed_amount": 7.27, "providers": [{"billed_charge": 23.0, "npi": [1558609008]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 38.85, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 73.0, "providers": [{"billed_charge": 73.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 51.64, "providers": [{"billed_charge": 126.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.83, "providers": [{"billed_charge": 155.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "592650456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 65.17, "providers": [{"billed_charge": 354.0, "npi": [1144228446]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 96.36, "providers": [{"billed_charge": 285.5, "npi": [1730132234]}, {"billed_charge": 317.0, "npi": [1982666111]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 69.87, "providers": [{"billed_charge": 253.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 61.45, "providers": [{"billed_charge": 227.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "811723202"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.83, "providers": [{"billed_charge": 126.0, "npi": [1063968196]}]}]}, {"tin": {"type": "ein", "value": "812857619"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 47.54, "providers": [{"billed_charge": 147.0, "npi": [1710491253]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 66.55, "providers": [{"billed_charge": 325.1, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.6, "providers": [{"billed_charge": 39.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.83, "providers": [{"billed_charge": 81.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.26, "providers": [{"billed_charge": 188.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 30.23, "providers": [{"billed_charge": 682.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.15, "providers": [{"billed_charge": 94.0, "npi": [1982606992]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.8, "providers": [{"billed_charge": 140.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 69.0, "providers": [{"billed_charge": 69.0, "npi": [1427806025]}]}]}]}, {"name": "C-reactive protein; high sensitivity (hsCRP)", "billing_code_type": "CPT", "billing_code": "86141", "billing_code_type_version": "2022", "description": "C-REACTIVE PROTEIN HIGH SENSITIVITY", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 51.8, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 73.36, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "208833340"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 21.0, "npi": [1922259753]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 12.95, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 119.14, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 64.75, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 264.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 69.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.01, "providers": [{"billed_charge": 25.9, "npi": [1710667050]}]}]}]}, {"name": "Collection of venous blood by venipuncture", "billing_code_type": "CPT", "billing_code": "36415", "billing_code_type_version": "2022", "description": "COLLECTION VENOUS BLOOD VENIPUNCTURE", "allowed_amounts": [{"tin": {"type": "ein", "value": "010894487"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 10.0, "npi": [1558672279]}]}]}, {"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 36.4, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "061520109"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 28.0, "npi": [1629082920]}]}]}, {"tin": {"type": "ein", "value": "077685850"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 56.03, "providers": [{"billed_charge": 5.0, "npi": [1053568873]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 12.0, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 25.0, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 12.0, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "131624082"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.63, "providers": [{"billed_charge": 116.0, "npi": [1841650330]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 22.08, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 20.0, "npi": [1134277494, 1215038310]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["32"], "payments": [{"allowed_amount": 4.73, "providers": [{"billed_charge": 10.57, "npi": [1093749087]}]}, {"allowed_amount": 7.72, "providers": [{"billed_charge": 10.57, "npi": [1093749087]}]}, {"allowed_amount": 7.73, "providers": [{"billed_charge": 10.57, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 9.09, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.0, "providers": [{"billed_charge": 25.0, "npi": [1164701561]}]}, {"allowed_amount": 7.73, "providers": [{"billed_charge": 20.0, "npi": [1164701561]}, {"billed_charge": 25.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "331946468"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 3.93, "providers": [{"billed_charge": 15.0, "npi": [1124437314]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 44.15, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.0, "providers": [{"billed_charge": 59.99, "npi": [1285018523]}]}, {"allowed_amount": 7.73, "providers": [{"billed_charge": 59.99, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "611661781"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 3.93, "providers": [{"billed_charge": 20.0, "npi": [1922758952]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 36.4, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "813168134"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 13.64, "npi": [1639621659]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 26.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 27.27, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 59.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 20.0, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.73, "providers": [{"billed_charge": 31.0, "npi": [1336763531]}]}]}]}, {"name": "Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphatase, alkaline (84075) Potassium (84132) Protein, total (84155) Sodium (84295) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450) Urea nitrogen (BUN) (84520)", "billing_code_type": "CPT", "billing_code": "80053", "billing_code_type_version": "2022", "description": "COMPREHENSIVE METABOLIC PANEL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 42.24, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 85.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.64, "providers": [{"billed_charge": 26.4, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 79.7, "providers": [{"billed_charge": 276.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131624082"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 33.26, "providers": [{"billed_charge": 381.0, "npi": [1841650330]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 79.7, "providers": [{"billed_charge": 168.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 40.08, "providers": [{"billed_charge": 40.08, "npi": [1467469023]}]}]}, {"tin": {"type": "ein", "value": "141338586"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 27.72, "providers": [{"billed_charge": 74.0, "npi": [1740233899]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.45, "providers": [{"billed_charge": 168.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 26.4, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 160.0, "npi": [1215038310]}]}, {"allowed_amount": 10.64, "providers": [{"billed_charge": 160.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 31.68, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.72, "providers": [{"billed_charge": 14.99, "npi": [1093749087]}]}, {"allowed_amount": 8.98, "providers": [{"billed_charge": 14.99, "npi": [1093749087]}]}, {"allowed_amount": 9.87, "providers": [{"billed_charge": 14.99, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 26.4, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 66.41, "providers": [{"billed_charge": 69.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "231996150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 123.18, "providers": [{"billed_charge": 491.0, "npi": [1174822068]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 57.16, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 10.56, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 61.61, "providers": [{"billed_charge": 310.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 123.78, "providers": [{"billed_charge": 1406.54, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 125.0, "providers": [{"billed_charge": 1406.54, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 123.78, "providers": [{"billed_charge": 1406.54, "npi": [1043475668]}]}, {"allowed_amount": 127.06, "providers": [{"billed_charge": 1406.54, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452497248"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 221.18, "providers": [{"billed_charge": 2252.0, "npi": [1114473329]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 74.25, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "461653414"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 32.0, "npi": [1558609008]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 52.8, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 73.92, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 112.0, "providers": [{"billed_charge": 112.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "561398929"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 35.65, "npi": [1811005150]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 58.24, "providers": [{"billed_charge": 400.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 56.68, "providers": [{"billed_charge": 297.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 177.32, "providers": [{"billed_charge": 531.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 100.75, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 571.63, "providers": [{"billed_charge": 785.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 571.68, "providers": [{"billed_charge": 996.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 95.83, "providers": [{"billed_charge": 354.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 571.63, "providers": [{"billed_charge": 2234.03, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 279.03, "providers": [{"billed_charge": 1230.33, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 49.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.98, "providers": [{"billed_charge": 105.6, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.64, "providers": [{"billed_charge": 140.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 192.0, "providers": [{"billed_charge": 192.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.57, "providers": [{"billed_charge": 2791.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.66, "providers": [{"billed_charge": 127.0, "npi": [1982606992]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 96.63, "providers": [{"billed_charge": 340.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 58.78, "providers": [{"billed_charge": 118.0, "npi": [1427806025]}]}]}]}, {"name": "Computed tomography, abdomen and pelvis; with contrast material(s)", "billing_code_type": "CPT", "billing_code": "74177", "billing_code_type_version": "2022", "description": "CT ABDOMEN & PELVIS W/CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "111631788"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 157.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 375.0, "npi": [1235699232]}]}]}, {"tin": {"type": "ein", "value": "131624082"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1075.69, "providers": [{"billed_charge": 4513.0, "npi": [1841650330]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1892.67, "providers": [{"billed_charge": 2511.46, "npi": [1467469023]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 157.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 236.0, "npi": [1790197663]}]}]}, {"tin": {"type": "ein", "value": "145908399"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 157.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 546.0, "npi": [1285842096]}]}]}, {"tin": {"type": "ein", "value": "223473330"}, "billing_class": "professional", "service_codes": ["22", "23"], "payments": [{"allowed_amount": 157.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 986.0, "npi": [1912915497, 1598753147, 1164756185]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 474.84, "providers": [{"billed_charge": 7194.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1786.0, "providers": [{"billed_charge": 1786.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "231855378"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 146.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 343.0, "npi": [1679992655]}]}]}, {"tin": {"type": "ein", "value": "232032300"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 146.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 375.0, "npi": [1053587485]}]}]}, {"tin": {"type": "ein", "value": "232700908"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 157.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 260.0, "npi": [1134103914]}]}]}, {"tin": {"type": "ein", "value": "232701565"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 84.52, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 345.0, "npi": [1790714111]}]}, {"allowed_amount": 146.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 345.0, "npi": [1457528697]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 146.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 281.0, "npi": [1245296235]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2015.42, "providers": [{"billed_charge": 5030.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 146.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 245.0, "npi": [1487189825, 1912550724]}]}]}, {"tin": {"type": "ein", "value": "461485841"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 136.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 348.0, "npi": [1891063996]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1307.36, "providers": [{"billed_charge": 37242.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 474.84, "providers": [{"billed_charge": 10584.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "990547982"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 157.97, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 334.0, "npi": [1770739260, 1689644213, 1407047228]}, {"billed_charge": 502.0, "npi": [1689644213]}]}]}]}, {"name": "Computed tomography, head or brain; without contrast material", "billing_code_type": "CPT", "billing_code": "70450", "billing_code_type_version": "2022", "description": "CT HEAD/BRAIN W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "011885702"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 255.0, "npi": [1386770121]}]}]}, {"tin": {"type": "ein", "value": "060646554"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 792.17, "providers": [{"billed_charge": 792.17, "npi": [1992910152]}]}]}, {"tin": {"type": "ein", "value": "060646973"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 98.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 190.0, "npi": [1255679064]}]}]}, {"tin": {"type": "ein", "value": "111631788"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 124.0, "npi": [1376563254]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 760.89, "providers": [{"billed_charge": 877.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 963.29, "providers": [{"billed_charge": 1332.9, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 108.0, "npi": [1376860114]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 963.29, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1800.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133964321"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 760.89, "providers": [{"billed_charge": 2311.0, "npi": [1932280666]}]}]}, {"tin": {"type": "ein", "value": "223473330"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 460.0, "npi": [1912915497, 1366462780, 1801152004]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 532.0, "providers": [{"billed_charge": 532.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "232701565"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 67.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 160.0, "npi": [1841584547]}]}, {"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 160.0, "npi": [1821395955]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 67.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 250.0, "npi": [1669601605]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 965.43, "providers": [{"billed_charge": 3030.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "264709927"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 162.0, "npi": [1619131505]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 502.9, "providers": [{"billed_charge": 9500.0, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 207.41, "npi": [1992125124]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 916.57, "providers": [{"billed_charge": 1885.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 987.03, "providers": [{"billed_charge": 1278.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "741688740"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 73.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 327.0, "npi": [1205223799]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 773.88, "providers": [{"billed_charge": 2427.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800886397"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 247.0, "npi": [1437180882]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 94.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 371.0, "npi": [1629065602]}]}]}, {"tin": {"type": "ein", "value": "911352172"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 653.36, "providers": [{"billed_charge": 3924.0, "npi": [1841258639]}]}]}, {"tin": {"type": "ein", "value": "990547982"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 74.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 156.0, "npi": [1033155320, 1770739260, 1396940342]}, {"billed_charge": 233.0, "npi": [1770739260]}]}, {"allowed_amount": 77.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 156.0, "npi": [1821040866]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3038.67, "providers": [{"billed_charge": 5840.0, "npi": [1427806025]}]}]}]}, {"name": "Creatinine; other source", "billing_code_type": "CPT", "billing_code": "82570", "billing_code_type_version": "2022", "description": "CREATININE OTHER SOURCE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 20.72, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 35.0, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.41, "providers": [{"billed_charge": 23.16, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 65.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 5.18, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 72.8, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 36.26, "npi": [1285018523]}]}, {"allowed_amount": 5.21, "providers": [{"billed_charge": 36.26, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 65.63, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 64.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.21, "providers": [{"billed_charge": 85.0, "npi": [1598315574]}]}]}]}, {"name": "Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes", "billing_code_type": "CPT", "billing_code": "99291", "billing_code_type_version": "2022", "description": "CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "151826896"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 37.98, "providers": [{"billed_charge": 1762.0, "npi": [1497152714]}]}]}, {"tin": {"type": "ein", "value": "222668179"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 496.79, "providers": [{"billed_charge": 1596.0, "npi": [1194302372]}]}]}, {"tin": {"type": "ein", "value": "222775331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 466.44, "providers": [{"billed_charge": 2330.8, "npi": [1154581635]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 496.79, "providers": [{"billed_charge": 885.0, "npi": [1689932493]}]}]}, {"tin": {"type": "ein", "value": "223527701"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 837.05, "providers": [{"billed_charge": 2063.0, "npi": [1881088821]}]}]}, {"tin": {"type": "ein", "value": "223586506"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 818.03, "providers": [{"billed_charge": 2046.0, "npi": [1447791868]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 837.05, "providers": [{"billed_charge": 2058.0, "npi": [1629233275]}, {"billed_charge": 2072.0, "npi": [1770947699, 1356929475]}]}]}, {"tin": {"type": "ein", "value": "223589282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 818.03, "providers": [{"billed_charge": 1331.0, "npi": [1275968570, 1265638787]}]}]}, {"tin": {"type": "ein", "value": "223838009"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 466.44, "providers": [{"billed_charge": 1257.07, "npi": [1841235777, 1831360502]}]}, {"allowed_amount": 496.79, "providers": [{"billed_charge": 1257.07, "npi": [1215462619]}]}]}, {"tin": {"type": "ein", "value": "232919472"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 389.64, "providers": [{"billed_charge": 663.0, "npi": [1205332483]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3940.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3940.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 484.28, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1922.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "320558440"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 275.57, "providers": [{"billed_charge": 1217.0, "npi": [1881140135]}]}, {"allowed_amount": 328.06, "providers": [{"billed_charge": 1217.0, "npi": [1215170527]}]}]}, {"tin": {"type": "ein", "value": "384105407"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 358.03, "providers": [{"billed_charge": 1358.0, "npi": [1871702977]}]}]}, {"tin": {"type": "ein", "value": "451499724"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 358.03, "providers": [{"billed_charge": 2500.0, "npi": [1245420470]}]}]}, {"tin": {"type": "ein", "value": "462911982"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 837.05, "providers": [{"billed_charge": 2096.0, "npi": [1881824548]}]}]}, {"tin": {"type": "ein", "value": "475032413"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 358.03, "providers": [{"billed_charge": 1500.0, "npi": [1033209333]}]}]}, {"tin": {"type": "ein", "value": "742501542"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.27, "providers": [{"billed_charge": 1847.37, "npi": [1669630067, 1306157334]}]}]}, {"tin": {"type": "ein", "value": "752778807"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 466.44, "providers": [{"billed_charge": 2163.0, "npi": [1235210279]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2585.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 9551.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "813879476"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 358.03, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 713.0, "npi": [1013127562]}]}, {"allowed_amount": 429.08, "providers": [{"billed_charge": 713.0, "npi": [1548208135]}]}, {"allowed_amount": 496.79, "providers": [{"billed_charge": 713.0, "npi": [1538628581, 1013234517]}]}]}, {"tin": {"type": "ein", "value": "822503787"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 466.44, "providers": [{"billed_charge": 1257.07, "npi": [1427025105, 1851489231]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3212.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6719.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "873517825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 466.44, "providers": [{"billed_charge": 2280.0, "npi": [1871765073, 1538175633, 1659803021, 1710399431]}]}]}, {"tin": {"type": "ein", "value": "922417967"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.27, "providers": [{"billed_charge": 1217.0, "npi": [1659758993]}]}]}, {"tin": {"type": "ein", "value": "954873894"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 386.52, "providers": [{"billed_charge": 1855.05, "npi": [1578190864]}]}]}]}, {"name": "Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates", "billing_code_type": "CPT", "billing_code": "87070", "billing_code_type_version": "2022", "description": "CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL", "allowed_amounts": [{"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.33, "providers": [{"billed_charge": 86.23, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.33, "providers": [{"billed_charge": 34.48, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.33, "providers": [{"billed_charge": 25.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 216.75, "providers": [{"billed_charge": 601.42, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 186.78, "providers": [{"billed_charge": 690.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.33, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 49.0, "npi": [1225110497]}]}]}]}, {"name": "Culture, bacterial; quantitative colony count, urine", "billing_code_type": "CPT", "billing_code": "87086", "billing_code_type_version": "2022", "description": "CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.86, "providers": [{"billed_charge": 32.28, "npi": [1598820235]}]}, {"allowed_amount": 8.08, "providers": [{"billed_charge": 32.28, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.86, "providers": [{"billed_charge": 13.39, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 49.65, "providers": [{"billed_charge": 235.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.49, "providers": [{"billed_charge": 180.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.04, "providers": [{"billed_charge": 56.49, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 18.07, "providers": [{"billed_charge": 223.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "593527036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 37.52, "providers": [{"billed_charge": 58.0, "npi": [1740276518]}]}]}, {"tin": {"type": "ein", "value": "610445850"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.28, "providers": [{"billed_charge": 32.28, "npi": [1467492421]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.86, "providers": [{"billed_charge": 10.0, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.86, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 39.0, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.86, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 80.7, "npi": [1881226579]}]}]}]}, {"name": "Cyanocobalamin (Vitamin B-12);", "billing_code_type": "CPT", "billing_code": "82607", "billing_code_type_version": "2022", "description": "CYANOCOBALAMIN VITAMIN B-12", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 105.56, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 60.32, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 125.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 83.2, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 46.72, "providers": [{"billed_charge": 133.48, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 85.0, "npi": [1134277494, 1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 45.24, "npi": [1053584482]}]}, {"allowed_amount": 15.19, "providers": [{"billed_charge": 45.24, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 25.0, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 89.19, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 15.08, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 27.0, "npi": [1164701561]}, {"billed_charge": 220.0, "npi": [1164701561]}]}, {"allowed_amount": 15.19, "providers": [{"billed_charge": 220.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 138.75, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 75.4, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 75.4, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 105.56, "npi": [1285018523]}]}, {"allowed_amount": 15.19, "providers": [{"billed_charge": 105.56, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 86.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 79.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 150.8, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.19, "providers": [{"billed_charge": 209.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 145.0, "npi": [1336763531]}]}]}]}, {"name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed", "billing_code_type": "CPT", "billing_code": "G0480", "billing_code_type_version": "2022", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed", "allowed_amounts": [{"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 357.59, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 286.08, "npi": [1447314513]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 135.9, "providers": [{"billed_charge": 230.92, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 250.0, "npi": [1164701561]}, {"billed_charge": 265.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "464460776"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 488.0, "npi": [1235665175]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 125.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "800270103"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 343.29, "npi": [1649418351]}]}]}, {"tin": {"type": "ein", "value": "820600568"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 323.53, "npi": [1780125633]}]}]}, {"tin": {"type": "ein", "value": "821256541"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 2265.0, "npi": [1952876203]}]}, {"allowed_amount": 141.25, "providers": [{"billed_charge": 2265.0, "npi": [1952876203]}]}]}, {"tin": {"type": "ein", "value": "823146637"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 779.86, "npi": [1861994600]}]}]}, {"tin": {"type": "ein", "value": "823473048"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.27, "providers": [{"billed_charge": 350.0, "npi": [1164924254]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 115.28, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 230.0, "npi": [1356783344]}]}]}]}, {"name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed", "billing_code_type": "CPT", "billing_code": "G0482", "billing_code_type_version": "2022", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed", "allowed_amounts": [{"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 168.93, "providers": [{"billed_charge": 2100.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 168.93, "providers": [{"billed_charge": 225.0, "npi": [1932586427]}]}, {"allowed_amount": 176.23, "providers": [{"billed_charge": 225.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "880241758"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 168.93, "providers": [{"billed_charge": 745.0, "npi": [1699782722]}]}]}, {"tin": {"type": "ein", "value": "921267784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 168.93, "providers": [{"billed_charge": 2500.0, "npi": [1588375828]}]}]}]}, {"name": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed", "billing_code_type": "CPT", "billing_code": "G0483", "billing_code_type_version": "2022", "description": "Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed", "allowed_amounts": [{"tin": {"type": "ein", "value": "261565558"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 209.88, "providers": [{"billed_charge": 499.0, "npi": [1497933162]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 209.88, "providers": [{"billed_charge": 2900.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "464460776"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 209.88, "providers": [{"billed_charge": 850.0, "npi": [1235665175]}]}]}, {"tin": {"type": "ein", "value": "880241758"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 209.88, "providers": [{"billed_charge": 926.0, "npi": [1699782722]}]}]}, {"tin": {"type": "ein", "value": "881194470"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 209.88, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 5050.0, "npi": [1497486880]}]}]}]}, {"name": "Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service", "billing_code_type": "CPT", "billing_code": "80307", "billing_code_type_version": "2022", "description": "DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE", "allowed_amounts": [{"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 194.18, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 179.48, "providers": [{"billed_charge": 297.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 87.48, "providers": [{"billed_charge": 988.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 49.71, "providers": [{"billed_charge": 155.35, "npi": [1447314513]}]}, {"allowed_amount": 52.82, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 155.35, "npi": [1881841120, 1447314513]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 240.69, "providers": [{"billed_charge": 1290.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 100.0, "npi": [1164701561]}, {"billed_charge": 200.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "352539778"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 77.68, "npi": [1972971265]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 400.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "464460776"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 248.56, "npi": [1235665175]}, {"billed_charge": 600.0, "npi": [1235665175]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 75.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 558.67, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 53.61, "providers": [{"billed_charge": 540.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "800270103"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 186.14, "npi": [1649418351]}]}]}, {"tin": {"type": "ein", "value": "820600568"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 219.47, "npi": [1780125633]}]}]}, {"tin": {"type": "ein", "value": "821256541"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 850.0, "npi": [1952876203]}]}]}, {"tin": {"type": "ein", "value": "823146637"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 2277.2, "npi": [1861994600]}]}]}, {"tin": {"type": "ein", "value": "823473048"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 240.0, "npi": [1164924254]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 309.0, "npi": [1356783344]}]}, {"allowed_amount": 65.15, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 125.0, "npi": [1356783344]}]}]}, {"tin": {"type": "ein", "value": "880241758"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 242.0, "npi": [1699782722]}]}]}, {"tin": {"type": "ein", "value": "881194470"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 710.0, "npi": [1497486880]}]}]}, {"tin": {"type": "ein", "value": "921267784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 52.82, "providers": [{"billed_charge": 1950.0, "npi": [1588375828]}]}]}]}, {"name": "Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only", "billing_code_type": "CPT", "billing_code": "93010", "billing_code_type_version": "2022", "description": "ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY", "allowed_amounts": [{"tin": {"type": "ein", "value": "061137531"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 24.49, "providers": [{"billed_charge": 33.0, "npi": [1235469263]}]}]}, {"tin": {"type": "ein", "value": "076481711"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 1.69, "providers": [{"billed_charge": 51.0, "npi": [1982603239]}]}]}, {"tin": {"type": "ein", "value": "113167120"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 28.0, "npi": [1346200383]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 22.0, "npi": [1942400254]}]}, {"allowed_amount": 14.21, "providers": [{"billed_charge": 22.0, "npi": [1447283940]}]}]}, {"tin": {"type": "ein", "value": "135562308"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 55.0, "npi": [1699735027]}]}]}, {"tin": {"type": "ein", "value": "135598093"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 16.09, "providers": [{"billed_charge": 70.0, "npi": [1942627955]}]}]}, {"tin": {"type": "ein", "value": "135925943"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.11, "providers": [{"billed_charge": 51.0, "npi": [1316947906]}]}]}, {"tin": {"type": "ein", "value": "200287387"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.43, "providers": [{"billed_charge": 72.0, "npi": [1811193253]}]}]}, {"tin": {"type": "ein", "value": "223476108"}, "billing_class": "professional", "service_codes": ["22", "21", "23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 35.0, "npi": [1184662470]}]}]}, {"tin": {"type": "ein", "value": "223527701"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 31.99, "providers": [{"billed_charge": 90.0, "npi": [1881088821]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 31.99, "providers": [{"billed_charge": 89.0, "npi": [1134513112, 1518127760, 1619544806, 1811936503]}, {"billed_charge": 90.0, "npi": [1356929475]}]}]}, {"tin": {"type": "ein", "value": "223589282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 31.19, "providers": [{"billed_charge": 70.0, "npi": [1881897916]}]}]}, {"tin": {"type": "ein", "value": "223817429"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 100.0, "npi": [1104999036]}]}]}, {"tin": {"type": "ein", "value": "223838009"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.87, "providers": [{"billed_charge": 48.02, "npi": [1215462619]}]}, {"allowed_amount": 16.43, "providers": [{"billed_charge": 48.02, "npi": [1841235777, 1437240363, 1104987932, 1568556751]}]}]}, {"tin": {"type": "ein", "value": "231352204"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.3, "providers": [{"billed_charge": 60.0, "npi": [1831234509]}]}]}, {"tin": {"type": "ein", "value": "232700908"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.3, "providers": [{"billed_charge": 45.0, "npi": [1790914299]}]}, {"allowed_amount": 18.71, "providers": [{"billed_charge": 45.0, "npi": [1366769663]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 13.98, "providers": [{"billed_charge": 30.0, "npi": [1417375924, 1093735847]}]}]}, {"tin": {"type": "ein", "value": "232790607"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.98, "providers": [{"billed_charge": 30.0, "npi": [1023273919]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.73, "providers": [{"billed_charge": 55.0, "npi": [1346263480, 1093164832]}]}, {"allowed_amount": 13.98, "providers": [{"billed_charge": 55.0, "npi": [1760590749]}]}]}, {"tin": {"type": "ein", "value": "232919472"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.74, "providers": [{"billed_charge": 31.0, "npi": [1205332483]}]}]}, {"tin": {"type": "ein", "value": "236291113"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.3, "providers": [{"billed_charge": 100.0, "npi": [1477947398]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.74, "providers": [{"billed_charge": 23.0, "npi": [1255080438]}]}]}, {"tin": {"type": "ein", "value": "264709927"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 32.0, "npi": [1720099732]}]}]}, {"tin": {"type": "ein", "value": "271369141"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 22.55, "providers": [{"billed_charge": 71.0, "npi": [1518703461]}]}]}, {"tin": {"type": "ein", "value": "273899821"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 45.0, "npi": [1700441482]}]}]}, {"tin": {"type": "ein", "value": "300520570"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.98, "providers": [{"billed_charge": 21.0, "npi": [1619080843]}]}]}, {"tin": {"type": "ein", "value": "331617353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.98, "providers": [{"billed_charge": 40.0, "npi": [1700049939]}]}]}, {"tin": {"type": "ein", "value": "331946468"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 40.0, "npi": [1396970208, 1881635084]}]}]}, {"tin": {"type": "ein", "value": "372985761"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.21, "providers": [{"billed_charge": 25.0, "npi": [1184987604]}]}]}, {"tin": {"type": "ein", "value": "452773050"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 31.59, "providers": [{"billed_charge": 92.0, "npi": [1275775967]}]}]}, {"tin": {"type": "ein", "value": "462333282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "providers": [{"billed_charge": 34.0, "npi": [1750499653]}]}]}, {"tin": {"type": "ein", "value": "465034266"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.21, "providers": [{"billed_charge": 86.0, "npi": [1013977453]}]}, {"allowed_amount": 16.43, "providers": [{"billed_charge": 86.0, "npi": [1629089719]}]}]}, {"tin": {"type": "ein", "value": "592623821"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 11.09, "providers": [{"billed_charge": 75.0, "npi": [1497758692]}]}]}, {"tin": {"type": "ein", "value": "611661781"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.04, "providers": [{"billed_charge": 58.0, "npi": [1629225479]}]}]}, {"tin": {"type": "ein", "value": "742501542"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 29.31, "providers": [{"billed_charge": 70.15, "npi": [1669630067, 1306157334]}]}]}, {"tin": {"type": "ein", "value": "752778807"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.43, "providers": [{"billed_charge": 101.0, "npi": [1235210279]}]}]}, {"tin": {"type": "ein", "value": "760459500"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 9.98, "providers": [{"billed_charge": 44.0, "npi": [1396904215]}]}]}, {"tin": {"type": "ein", "value": "811075984"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.21, "providers": [{"billed_charge": 68.75, "npi": [1992017719]}]}, {"allowed_amount": 16.43, "providers": [{"billed_charge": 68.75, "npi": [1578797007]}]}]}, {"tin": {"type": "ein", "value": "812705668"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.43, "providers": [{"billed_charge": 68.0, "npi": [1366868226]}]}]}, {"tin": {"type": "ein", "value": "812875670"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.37, "providers": [{"billed_charge": 64.8, "npi": [1831774504]}]}]}, {"tin": {"type": "ein", "value": "822503787"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.11, "providers": [{"billed_charge": 48.23, "npi": [1346690583]}]}, {"allowed_amount": 16.43, "providers": [{"billed_charge": 48.02, "npi": [1427025105, 1841282381, 1851489231]}]}]}, {"tin": {"type": "ein", "value": "831002191"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.74, "providers": [{"billed_charge": 30.0, "npi": [1457713554]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 21.21, "providers": [{"billed_charge": 78.0, "npi": [1831610948]}]}]}, {"tin": {"type": "ein", "value": "862109896"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.06, "providers": [{"billed_charge": 28.0, "npi": [1518193838]}]}, {"allowed_amount": 13.69, "providers": [{"billed_charge": 28.0, "npi": [1093775009]}]}]}, {"tin": {"type": "ein", "value": "862752298"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.43, "providers": [{"billed_charge": 96.0, "npi": [1548898141, 1114488285]}]}]}, {"tin": {"type": "ein", "value": "922826272"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.04, "providers": [{"billed_charge": 71.0, "npi": [1467718163]}]}]}, {"tin": {"type": "ein", "value": "954873894"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.92, "providers": [{"billed_charge": 77.95, "npi": [1578190864]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 25.06, "providers": [{"billed_charge": 32.0, "npi": [1790898229]}]}]}]}, {"name": "Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report", "billing_code_type": "CPT", "billing_code": "93005", "billing_code_type_version": "2022", "description": "ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R", "allowed_amounts": [{"tin": {"type": "ein", "value": "050258905"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 94.1, "providers": [{"billed_charge": 428.0, "npi": [1487649430]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 162.44, "providers": [{"billed_charge": 592.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.31, "providers": [{"billed_charge": 774.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 274.61, "providers": [{"billed_charge": 408.8, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 274.61, "providers": [{"billed_charge": 395.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 180.53, "providers": [{"billed_charge": 515.81, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "150532254"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 162.44, "providers": [{"billed_charge": 311.0, "npi": [1508815333]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 270.05, "providers": [{"billed_charge": 827.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "231996150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 172.02, "providers": [{"billed_charge": 430.0, "npi": [1174822068]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 167.5, "providers": [{"billed_charge": 380.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 85.82, "providers": [{"billed_charge": 128.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 105.64, "providers": [{"billed_charge": 2050.0, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 105.61, "providers": [{"billed_charge": 137.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 118.04, "providers": [{"billed_charge": 220.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 132.66, "providers": [{"billed_charge": 146.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "590774199"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 115.14, "providers": [{"billed_charge": 480.0, "npi": [1881632818]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 125.25, "providers": [{"billed_charge": 1715.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 275.54, "providers": [{"billed_charge": 1038.75, "npi": [1982666111]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 128.91, "providers": [{"billed_charge": 1435.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 275.54, "providers": [{"billed_charge": 1781.9, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 122.25, "providers": [{"billed_charge": 300.48, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 326.6, "providers": [{"billed_charge": 899.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 83.08, "providers": [{"billed_charge": 999.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 128.96, "providers": [{"billed_charge": 500.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 372.0, "providers": [{"billed_charge": 716.0, "npi": [1427806025]}]}]}]}, {"name": "Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making", "billing_code_type": "CPT", "billing_code": "99285", "billing_code_type_version": "2022", "description": "EMERGENCY DEPARTMENT VISIT HIGH MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 820.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4364.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1829.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1832.24, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 492.0, "providers": [{"billed_charge": 492.0, "npi": [1740345719]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1901.05, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2600.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133964321"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 846.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 7818.0, "npi": [1932280666]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2066.44, "providers": [{"billed_charge": 5904.1, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "135562308"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "providers": [{"billed_charge": 1107.0, "npi": [1255894390]}]}]}, {"tin": {"type": "ein", "value": "139601276"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 29.01, "providers": [{"billed_charge": 1985.0, "npi": [1770789703]}]}]}, {"tin": {"type": "ein", "value": "141338586"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 820.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3370.0, "npi": [1740233899]}]}]}, {"tin": {"type": "ein", "value": "154722440"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 406.64, "providers": [{"billed_charge": 1176.0, "npi": [1134386774]}]}]}, {"tin": {"type": "ein", "value": "155862680"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 63.05, "providers": [{"billed_charge": 1176.0, "npi": [1629495544]}]}]}, {"tin": {"type": "ein", "value": "158908765"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 115.18, "providers": [{"billed_charge": 575.0, "npi": [1841795044]}]}]}, {"tin": {"type": "ein", "value": "200287387"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 433.67, "providers": [{"billed_charge": 1456.0, "npi": [1124570098, 1861849309]}]}, {"allowed_amount": 780.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1456.0, "npi": [1467802348, 1609149293, 1811193253]}]}]}, {"tin": {"type": "ein", "value": "201987098"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 570.75, "providers": [{"billed_charge": 1784.0, "npi": [1497780449, 1932938982]}]}, {"allowed_amount": 671.47, "providers": [{"billed_charge": 1784.0, "npi": [1518344019, 1528090586, 1558392043]}]}]}, {"tin": {"type": "ein", "value": "205615996"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 264.15, "providers": [{"billed_charge": 2026.0, "npi": [1134109028]}]}]}, {"tin": {"type": "ein", "value": "214274413"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 84.02, "providers": [{"billed_charge": 1838.0, "npi": [1326604448]}]}]}, {"tin": {"type": "ein", "value": "221932480"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1605.0, "npi": [1134292329]}]}]}, {"tin": {"type": "ein", "value": "222668179"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "providers": [{"billed_charge": 1306.0, "npi": [1962068080]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1306.0, "npi": [1407956808, 1528018991, 1205886611, 1548314263, 1215678297, 1356870331]}]}]}, {"tin": {"type": "ein", "value": "222775331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "providers": [{"billed_charge": 1889.9, "npi": [1184251696, 1841244365]}]}]}, {"tin": {"type": "ein", "value": "223527701"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 684.91, "providers": [{"billed_charge": 1806.0, "npi": [1053730283, 1477986610, 1881856631, 1831755289, 1033394366, 1851902142]}]}]}, {"tin": {"type": "ein", "value": "223586506"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 570.75, "providers": [{"billed_charge": 1838.0, "npi": [1528656808, 1982488961, 1417348228]}]}, {"allowed_amount": 671.47, "providers": [{"billed_charge": 1838.0, "npi": [1457386112, 1962734913, 1023214178, 1477105443, 1174142269, 1972789162, 1831146570, 1104023852, 1770894925, 1932495694, 1699973776, 1336880475, 1700129301, 1164916219, 1467658104, 1861985467, 1710503677]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 570.75, "providers": [{"billed_charge": 1807.0, "npi": [1255197836]}]}, {"allowed_amount": 582.17, "providers": [{"billed_charge": 1678.0, "npi": [1194483040, 1528216389]}, {"billed_charge": 1723.0, "npi": [1134579816, 1376758201, 1134952492, 1912585902, 1255011417]}, {"billed_charge": 1775.0, "npi": [1134579816]}]}, {"allowed_amount": 671.47, "providers": [{"billed_charge": 1527.0, "npi": [1912297896, 1184915191]}, {"billed_charge": 1573.0, "npi": [1912297896, 1215497029, 1730709783]}, {"billed_charge": 1807.0, "npi": [1033394366, 1154850501, 1760988430, 1255823415]}]}, {"allowed_amount": 684.91, "providers": [{"billed_charge": 1678.0, "npi": [1770160707, 1730445701, 1003224197, 1497383079, 1164171849, 1649857996, 1134658933, 1720029820]}, {"billed_charge": 1723.0, "npi": [1518127760, 1457970931, 1285969980, 1811936503]}, {"billed_charge": 1728.0, "npi": [1770160707]}, {"billed_charge": 1775.0, "npi": [1134664170]}, {"billed_charge": 1838.0, "npi": [1720585094, 1649858986, 1073020269, 1770947699, 1639461239, 1851823223, 1215291034, 1487150363]}]}, {"allowed_amount": 708.88, "providers": [{"billed_charge": 1775.0, "npi": [1467991471]}]}]}, {"tin": {"type": "ein", "value": "223589282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 671.47, "providers": [{"billed_charge": 1183.0, "npi": [1811250467, 1619108347, 1881897916, 1982715967]}, {"billed_charge": 1274.0, "npi": [1235156258, 1104937903]}]}]}, {"tin": {"type": "ein", "value": "223838009"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "providers": [{"billed_charge": 1028.24, "npi": [1356235030]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1028.24, "npi": [1205135761, 1568556751]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 985.45, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6331.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1191.89, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3985.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "231996150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2079.67, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5283.0, "npi": [1174822068]}]}]}, {"tin": {"type": "ein", "value": "232266054"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 317.65, "providers": [{"billed_charge": 1001.0, "npi": [1063673804]}]}]}, {"tin": {"type": "ein", "value": "232380812"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 263.34, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 416.0, "npi": [1609267368]}]}, {"allowed_amount": 317.65, "providers": [{"billed_charge": 416.0, "npi": [1194389296]}]}]}, {"tin": {"type": "ein", "value": "232669993"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 283.01, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1536.0, "npi": [1144704958]}]}]}, {"tin": {"type": "ein", "value": "232700908"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 317.65, "providers": [{"billed_charge": 405.0, "npi": [1578507802]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 306.7, "providers": [{"billed_charge": 365.0, "npi": [1609160993]}]}]}, {"tin": {"type": "ein", "value": "236291113"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 317.65, "providers": [{"billed_charge": 1070.0, "npi": [1942644828]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 805.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3020.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 317.65, "providers": [{"billed_charge": 502.0, "npi": [1134193881]}]}, {"allowed_amount": 382.26, "providers": [{"billed_charge": 502.0, "npi": [1295744951]}]}]}, {"tin": {"type": "ein", "value": "262307339"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1109.0, "npi": [1821579566]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1109.0, "npi": [1306165089, 1922115435, 1285969980, 1356795819]}]}]}, {"tin": {"type": "ein", "value": "271369141"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 499.86, "providers": [{"billed_charge": 1286.0, "npi": [1851766844]}]}]}, {"tin": {"type": "ein", "value": "311479038"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1151.95, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4088.0, "npi": [1033154026]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1212.48, "providers": [{"billed_charge": 21839.9, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452773050"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 654.11, "providers": [{"billed_charge": 1691.0, "npi": [1275775967]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "providers": [{"billed_charge": 1211.0, "npi": [1073959573]}]}]}, {"tin": {"type": "ein", "value": "461415202"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 685.29, "providers": [{"billed_charge": 1624.0, "npi": [1366025934]}]}]}, {"tin": {"type": "ein", "value": "462333282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 737.0, "providers": [{"billed_charge": 737.0, "npi": [1225004708]}]}]}, {"tin": {"type": "ein", "value": "462911982"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 570.75, "providers": [{"billed_charge": 1838.0, "npi": [1992935100, 1669832150]}]}, {"allowed_amount": 582.17, "providers": [{"billed_charge": 1265.0, "npi": [1912150889, 1932571494, 1174967657, 1467648766]}, {"billed_charge": 1655.0, "npi": [1780330571]}]}, {"allowed_amount": 671.47, "providers": [{"billed_charge": 1838.0, "npi": [1487311684, 1538301676, 1073279311, 1023125234, 1871118935]}]}, {"allowed_amount": 684.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1265.0, "npi": [1306073218, 1457545576, 1265452841, 1396286738, 1912566837, 1730760117]}, {"billed_charge": 1328.0, "npi": [1285608034, 1730760117]}, {"billed_charge": 1655.0, "npi": [1588891840, 1154534337, 1073805479, 1164806097, 1720440563, 1194130260, 1295239192]}, {"billed_charge": 1705.0, "npi": [1942888458, 1710183751]}]}, {"allowed_amount": 708.88, "providers": [{"billed_charge": 1705.0, "npi": [1710183751]}]}]}, {"tin": {"type": "ein", "value": "465034266"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "providers": [{"billed_charge": 2113.0, "npi": [1437143237]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 2113.0, "npi": [1790054526, 1629089719]}]}]}, {"tin": {"type": "ein", "value": "522296941"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 684.91, "providers": [{"billed_charge": 1806.0, "npi": [1861431702, 1437411956, 1730828070]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 765.68, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2522.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "611661781"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 935.0, "npi": [1629225479]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 586.7, "providers": [{"billed_charge": 16140.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "650622862"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 713.29, "providers": [{"billed_charge": 2254.0, "npi": [1457849358]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2205.82, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5297.5, "npi": [1730132234]}, {"billed_charge": 5509.5, "npi": [1982666111]}]}]}, {"tin": {"type": "ein", "value": "760459500"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 644.22, "providers": [{"billed_charge": 1957.0, "npi": [1770073454]}]}]}, {"tin": {"type": "ein", "value": "811075984"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1134.38, "npi": [1992017719]}]}, {"allowed_amount": 780.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1134.38, "npi": [1578797007, 1922037746, 1700811155, 1083792410, 1700296415]}]}]}, {"tin": {"type": "ein", "value": "812705668"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 653.64, "providers": [{"billed_charge": 1134.0, "npi": [1003065046]}]}, {"allowed_amount": 780.53, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1134.0, "npi": [1366868226]}]}]}, {"tin": {"type": "ein", "value": "812875670"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 272.88, "providers": [{"billed_charge": 1528.0, "npi": [1831774504]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2205.82, "providers": [{"billed_charge": 3138.23, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "822503787"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.28, "providers": [{"billed_charge": 976.95, "npi": [1346690583]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1028.24, "npi": [1245302702, 1851489231]}]}, {"allowed_amount": 786.32, "providers": [{"billed_charge": 976.95, "npi": [1245302702]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1152.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3034.16, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "845095889"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 786.32, "providers": [{"billed_charge": 1950.0, "npi": [1285989038]}]}]}, {"tin": {"type": "ein", "value": "862752298"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "providers": [{"billed_charge": 1737.0, "npi": [1477564425, 1548898141, 1255431854, 1417915737, 1114488285]}]}]}, {"tin": {"type": "ein", "value": "873517825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 300.6, "providers": [{"billed_charge": 1870.0, "npi": [1710508833]}]}, {"allowed_amount": 653.64, "providers": [{"billed_charge": 1870.0, "npi": [1881437853, 1225591423, 1275028607]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1870.0, "npi": [1790717890, 1285947911, 1013174507, 1487304747, 1043638638, 1144808817, 1336453745, 1750378451, 1871765073, 1215686357, 1730717398, 1083876213, 1558377754]}]}, {"allowed_amount": 786.32, "providers": [{"billed_charge": 1870.0, "npi": [1871765073, 1336487834]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 328.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 11804.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "883895171"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.28, "providers": [{"billed_charge": 1085.0, "npi": [1881213338]}]}, {"allowed_amount": 653.64, "providers": [{"billed_charge": 1085.0, "npi": [1518664481, 1023838372, 1366211724, 1013977453, 1447838545]}]}, {"allowed_amount": 780.53, "providers": [{"billed_charge": 1085.0, "npi": [1316177728, 1487652251]}]}]}, {"tin": {"type": "ein", "value": "900136825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 518.85, "providers": [{"billed_charge": 572.29, "npi": [1447291448]}]}]}, {"tin": {"type": "ein", "value": "922099454"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 365.26, "providers": [{"billed_charge": 984.0, "npi": [1457552531]}]}]}, {"tin": {"type": "ein", "value": "922826272"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 780.53, "providers": [{"billed_charge": 1286.0, "npi": [1164078853]}, {"billed_charge": 1415.0, "npi": [1467718163]}]}]}, {"tin": {"type": "ein", "value": "954558726"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 297.4, "providers": [{"billed_charge": 898.0, "npi": [1528647294]}]}]}]}, {"name": "Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making", "billing_code_type": "CPT", "billing_code": "99283", "billing_code_type_version": "2022", "description": "EMERGENCY DEPARTMENT VISIT LOW MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "071827036"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 23.5, "providers": [{"billed_charge": 750.0, "npi": [1699303818]}]}]}, {"tin": {"type": "ein", "value": "099729246"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 165.1, "providers": [{"billed_charge": 443.0, "npi": [1265810386]}]}]}, {"tin": {"type": "ein", "value": "111631781"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 932.9, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 940.0, "npi": [1154461622]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1591.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3477.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 870.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 870.32, "npi": [1467469023]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1950.0, "providers": [{"billed_charge": 5571.43, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "135562308"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 251.96, "providers": [{"billed_charge": 400.0, "npi": [1255894390]}]}]}, {"tin": {"type": "ein", "value": "150532254"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 932.9, "providers": [{"billed_charge": 1114.0, "npi": [1508815333]}]}]}, {"tin": {"type": "ein", "value": "201987098"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 274.77, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 777.0, "npi": [1558392043, 1073059911]}]}]}, {"tin": {"type": "ein", "value": "204377711"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 124.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 780.0, "npi": [1801536693]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 228.0, "providers": [{"billed_charge": 228.0, "npi": [1710199138]}]}]}, {"tin": {"type": "ein", "value": "223527701"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 140.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 787.0, "npi": [1619499431]}]}, {"allowed_amount": 290.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 787.0, "npi": [1063677029]}]}]}, {"tin": {"type": "ein", "value": "223586506"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 233.55, "providers": [{"billed_charge": 763.0, "npi": [1417348228]}]}, {"allowed_amount": 274.77, "providers": [{"billed_charge": 763.0, "npi": [1760431449]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 119.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 748.0, "npi": [1801239363]}]}, {"allowed_amount": 233.55, "providers": [{"billed_charge": 625.0, "npi": [1942083498]}]}, {"allowed_amount": 238.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 774.0, "npi": [1134579816, 1770617680]}, {"billed_charge": 777.0, "npi": [1497106991]}]}, {"allowed_amount": 274.77, "providers": [{"billed_charge": 763.0, "npi": [1427476084]}]}, {"allowed_amount": 280.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 726.0, "npi": [1144336777, 1992192066, 1740335892, 1184642126]}, {"billed_charge": 774.0, "npi": [1518127760, 1467991471]}, {"billed_charge": 777.0, "npi": [1962065599]}]}, {"allowed_amount": 290.19, "providers": [{"billed_charge": 748.0, "npi": [1497383079]}]}]}, {"tin": {"type": "ein", "value": "223762184"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 249.46, "providers": [{"billed_charge": 683.0, "npi": [1588014971]}]}]}, {"tin": {"type": "ein", "value": "233065896"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 150.0, "providers": [{"billed_charge": 150.0, "npi": [1679152581]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 929.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 13269.54, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "261869104"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 101.01, "providers": [{"billed_charge": 210.0, "npi": [1104996461]}]}]}, {"tin": {"type": "ein", "value": "262307339"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 251.96, "providers": [{"billed_charge": 490.0, "npi": [1861661704, 1497244271]}]}]}, {"tin": {"type": "ein", "value": "300976099"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 131.17, "providers": [{"billed_charge": 2736.0, "npi": [1154594919]}]}]}, {"tin": {"type": "ein", "value": "330729128"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 106.74, "providers": [{"billed_charge": 516.03, "npi": [1831651231]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 920.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 13269.54, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 820.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 13269.54, "npi": [1043475668]}]}, {"allowed_amount": 929.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 13269.54, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 174.75, "providers": [{"billed_charge": 577.0, "npi": [1609991835]}]}]}, {"tin": {"type": "ein", "value": "462710304"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 115.98, "providers": [{"billed_charge": 416.0, "npi": [1902084148]}]}]}, {"tin": {"type": "ein", "value": "462911982"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 140.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 729.0, "npi": [1720440563]}]}, {"allowed_amount": 233.55, "providers": [{"billed_charge": 763.0, "npi": [1992935100]}]}, {"allowed_amount": 238.32, "providers": [{"billed_charge": 454.0, "npi": [1457823999]}, {"billed_charge": 729.0, "npi": [1699077354]}, {"billed_charge": 751.0, "npi": [1861256158]}]}, {"allowed_amount": 280.38, "providers": [{"billed_charge": 454.0, "npi": [1235983115]}, {"billed_charge": 729.0, "npi": [1588891840, 1154534337]}]}]}, {"tin": {"type": "ein", "value": "465034266"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 251.96, "providers": [{"billed_charge": 833.0, "npi": [1649756909]}]}]}, {"tin": {"type": "ein", "value": "522296941"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 280.38, "providers": [{"billed_charge": 787.0, "npi": [1629060231]}]}]}, {"tin": {"type": "ein", "value": "522438452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 983.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1814.0, "npi": [1417279936]}]}]}, {"tin": {"type": "ein", "value": "540793767"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 601.81, "providers": [{"billed_charge": 2201.0, "npi": [1962464016]}]}]}, {"tin": {"type": "ein", "value": "591713947"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 983.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1320.0, "npi": [1225033020]}]}]}, {"tin": {"type": "ein", "value": "592650456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2429.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2429.0, "npi": [1144228446]}]}]}, {"tin": {"type": "ein", "value": "610445850"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 974.55, "providers": [{"billed_charge": 1008.65, "npi": [1467492421]}]}]}, {"tin": {"type": "ein", "value": "752778807"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 251.96, "providers": [{"billed_charge": 875.0, "npi": [1801138193]}]}]}, {"tin": {"type": "ein", "value": "752922687"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 396.9, "providers": [{"billed_charge": 3612.0, "npi": [1326078288]}]}, {"allowed_amount": 983.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3612.0, "npi": [1326078288]}]}]}, {"tin": {"type": "ein", "value": "810584939"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 248.12, "providers": [{"billed_charge": 898.0, "npi": [1083811053]}]}]}, {"tin": {"type": "ein", "value": "811075984"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 249.46, "providers": [{"billed_charge": 584.38, "npi": [1992017719]}]}, {"allowed_amount": 251.96, "providers": [{"billed_charge": 584.38, "npi": [1467718163]}]}]}, {"tin": {"type": "ein", "value": "812705668"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 249.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 584.0, "npi": [1194915512, 1043961873]}]}, {"allowed_amount": 251.96, "providers": [{"billed_charge": 584.0, "npi": [1275706202, 1366868226]}]}]}, {"tin": {"type": "ein", "value": "812857619"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 929.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3547.32, "npi": [1710491253]}]}]}, {"tin": {"type": "ein", "value": "822503787"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 249.46, "providers": [{"billed_charge": 417.68, "npi": [1972162501]}]}, {"allowed_amount": 251.96, "providers": [{"billed_charge": 417.68, "npi": [1841282381]}]}]}, {"tin": {"type": "ein", "value": "862752298"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 251.96, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 782.0, "npi": [1316361637]}]}]}, {"tin": {"type": "ein", "value": "873517825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 249.46, "providers": [{"billed_charge": 750.0, "npi": [1427782481, 1952199051, 1073404406]}]}, {"allowed_amount": 251.96, "providers": [{"billed_charge": 750.0, "npi": [1629162888, 1255711875]}]}]}, {"tin": {"type": "ein", "value": "911352172"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 422.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1755.0, "npi": [1841258639]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1257.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2418.0, "npi": [1427806025]}]}]}]}, {"name": "Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making", "billing_code_type": "CPT", "billing_code": "99284", "billing_code_type_version": "2022", "description": "EMERGENCY DEPARTMENT VISIT MODERATE MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "043949449"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 79.12, "providers": [{"billed_charge": 882.0, "npi": [1912384405]}]}]}, {"tin": {"type": "ein", "value": "050258905"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 989.4, "providers": [{"billed_charge": 3500.0, "npi": [1487649430]}]}]}, {"tin": {"type": "ein", "value": "050486254"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 489.93, "providers": [{"billed_charge": 1011.46, "npi": [1285898890]}]}]}, {"tin": {"type": "ein", "value": "060646554"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1633.29, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2662.16, "npi": [1992910152]}]}]}, {"tin": {"type": "ein", "value": "060646973"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 336.8, "providers": [{"billed_charge": 405.0, "npi": [1508495185]}]}]}, {"tin": {"type": "ein", "value": "100761443"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 45.02, "providers": [{"billed_charge": 336.0, "npi": [1548355464]}]}]}, {"tin": {"type": "ein", "value": "101132605"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 92.08, "providers": [{"billed_charge": 1289.0, "npi": [1720652779]}]}]}, {"tin": {"type": "ein", "value": "109821507"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 35.0, "providers": [{"billed_charge": 804.0, "npi": [1114432275]}]}]}, {"tin": {"type": "ein", "value": "111630755"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 820.38, "providers": [{"billed_charge": 2869.1, "npi": [1326046467]}]}]}, {"tin": {"type": "ein", "value": "111631781"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 344.0, "providers": [{"billed_charge": 344.0, "npi": [1851404388]}]}]}, {"tin": {"type": "ein", "value": "111631788"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 344.0, "providers": [{"billed_charge": 344.0, "npi": [1164051975]}]}]}, {"tin": {"type": "ein", "value": "131623978"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 425.0, "providers": [{"billed_charge": 425.0, "npi": [1982921102]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1591.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1757.5, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1829.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6614.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 329.0, "providers": [{"billed_charge": 329.0, "npi": [1699017111]}]}, {"allowed_amount": 336.0, "providers": [{"billed_charge": 336.0, "npi": [1033121751]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1744.84, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4985.25, "npi": [1801992631]}]}]}, {"tin": {"type": "ein", "value": "136137051"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 79.12, "providers": [{"billed_charge": 1166.0, "npi": [1619541554]}]}]}, {"tin": {"type": "ein", "value": "136887862"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 21.57, "providers": [{"billed_charge": 804.0, "npi": [1033607759]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 842.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 7011.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "157822175"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 79.12, "providers": [{"billed_charge": 640.0, "npi": [1164806865]}]}]}, {"tin": {"type": "ein", "value": "200287387"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.89, "providers": [{"billed_charge": 1005.0, "npi": [1124570098, 1205348679, 1316178791]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1005.0, "npi": [1982672960, 1356397590]}]}, {"allowed_amount": 532.42, "providers": [{"billed_charge": 1005.0, "npi": [1518312487]}]}]}, {"tin": {"type": "ein", "value": "201987098"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 392.47, "providers": [{"billed_charge": 1196.0, "npi": [1497780449]}]}, {"allowed_amount": 461.72, "providers": [{"billed_charge": 1196.0, "npi": [1518344019, 1861735987, 1053806919]}]}]}, {"tin": {"type": "ein", "value": "208624691"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 2200.0, "npi": [1548208135]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 387.0, "npi": [1710199138, 1497323927]}]}]}, {"tin": {"type": "ein", "value": "222095812"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 400.0, "npi": [1891372892]}]}]}, {"tin": {"type": "ein", "value": "222668179"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 902.0, "npi": [1194388512, 1578213492, 1528068830]}]}, {"allowed_amount": 528.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 902.0, "npi": [1083765408, 1376033415, 1730486846, 1982633327, 1528018991, 1861430001, 1821048273, 1477813848, 1861521726]}]}]}, {"tin": {"type": "ein", "value": "222775331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.89, "providers": [{"billed_charge": 1296.8, "npi": [1962071159]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1296.8, "npi": [1831718006, 1962071159]}]}]}, {"tin": {"type": "ein", "value": "222972317"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 528.5, "providers": [{"billed_charge": 558.0, "npi": [1164680138, 1538546452]}]}]}, {"tin": {"type": "ein", "value": "223527701"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 400.5, "providers": [{"billed_charge": 1255.0, "npi": [1003588054]}]}, {"allowed_amount": 471.18, "providers": [{"billed_charge": 1255.0, "npi": [1750743779, 1730828070, 1619499431, 1457812273, 1477986610, 1831755289, 1922523802, 1992446173]}, {"billed_charge": 1293.0, "npi": [1831755289, 1164611851]}]}, {"allowed_amount": 487.67, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1293.0, "npi": [1033394366]}]}]}, {"tin": {"type": "ein", "value": "223586506"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 392.47, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 1255.0, "npi": [1730959842, 1841004314, 1548298268, 1356117279]}]}, {"allowed_amount": 406.2, "providers": [{"billed_charge": 1255.0, "npi": [1356117279]}]}, {"allowed_amount": 461.72, "providers": [{"billed_charge": 1255.0, "npi": [1629732128, 1629639976, 1164628392, 1073554697, 1649464140, 1104023852, 1932495694, 1669886768, 1336400241, 1699973776, 1700129301, 1427005750, 1386004828, 1467013144, 1336880475, 1447791868, 1720284383]}]}, {"allowed_amount": 477.88, "providers": [{"billed_charge": 1255.0, "npi": [1336400241, 1275573339]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 235.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1255.0, "npi": [1164171849]}]}, {"allowed_amount": 392.47, "providers": [{"billed_charge": 1051.0, "npi": [1942083498]}, {"billed_charge": 1255.0, "npi": [1932754843]}]}, {"allowed_amount": 400.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1155.0, "npi": [1124824321, 1134579816, 1134952492, 1003297201, 1255011417]}, {"billed_charge": 1190.0, "npi": [1134952492, 1336100486]}, {"billed_charge": 1255.0, "npi": [1801239363, 1023224219]}, {"billed_charge": 1293.0, "npi": [1801239363, 1114616059]}]}, {"allowed_amount": 461.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1051.0, "npi": [1801834338, 1104486349, 1629235502]}, {"billed_charge": 1083.0, "npi": [1568103083, 1598159444, 1780061903]}, {"billed_charge": 1255.0, "npi": [1154850501, 1730768359, 1760988430, 1891792123, 1427476084, 1356870331]}]}, {"allowed_amount": 471.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1155.0, "npi": [1568464311, 1194338731, 1518127760, 1831281815, 1376537241, 1811936503, 1285969980]}, {"billed_charge": 1190.0, "npi": [1982059184]}, {"billed_charge": 1255.0, "npi": [1770160707, 1144336777, 1649857996, 1184642126, 1740335892, 1720184468, 1720029820]}, {"billed_charge": 1293.0, "npi": [1992192066, 1245677004]}]}, {"allowed_amount": 487.67, "providers": [{"billed_charge": 1190.0, "npi": [1366730707]}, {"billed_charge": 1293.0, "npi": [1518971456]}]}]}, {"tin": {"type": "ein", "value": "223589282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 461.72, "providers": [{"billed_charge": 793.0, "npi": [1881897916, 1073346748, 1952132060]}, {"billed_charge": 882.0, "npi": [1093179392]}]}]}, {"tin": {"type": "ein", "value": "223594884"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 474.11, "providers": [{"billed_charge": 1044.0, "npi": [1700248986]}]}]}, {"tin": {"type": "ein", "value": "223837316"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 114.4, "providers": [{"billed_charge": 287.0, "npi": [1487383907]}]}]}, {"tin": {"type": "ein", "value": "223838009"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 710.28, "npi": [1639060130, 1770665341, 1356235030, 1881767143]}]}, {"allowed_amount": 354.33, "providers": [{"billed_charge": 710.28, "npi": [1104571272]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 710.28, "npi": [1104987932]}]}, {"allowed_amount": 532.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 674.16, "npi": [1184062499]}]}]}, {"tin": {"type": "ein", "value": "232380812"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 114.4, "providers": [{"billed_charge": 416.0, "npi": [1003309121]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 218.71, "providers": [{"billed_charge": 345.0, "npi": [1710502109]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 218.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 300.0, "npi": [1861435976, 1336643949]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 805.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2265.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "249836645"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 87.91, "providers": [{"billed_charge": 1289.0, "npi": [1164915682]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 260.07, "providers": [{"billed_charge": 347.0, "npi": [1932694510]}]}]}, {"tin": {"type": "ein", "value": "262307339"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.54, "providers": [{"billed_charge": 748.0, "npi": [1609399740, 1821579566]}]}, {"allowed_amount": 354.33, "providers": [{"billed_charge": 748.0, "npi": [1629233275]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 748.0, "npi": [1306165089, 1922115435, 1750813838, 1497244271, 1346667185, 1407876337, 1285969980, 1639437437]}]}, {"allowed_amount": 532.42, "providers": [{"billed_charge": 748.0, "npi": [1306165089]}]}]}, {"tin": {"type": "ein", "value": "271369141"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 528.72, "providers": [{"billed_charge": 874.0, "npi": [1568959583]}]}]}, {"tin": {"type": "ein", "value": "273184128"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 2500.0, "npi": [1508494204]}]}]}, {"tin": {"type": "ein", "value": "310867547"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 340.89, "providers": [{"billed_charge": 582.0, "npi": [1669477279]}]}]}, {"tin": {"type": "ein", "value": "311405915"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 240.96, "providers": [{"billed_charge": 359.0, "npi": [1952667446]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 929.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 14610.29, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452497248"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1347.35, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6263.0, "npi": [1114473329]}]}]}, {"tin": {"type": "ein", "value": "454251484"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 15000.0, "npi": [1760660559]}]}]}, {"tin": {"type": "ein", "value": "461707288"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 528.72, "providers": [{"billed_charge": 1151.76, "npi": [1093378952]}]}]}, {"tin": {"type": "ein", "value": "462911982"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 400.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 861.0, "npi": [1932571494]}, {"billed_charge": 904.0, "npi": [1235983115]}, {"billed_charge": 1109.0, "npi": [1932622081, 1699077354, 1124081732, 1245226836]}, {"billed_charge": 1142.0, "npi": [1124081732]}]}, {"allowed_amount": 461.72, "providers": [{"billed_charge": 1255.0, "npi": [1730527938, 1407235906, 1487311684, 1972187219, 1235585050]}]}, {"allowed_amount": 471.18, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 861.0, "npi": [1265452841, 1306073218, 1528647419, 1285608034]}, {"billed_charge": 904.0, "npi": [1508969759]}, {"billed_charge": 1109.0, "npi": [1154534337, 1386809671, 1073805479, 1235524083, 1295239192, 1467715417, 1093940249]}, {"billed_charge": 1142.0, "npi": [1295239192, 1235524083, 1881824548, 1720440563]}]}]}, {"tin": {"type": "ein", "value": "465034266"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 1324.0, "npi": [1013977453]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1324.0, "npi": [1649756909, 1790054526]}]}]}, {"tin": {"type": "ein", "value": "522103311"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 366.91, "providers": [{"billed_charge": 1218.0, "npi": [1407206485]}]}]}, {"tin": {"type": "ein", "value": "540620889"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 999.87, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2778.0, "npi": [1255684460]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 345.0, "providers": [{"billed_charge": 345.0, "npi": [1508108739]}]}]}, {"tin": {"type": "ein", "value": "571004971"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 238.26, "providers": [{"billed_charge": 368.0, "npi": [1447753231]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 627.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3023.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "590624424"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 396.9, "providers": [{"billed_charge": 2481.34, "npi": [1912964768]}]}]}, {"tin": {"type": "ein", "value": "590774199"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 561.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4561.0, "npi": [1881632818]}]}]}, {"tin": {"type": "ein", "value": "591524072"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 32.36, "providers": [{"billed_charge": 804.0, "npi": [1659789816]}]}]}, {"tin": {"type": "ein", "value": "591726273"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1438.5, "providers": [{"billed_charge": 5314.0, "npi": [1184709057]}]}]}, {"tin": {"type": "ein", "value": "591835473"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 47.89, "providers": [{"billed_charge": 1087.45, "npi": [1891783213]}]}]}, {"tin": {"type": "ein", "value": "593259553"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 177.88, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 373.0, "npi": [1013225317]}]}]}, {"tin": {"type": "ein", "value": "593527036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 424.47, "providers": [{"billed_charge": 3837.0, "npi": [1740276518]}]}]}, {"tin": {"type": "ein", "value": "650622862"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 430.42, "providers": [{"billed_charge": 1577.0, "npi": [1730943143]}]}, {"allowed_amount": 506.37, "providers": [{"billed_charge": 1577.0, "npi": [1689669400]}]}]}, {"tin": {"type": "ein", "value": "650859880"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 285.79, "providers": [{"billed_charge": 1273.0, "npi": [1699735258]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 894.39, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4093.0, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "742931198"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 436.98, "providers": [{"billed_charge": 970.45, "npi": [1639161193]}]}]}, {"tin": {"type": "ein", "value": "752562784"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 394.98, "providers": [{"billed_charge": 1052.0, "npi": [1245638105]}]}]}, {"tin": {"type": "ein", "value": "752778807"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 484.44, "providers": [{"billed_charge": 1307.0, "npi": [1932691128, 1447780184]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1307.0, "npi": [1942861315, 1730575283, 1932691128, 1235210279]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 408.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3813.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1438.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5314.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "811075984"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 866.25, "npi": [1619538881, 1992017719]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 866.25, "npi": [1750525432, 1083792410, 1164421491]}]}]}, {"tin": {"type": "ein", "value": "811723202"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 627.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1939.0, "npi": [1063968196]}]}]}, {"tin": {"type": "ein", "value": "812705668"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.54, "providers": [{"billed_charge": 866.0, "npi": [1740173459]}]}, {"allowed_amount": 354.33, "providers": [{"billed_charge": 866.0, "npi": [1043961873, 1730719782]}]}, {"allowed_amount": 528.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 866.0, "npi": [1750760625, 1275706202, 1396737763, 1457446817]}]}]}, {"tin": {"type": "ein", "value": "822503787"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 91.27, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 710.28, "npi": [1639060130]}]}, {"allowed_amount": 182.54, "providers": [{"billed_charge": 710.28, "npi": [1639060130, 1063102002, 1972162501, 1760851141]}]}, {"allowed_amount": 222.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 674.16, "npi": [1639060130]}]}, {"allowed_amount": 354.33, "providers": [{"billed_charge": 710.28, "npi": [1346690583]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 710.28, "npi": [1841235777, 1851489231, 1841282381, 1306845391]}]}, {"allowed_amount": 532.42, "providers": [{"billed_charge": 674.16, "npi": [1831360502, 1245302702]}]}]}, {"tin": {"type": "ein", "value": "831002191"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 218.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 375.0, "npi": [1457713554]}]}]}, {"tin": {"type": "ein", "value": "833563831"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 71.5, "providers": [{"billed_charge": 1534.0, "npi": [1225490899, 1356608475]}]}]}, {"tin": {"type": "ein", "value": "843715231"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 1270.0, "npi": [1952509820]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1296.6, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3985.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "844504483"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 383.04, "providers": [{"billed_charge": 782.0, "npi": [1932125879]}]}]}, {"tin": {"type": "ein", "value": "860181654"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 433.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3510.0, "npi": [1114744752]}]}]}, {"tin": {"type": "ein", "value": "862752298"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 354.33, "providers": [{"billed_charge": 1166.0, "npi": [1972998417]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1166.0, "npi": [1316361637, 1619361995, 1750667283, 1528140084, 1083792410, 1487856316]}]}]}, {"tin": {"type": "ein", "value": "873517825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.54, "providers": [{"billed_charge": 1280.0, "npi": [1326649955, 1952199051, 1639921554, 1336839927, 1881437853]}]}, {"allowed_amount": 354.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1280.0, "npi": [1972328805, 1912204777, 1487304747, 1659803021, 1205412301, 1427782481, 1972947729, 1225591423]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 1280.0, "npi": [1255711875, 1184054918, 1285947911, 1629162888, 1447541768, 1699303818, 1659803021, 1972947729, 1558377754, 1245308576, 1972943652, 1487304747, 1902425135, 1790717890, 1871765073, 1750378451, 1306226139, 1205874781, 1700931680, 1568674273, 1972328805, 1013174507, 1144808817, 1336453745, 1083876213]}]}, {"allowed_amount": 532.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1280.0, "npi": [1871765073, 1558377754, 1306226139, 1659803021]}]}]}, {"tin": {"type": "ein", "value": "874650553"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 195.95, "providers": [{"billed_charge": 1196.0, "npi": [1417452608]}]}]}, {"tin": {"type": "ein", "value": "883895171"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.54, "providers": [{"billed_charge": 747.0, "npi": [1023838372, 1235147190]}]}, {"allowed_amount": 354.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 747.0, "npi": [1366211724, 1679063218, 1841459732, 1982346599]}]}, {"allowed_amount": 528.5, "providers": [{"billed_charge": 747.0, "npi": [1710419650, 1356721195, 1447838545, 1528419058, 1881213338, 1912567199]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 544.58, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2420.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 443.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 443.0, "npi": [1790898229]}]}]}]}, {"name": "Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making", "billing_code_type": "CPT", "billing_code": "99282", "billing_code_type_version": "2022", "description": "EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM", "allowed_amounts": [{"tin": {"type": "ein", "value": "151193009"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 27.52, "providers": [{"billed_charge": 125.0, "npi": [1225260490]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 96.66, "providers": [{"billed_charge": 134.0, "npi": [1083463657, 1407499031, 1497323927]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 96.66, "providers": [{"billed_charge": 135.0, "npi": [1184245797]}]}, {"allowed_amount": 135.0, "providers": [{"billed_charge": 135.0, "npi": [1184245797]}]}]}, {"tin": {"type": "ein", "value": "223586506"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 136.04, "providers": [{"billed_charge": 504.0, "npi": [1902213747, 1083843742]}]}, {"allowed_amount": 160.04, "providers": [{"billed_charge": 504.0, "npi": [1295350171]}]}]}, {"tin": {"type": "ein", "value": "223586664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 138.87, "providers": [{"billed_charge": 469.0, "npi": [1336100486]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 83.13, "providers": [{"billed_charge": 250.0, "npi": [1972088292]}]}]}, {"tin": {"type": "ein", "value": "232829095"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 265.44, "providers": [{"billed_charge": 2095.0, "npi": [1215916002]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 842.77, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6172.34, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "590724459"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 328.88, "providers": [{"billed_charge": 631.0, "npi": [1306938071]}]}]}, {"tin": {"type": "ein", "value": "591281714"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 169.59, "providers": [{"billed_charge": 389.0, "npi": [1518329507]}]}]}, {"tin": {"type": "ein", "value": "592650456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 732.73, "providers": [{"billed_charge": 1822.0, "npi": [1144228446]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 307.52, "providers": [{"billed_charge": 1136.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "812705668"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 83.13, "providers": [{"billed_charge": 412.0, "npi": [1275706202]}]}, {"allowed_amount": 96.66, "providers": [{"billed_charge": 412.0, "npi": [1740173459]}]}]}, {"tin": {"type": "ein", "value": "873517825"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 96.66, "providers": [{"billed_charge": 440.0, "npi": [1336839927]}]}]}, {"tin": {"type": "ein", "value": "951816017"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 333.08, "providers": [{"billed_charge": 1481.0, "npi": [1831188275]}]}]}]}, {"name": "Ferritin", "billing_code_type": "CPT", "billing_code": "82728", "billing_code_type_version": "2022", "description": "ASSAY OF FERRITIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 128.69, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 95.41, "npi": [1124024922]}]}, {"allowed_amount": 13.14, "providers": [{"billed_charge": 95.41, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 54.52, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 85.0, "npi": [1033281126]}]}, {"allowed_amount": 13.73, "providers": [{"billed_charge": 85.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 77.2, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 49.92, "providers": [{"billed_charge": 142.64, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 125.0, "npi": [1215038310, 1134277494]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 40.89, "npi": [1053584482]}]}, {"allowed_amount": 13.73, "providers": [{"billed_charge": 40.89, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 93.1, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 13.63, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 146.0, "npi": [1164701561]}]}, {"allowed_amount": 13.14, "providers": [{"billed_charge": 146.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 68.15, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "461653414"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 41.0, "npi": [1558609008]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 68.15, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 86.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 69.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 136.3, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 13.14, "providers": [{"billed_charge": 172.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.59, "providers": [{"billed_charge": 93.0, "npi": [1336763531]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.29, "providers": [{"billed_charge": 164.0, "npi": [1982606992]}]}]}]}, {"name": "Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21", "billing_code_type": "CPT", "billing_code": "81420", "billing_code_type_version": "2022", "description": "FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS", "allowed_amounts": [{"tin": {"type": "ein", "value": "010894487"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 250.49, "providers": [{"billed_charge": 3400.0, "npi": [1558672279]}]}, {"allowed_amount": 645.19, "providers": [{"billed_charge": 3400.0, "npi": [1235528225, 1558672279]}, {"billed_charge": 3900.0, "npi": [1235528225, 1558672279]}]}, {"allowed_amount": 863.94, "providers": [{"billed_charge": 3900.0, "npi": [1558672279]}]}, {"allowed_amount": 907.87, "providers": [{"billed_charge": 3400.0, "npi": [1235528225]}, {"billed_charge": 3900.0, "npi": [1235528225]}]}]}, {"tin": {"type": "ein", "value": "431039532"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 645.19, "providers": [{"billed_charge": 3159.73, "npi": [1780620526]}]}]}, {"tin": {"type": "ein", "value": "811082020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 645.19, "providers": [{"billed_charge": 3036.2, "npi": [1598314437]}]}, {"allowed_amount": 863.94, "providers": [{"billed_charge": 3036.2, "npi": [1598314437]}]}]}]}, {"name": "Folic acid; serum", "billing_code_type": "CPT", "billing_code": "82746", "billing_code_type_version": "2022", "description": "ASSAY OF FOLIC ACID SERUM", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 58.8, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 105.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 76.44, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.93, "providers": [{"billed_charge": 131.23, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 85.0, "npi": [1134277494]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 44.1, "npi": [1053584482]}]}, {"allowed_amount": 14.81, "providers": [{"billed_charge": 44.1, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 24.38, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 14.7, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 35.0, "npi": [1164701561]}, {"billed_charge": 195.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 135.35, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 147.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 102.9, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 86.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 79.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 147.0, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 103.0, "npi": [1336763531]}]}]}]}, {"name": "General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009) Thyroid stimulating hormone (TSH) (84443)", "billing_code_type": "CPT", "billing_code": "80050", "billing_code_type_version": "2022", "description": "GENERAL HEALTH PANEL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 189.96, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 41.73, "providers": [{"billed_charge": 290.0, "npi": [1033281126]}]}, {"allowed_amount": 154.52, "providers": [{"billed_charge": 290.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 198.88, "npi": [1194744185]}, {"billed_charge": 198.98, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 490.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 35.13, "providers": [{"billed_charge": 35.13, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 41.73, "providers": [{"billed_charge": 460.0, "npi": [1164701561]}]}, {"allowed_amount": 154.52, "providers": [{"billed_charge": 450.0, "npi": [1164701561]}, {"billed_charge": 460.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 292.7, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 41.73, "providers": [{"billed_charge": 327.74, "npi": [1285018523]}]}, {"allowed_amount": 154.52, "providers": [{"billed_charge": 327.74, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 259.12, "providers": [{"billed_charge": 369.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 205.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 199.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 154.52, "providers": [{"billed_charge": 198.88, "npi": [1881226579]}]}]}]}, {"name": "Glucose; quantitative, blood (except reagent strip)", "billing_code_type": "CPT", "billing_code": "82947", "billing_code_type_version": "2022", "description": "GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.34, "providers": [{"billed_charge": 27.51, "npi": [1124024922]}]}, {"allowed_amount": 3.78, "providers": [{"billed_charge": 27.51, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "111630755"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.8, "providers": [{"billed_charge": 145.28, "npi": [1326046467]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.34, "providers": [{"billed_charge": 15.72, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.34, "providers": [{"billed_charge": 27.51, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "592650456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 33.53, "providers": [{"billed_charge": 148.0, "npi": [1144228446]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.34, "providers": [{"billed_charge": 83.96, "npi": [1245720820]}]}, {"allowed_amount": 4.2, "providers": [{"billed_charge": 83.96, "npi": [1245720820]}]}]}]}, {"name": "Ground mileage, per statute mile", "billing_code_type": "CPT", "billing_code": "A0425", "billing_code_type_version": "2022", "description": "Ground mileage, per statute mile", "allowed_amounts": [{"tin": {"type": "ein", "value": "111631788"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 8.28, "providers": [{"billed_charge": 17.0, "npi": [1245370717]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 8.28, "providers": [{"billed_charge": 32.65, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.65, "providers": [{"billed_charge": 32.65, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 14.13, "providers": [{"billed_charge": 20.0, "npi": [1083715460]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 12.68, "providers": [{"billed_charge": 36.23, "npi": [1346614443]}]}]}, {"tin": {"type": "ein", "value": "136007293"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.42, "providers": [{"billed_charge": 35.0, "npi": [1154423051]}]}]}, {"tin": {"type": "ein", "value": "161451102"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 36.75, "providers": [{"billed_charge": 36.75, "npi": [1255424800]}]}]}, {"tin": {"type": "ein", "value": "203896610"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 5.63, "providers": [{"billed_charge": 30.0, "npi": [1912926106]}]}]}, {"tin": {"type": "ein", "value": "205015479"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.18, "providers": [{"billed_charge": 12.0, "npi": [1912112491]}]}, {"allowed_amount": 12.0, "providers": [{"billed_charge": 12.0, "npi": [1912112491]}]}]}, {"tin": {"type": "ein", "value": "208424689"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 85.0, "npi": [1952588329]}]}]}, {"tin": {"type": "ein", "value": "210737081"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.21, "providers": [{"billed_charge": 19.0, "npi": [1992837363]}]}]}, {"tin": {"type": "ein", "value": "210742613"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 25.0, "providers": [{"billed_charge": 25.0, "npi": [1871691774]}]}]}, {"tin": {"type": "ein", "value": "216000035"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 15.0, "providers": [{"billed_charge": 15.0, "npi": [1659562668]}]}]}, {"tin": {"type": "ein", "value": "216000379"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.74, "providers": [{"billed_charge": 30.0, "npi": [1720090491]}]}]}, {"tin": {"type": "ein", "value": "216000541"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 8.24, "providers": [{"billed_charge": 18.0, "npi": [1073509154]}]}]}, {"tin": {"type": "ein", "value": "216000660"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 5.61, "providers": [{"billed_charge": 23.7, "npi": [1770777674]}]}, {"allowed_amount": 8.16, "providers": [{"billed_charge": 22.91, "npi": [1770777674]}]}, {"allowed_amount": 11.23, "providers": [{"billed_charge": 23.1, "npi": [1770777674]}, {"billed_charge": 24.0, "npi": [1770777674]}]}]}, {"tin": {"type": "ein", "value": "216000749"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.18, "providers": [{"billed_charge": 35.0, "npi": [1174630172]}]}, {"allowed_amount": 10.59, "providers": [{"billed_charge": 35.0, "npi": [1174630172]}]}, {"allowed_amount": 12.35, "providers": [{"billed_charge": 35.0, "npi": [1174630172]}]}]}, {"tin": {"type": "ein", "value": "216000784"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.0, "providers": [{"billed_charge": 10.0, "npi": [1053307157]}]}]}, {"tin": {"type": "ein", "value": "216000823"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 5.29, "providers": [{"billed_charge": 30.0, "npi": [1639702368]}]}, {"allowed_amount": 6.18, "providers": [{"billed_charge": 30.0, "npi": [1639702368]}]}, {"allowed_amount": 14.83, "providers": [{"billed_charge": 30.0, "npi": [1639702368]}]}, {"allowed_amount": 18.53, "providers": [{"billed_charge": 30.0, "npi": [1639702368]}]}, {"allowed_amount": 30.0, "providers": [{"billed_charge": 30.0, "npi": [1639702368]}]}]}, {"tin": {"type": "ein", "value": "216000881"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 14.83, "providers": [{"billed_charge": 25.0, "npi": [1255778486]}]}]}, {"tin": {"type": "ein", "value": "216000916"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 25.0, "providers": [{"billed_charge": 25.0, "npi": [1326498643]}]}]}, {"tin": {"type": "ein", "value": "221714121"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.27, "providers": [{"billed_charge": 18.0, "npi": [1245564467]}]}]}, {"tin": {"type": "ein", "value": "221915868"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 14.0, "providers": [{"billed_charge": 14.0, "npi": [1831349380]}]}]}, {"tin": {"type": "ein", "value": "222319642"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.59, "providers": [{"billed_charge": 30.0, "npi": [1588401707]}]}]}, {"tin": {"type": "ein", "value": "222442017"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 8.93, "providers": [{"billed_charge": 15.0, "npi": [1215916440]}]}, {"allowed_amount": 15.0, "providers": [{"billed_charge": 15.0, "npi": [1215916440]}]}]}, {"tin": {"type": "ein", "value": "222581178"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 7.81, "providers": [{"billed_charge": 20.0, "npi": [1316493596]}]}]}, {"tin": {"type": "ein", "value": "222940768"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 4.63, "providers": [{"billed_charge": 25.0, "npi": [1821231721]}]}]}, {"tin": {"type": "ein", "value": "223097062"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.0, "providers": [{"billed_charge": 18.0, "npi": [1184118457]}]}]}, {"tin": {"type": "ein", "value": "223257717"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 17.0, "providers": [{"billed_charge": 17.0, "npi": [1275664823]}]}, {"allowed_amount": 17.96, "providers": [{"billed_charge": 18.0, "npi": [1275664823]}, {"billed_charge": 19.6, "npi": [1275664823]}]}]}, {"tin": {"type": "ein", "value": "223385668"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.18, "providers": [{"billed_charge": 40.0, "npi": [1326141771]}]}, {"allowed_amount": 6.74, "providers": [{"billed_charge": 40.0, "npi": [1326141771]}]}]}, {"tin": {"type": "ein", "value": "223472557"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 33.0, "providers": [{"billed_charge": 33.0, "npi": [1144543653]}]}]}, {"tin": {"type": "ein", "value": "223655842"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 3.13, "providers": [{"billed_charge": 21.61, "npi": [1033769849]}]}]}, {"tin": {"type": "ein", "value": "223702071"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.0, "providers": [{"billed_charge": 11.0, "npi": [1811949779]}]}]}, {"tin": {"type": "ein", "value": "225002051"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 7.41, "providers": [{"billed_charge": 16.15, "npi": [1154651990]}]}, {"allowed_amount": 8.24, "providers": [{"billed_charge": 15.3, "npi": [1154651990]}, {"billed_charge": 16.43, "npi": [1154651990]}]}]}, {"tin": {"type": "ein", "value": "226001739"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 8.24, "providers": [{"billed_charge": 30.0, "npi": [1689653883]}]}]}, {"tin": {"type": "ein", "value": "226001742"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.59, "providers": [{"billed_charge": 20.0, "npi": [1588937908]}]}]}, {"tin": {"type": "ein", "value": "226001772"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.27, "providers": [{"billed_charge": 25.0, "npi": [1922267004]}]}]}, {"tin": {"type": "ein", "value": "226001779"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.35, "providers": [{"billed_charge": 11.35, "npi": [1366435745]}]}]}, {"tin": {"type": "ein", "value": "226002036"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 12.35, "providers": [{"billed_charge": 25.0, "npi": [1083061402]}]}]}, {"tin": {"type": "ein", "value": "226002052"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.53, "providers": [{"billed_charge": 25.0, "npi": [1770338329]}]}]}, {"tin": {"type": "ein", "value": "226002092"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.18, "providers": [{"billed_charge": 25.0, "npi": [1730182627]}]}, {"allowed_amount": 7.41, "providers": [{"billed_charge": 25.0, "npi": [1730182627]}]}]}, {"tin": {"type": "ein", "value": "226002115"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 7.41, "providers": [{"billed_charge": 10.0, "npi": [1225024334]}]}, {"allowed_amount": 9.27, "providers": [{"billed_charge": 10.0, "npi": [1225024334]}]}]}, {"tin": {"type": "ein", "value": "226002151"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 14.83, "providers": [{"billed_charge": 30.0, "npi": [1962498063]}]}, {"allowed_amount": 24.71, "providers": [{"billed_charge": 30.0, "npi": [1962498063]}]}]}, {"tin": {"type": "ein", "value": "226002186"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1265656805]}]}]}, {"tin": {"type": "ein", "value": "226002190"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.73, "providers": [{"billed_charge": 20.0, "npi": [1962481101]}]}]}, {"tin": {"type": "ein", "value": "226002200"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.59, "providers": [{"billed_charge": 20.0, "npi": [1174519292]}]}, {"allowed_amount": 10.73, "providers": [{"billed_charge": 20.0, "npi": [1174519292]}]}, {"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1174519292]}]}]}, {"tin": {"type": "ein", "value": "226002394"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1467699785]}]}]}, {"tin": {"type": "ein", "value": "226002416"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.53, "providers": [{"billed_charge": 30.0, "npi": [1326175191]}]}]}, {"tin": {"type": "ein", "value": "226002426"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.27, "providers": [{"billed_charge": 20.0, "npi": [1639878432]}]}, {"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1639878432]}]}]}, {"tin": {"type": "ein", "value": "226002481"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.27, "providers": [{"billed_charge": 20.0, "npi": [1861784266]}]}, {"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1861784266]}]}]}, {"tin": {"type": "ein", "value": "226043859"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 7.97, "providers": [{"billed_charge": 44.0, "npi": [1023097268]}]}]}, {"tin": {"type": "ein", "value": "226064813"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1548394786]}]}]}, {"tin": {"type": "ein", "value": "226208273"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 30.0, "providers": [{"billed_charge": 30.0, "npi": [1750560975]}]}]}, {"tin": {"type": "ein", "value": "236003047"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.0, "providers": [{"billed_charge": 10.0, "npi": [1255468435]}]}]}, {"tin": {"type": "ein", "value": "237000760"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.74, "providers": [{"billed_charge": 26.0, "npi": [1295715357]}]}]}, {"tin": {"type": "ein", "value": "237102800"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.53, "providers": [{"billed_charge": 30.0, "npi": [1598923781]}]}]}, {"tin": {"type": "ein", "value": "237107761"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.73, "providers": [{"billed_charge": 20.0, "npi": [1982603544]}]}]}, {"tin": {"type": "ein", "value": "237113915"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.73, "providers": [{"billed_charge": 30.0, "npi": [1316359706]}]}]}, {"tin": {"type": "ein", "value": "237125570"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 3.37, "providers": [{"billed_charge": 25.0, "npi": [1730564436]}]}]}, {"tin": {"type": "ein", "value": "237140015"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 17.0, "providers": [{"billed_charge": 17.0, "npi": [1184600454]}]}]}, {"tin": {"type": "ein", "value": "260058225"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 24.71, "providers": [{"billed_charge": 30.0, "npi": [1952588352]}]}]}, {"tin": {"type": "ein", "value": "262220917"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.23, "providers": [{"billed_charge": 20.0, "npi": [1194986083]}]}]}, {"tin": {"type": "ein", "value": "270294681"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.59, "providers": [{"billed_charge": 42.0, "npi": [1457680001]}]}, {"allowed_amount": 14.83, "providers": [{"billed_charge": 42.0, "npi": [1457680001]}]}, {"allowed_amount": 24.71, "providers": [{"billed_charge": 42.0, "npi": [1457680001]}]}]}, {"tin": {"type": "ein", "value": "452401199"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 1.04, "providers": [{"billed_charge": 10.0, "npi": [1598000648]}]}, {"allowed_amount": 3.9, "providers": [{"billed_charge": 10.0, "npi": [1598000648]}]}, {"allowed_amount": 5.29, "providers": [{"billed_charge": 10.0, "npi": [1598000648]}]}, {"allowed_amount": 6.18, "providers": [{"billed_charge": 10.0, "npi": [1598000648]}]}, {"allowed_amount": 10.0, "providers": [{"billed_charge": 10.0, "npi": [1598000648]}]}]}, {"tin": {"type": "ein", "value": "465462438"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.27, "providers": [{"billed_charge": 15.0, "npi": [1538566138]}]}]}, {"tin": {"type": "ein", "value": "475029024"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.53, "providers": [{"billed_charge": 50.0, "npi": [1780138826]}]}]}, {"tin": {"type": "ein", "value": "591395439"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 13.52, "providers": [{"billed_charge": 22.46, "npi": [1598715716]}]}]}, {"tin": {"type": "ein", "value": "596000735"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 12.5, "providers": [{"billed_charge": 12.5, "npi": [1700050705]}]}]}, {"tin": {"type": "ein", "value": "830812803"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 25.56, "providers": [{"billed_charge": 27.5, "npi": [1740774504]}]}]}, {"tin": {"type": "ein", "value": "873690973"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 20.04, "providers": [{"billed_charge": 25.0, "npi": [1780339051]}]}]}, {"tin": {"type": "ein", "value": "920682174"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 22.46, "providers": [{"billed_charge": 35.0, "npi": [1639955354]}]}]}, {"tin": {"type": "ein", "value": "992723575"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 1.32, "providers": [{"billed_charge": 45.54, "npi": [1134959604]}]}, {"allowed_amount": 4.1, "providers": [{"billed_charge": 45.54, "npi": [1134959604]}]}]}]}, {"name": "Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes", "billing_code_type": "CPT", "billing_code": "97154", "billing_code_type_version": "2022", "description": "GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "271365998"}, "billing_class": "professional", "service_codes": ["11", "12"], "payments": [{"allowed_amount": 69.28, "providers": [{"billed_charge": 200.0, "npi": [1144552621, 1679961205]}]}, {"allowed_amount": 90.0, "providers": [{"billed_charge": 200.0, "npi": [1972327815, 1114533320, 1144552621, 1538564497, 1679961205]}]}]}]}, {"name": "Hemoglobin; glycosylated (A1C)", "billing_code_type": "CPT", "billing_code": "83036", "billing_code_type_version": "2022", "description": "HEMOGLOBIN GLYCOSYLATED A1C", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 67.97, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 38.84, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 85.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 55.0, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 34.74, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 150.0, "npi": [1134277494, 1215038310]}]}, {"allowed_amount": 10.72, "providers": [{"billed_charge": 150.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 29.13, "npi": [1053584482]}]}, {"allowed_amount": 10.72, "providers": [{"billed_charge": 29.13, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 16.1, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 9.71, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 18.2, "providers": [{"billed_charge": 125.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 185.0, "npi": [1164701561]}]}, {"allowed_amount": 10.72, "providers": [{"billed_charge": 185.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 89.25, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 48.55, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 48.55, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 67.97, "npi": [1285018523]}]}, {"allowed_amount": 10.72, "providers": [{"billed_charge": 67.97, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 207.67, "npi": [1245720820]}]}, {"allowed_amount": 9.47, "providers": [{"billed_charge": 207.67, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 84.95, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 24.76, "providers": [{"billed_charge": 431.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 73.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 29.13, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 49.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 97.1, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.25, "providers": [{"billed_charge": 94.0, "npi": [1336763531]}]}]}]}, {"name": "Hepatitis B surface antibody (HBsAb)", "billing_code_type": "CPT", "billing_code": "86706", "billing_code_type_version": "2022", "description": "HEPATITIS B SURF ANTIBODY HBSAB", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 75.18, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 42.96, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.43, "providers": [{"billed_charge": 286.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 66.81, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 175.0, "npi": [1164701561]}]}, {"allowed_amount": 10.76, "providers": [{"billed_charge": 175.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 107.4, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 53.7, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.76, "providers": [{"billed_charge": 75.18, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 59.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.13, "providers": [{"billed_charge": 129.0, "npi": [1598315574]}]}]}]}, {"name": "Hepatitis C antibody;", "billing_code_type": "CPT", "billing_code": "86803", "billing_code_type_version": "2022", "description": "HEPATITIS C ANTIBODY", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 99.89, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 57.08, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.52, "providers": [{"billed_charge": 59.82, "npi": [1467469023]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 35.68, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.84, "providers": [{"billed_charge": 479.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 102.64, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 206.0, "npi": [1164701561]}]}, {"allowed_amount": 14.21, "providers": [{"billed_charge": 206.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 132.35, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 71.35, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.21, "providers": [{"billed_charge": 99.89, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 305.37, "npi": [1245720820]}]}, {"allowed_amount": 14.83, "providers": [{"billed_charge": 305.37, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 99.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 69.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.13, "providers": [{"billed_charge": 178.0, "npi": [1598315574]}]}]}]}, {"name": "Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter", "billing_code_type": "CPT", "billing_code": "99238", "billing_code_type_version": "2022", "description": "HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<", "allowed_amounts": [{"tin": {"type": "ein", "value": "125784045"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.04, "providers": [{"billed_charge": 516.0, "npi": [1457889594]}]}]}, {"tin": {"type": "ein", "value": "138880345"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 23.5, "providers": [{"billed_charge": 516.0, "npi": [1013478809]}]}]}, {"tin": {"type": "ein", "value": "145844843"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.04, "providers": [{"billed_charge": 516.0, "npi": [1285847863]}]}]}, {"tin": {"type": "ein", "value": "156342255"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.04, "providers": [{"billed_charge": 165.0, "npi": [1225089923]}]}]}, {"tin": {"type": "ein", "value": "158803717"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 19.98, "providers": [{"billed_charge": 240.0, "npi": [1013556067]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 122.06, "providers": [{"billed_charge": 265.0, "npi": [1427398239]}]}]}, {"tin": {"type": "ein", "value": "223346014"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 135.14, "providers": [{"billed_charge": 183.0, "npi": [1659344869]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 143.69, "providers": [{"billed_charge": 155.0, "npi": [1023403573]}]}]}, {"tin": {"type": "ein", "value": "232919472"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 120.81, "providers": [{"billed_charge": 177.0, "npi": [1982059341]}]}]}, {"tin": {"type": "ein", "value": "380082274"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.04, "providers": [{"billed_charge": 516.0, "npi": [1992211171]}]}]}, {"tin": {"type": "ein", "value": "455028775"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.71, "providers": [{"billed_charge": 200.0, "npi": [1619142833]}]}]}, {"tin": {"type": "ein", "value": "874389273"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 122.06, "providers": [{"billed_charge": 562.0, "npi": [1760274088, 1669286449, 1073404406, 1114709599]}]}, {"allowed_amount": 153.13, "providers": [{"billed_charge": 562.0, "npi": [1508968561, 1972328805, 1326268871]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.71, "providers": [{"billed_charge": 257.88, "npi": [1316408024, 1942402243]}]}]}, {"tin": {"type": "ein", "value": "922465140"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 85.39, "providers": [{"billed_charge": 406.0, "npi": [1194287813]}]}]}, {"tin": {"type": "ein", "value": "932402869"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.04, "providers": [{"billed_charge": 570.0, "npi": [1295398725]}]}]}]}, {"name": "Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter", "billing_code_type": "CPT", "billing_code": "99239", "billing_code_type_version": "2022", "description": "HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "061137531"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 207.88, "providers": [{"billed_charge": 409.0, "npi": [1659727709]}]}]}, {"tin": {"type": "ein", "value": "089681607"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 72.24, "providers": [{"billed_charge": 486.0, "npi": [1457365249]}]}]}, {"tin": {"type": "ein", "value": "223346014"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 202.61, "providers": [{"billed_charge": 270.0, "npi": [1861465072]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.51, "providers": [{"billed_charge": 365.0, "npi": [1033310404]}]}, {"allowed_amount": 365.0, "providers": [{"billed_charge": 365.0, "npi": [1174029565]}]}]}, {"tin": {"type": "ein", "value": "232266054"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 215.07, "providers": [{"billed_charge": 327.0, "npi": [1568102515]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 174.61, "providers": [{"billed_charge": 203.0, "npi": [1477541381]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 181.07, "providers": [{"billed_charge": 325.0, "npi": [1922665892]}]}]}, {"tin": {"type": "ein", "value": "264709927"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 196.44, "providers": [{"billed_charge": 409.0, "npi": [1669419388]}]}]}, {"tin": {"type": "ein", "value": "394912033"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 304.0, "npi": [1710114301]}]}]}, {"tin": {"type": "ein", "value": "452041811"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 436.0, "npi": [1144429697, 1730751330, 1992380695]}]}, {"allowed_amount": 177.51, "providers": [{"billed_charge": 436.0, "npi": [1104378512]}]}, {"allowed_amount": 202.61, "providers": [{"billed_charge": 436.0, "npi": [1396235800]}, {"billed_charge": 458.0, "npi": [1164783205]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 486.0, "npi": [1063795623]}]}]}, {"tin": {"type": "ein", "value": "481154210"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 152.92, "providers": [{"billed_charge": 252.0, "npi": [1851912992]}]}]}, {"tin": {"type": "ein", "value": "760459500"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 125.05, "providers": [{"billed_charge": 289.0, "npi": [1093378119]}]}]}, {"tin": {"type": "ein", "value": "821246817"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.51, "providers": [{"billed_charge": 4600.0, "npi": [1194957126]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 194.52, "providers": [{"billed_charge": 335.0, "npi": [1437162674]}]}]}, {"tin": {"type": "ein", "value": "873968165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 3200.0, "npi": [1356516082]}]}]}, {"tin": {"type": "ein", "value": "881093200"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.51, "providers": [{"billed_charge": 1800.0, "npi": [1992750715]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 364.26, "npi": [1568877074, 1942402243]}]}]}, {"tin": {"type": "ein", "value": "920697989"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 300.0, "npi": [1871884007]}]}]}, {"tin": {"type": "ein", "value": "922116659"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 127.46, "providers": [{"billed_charge": 592.0, "npi": [1205144649]}]}]}, {"tin": {"type": "ein", "value": "932402869"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.15, "providers": [{"billed_charge": 790.0, "npi": [1306238100]}]}, {"allowed_amount": 177.51, "providers": [{"billed_charge": 790.0, "npi": [1295398725]}]}]}]}, {"name": "Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure", "billing_code_type": "CPT", "billing_code": "88342", "billing_code_type_version": "2022", "description": "IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE", "allowed_amounts": [{"tin": {"type": "ein", "value": "043452130"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.36, "providers": [{"billed_charge": 307.0, "npi": [1477522910]}]}, {"allowed_amount": 176.48, "providers": [{"billed_charge": 307.0, "npi": [1477522910]}]}]}, {"tin": {"type": "ein", "value": "133377201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 49.59, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1115.86, "npi": [1134213598]}]}]}, {"tin": {"type": "ein", "value": "205405972"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 75.8, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 253.26, "npi": [1992812473]}]}, {"allowed_amount": 136.82, "providers": [{"billed_charge": 357.27, "npi": [1992812473]}]}]}, {"tin": {"type": "ein", "value": "222810004"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 40.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 122.0, "npi": [1164735650]}]}]}, {"tin": {"type": "ein", "value": "272373546"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 126.65, "providers": [{"billed_charge": 390.0, "npi": [1508248782]}]}, {"allowed_amount": 152.15, "providers": [{"billed_charge": 390.0, "npi": [1194950683]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.36, "providers": [{"billed_charge": 140.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "455014226"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 26.26, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 404.0, "npi": [1720426992]}]}, {"allowed_amount": 141.76, "providers": [{"billed_charge": 404.0, "npi": [1720426992]}]}]}, {"tin": {"type": "ein", "value": "562444564"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 74.29, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 447.1, "npi": [1306814900]}]}]}, {"tin": {"type": "ein", "value": "621637129"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.36, "providers": [{"billed_charge": 307.0, "npi": [1467433292]}]}, {"allowed_amount": 111.13, "providers": [{"billed_charge": 307.0, "npi": [1467433292]}]}]}, {"tin": {"type": "ein", "value": "650819138"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.36, "providers": [{"billed_charge": 148.0, "npi": [1740712181]}]}]}, {"tin": {"type": "ein", "value": "831002191"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 56.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1093159329]}]}]}, {"tin": {"type": "ein", "value": "843964342"}, "billing_class": "professional", "service_codes": ["11", "81"], "payments": [{"allowed_amount": 41.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 800.0, "npi": [1104962372]}]}, {"allowed_amount": 75.79, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 750.0, "npi": [1366039638]}]}]}, {"tin": {"type": "ein", "value": "872708442"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 40.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 242.0, "npi": [1750615720, 1154483436, 1417908468, 1316162621, 1346627486]}]}]}]}, {"name": "Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result", "billing_code_type": "CPT", "billing_code": "87389", "billing_code_type_version": "2022", "description": "IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 96.32, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 175.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 56.77, "providers": [{"billed_charge": 240.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 117.67, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 335.0, "npi": [1164701561]}]}, {"allowed_amount": 23.98, "providers": [{"billed_charge": 335.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 96.32, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 120.4, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 20.47, "providers": [{"billed_charge": 194.0, "npi": [1598315574]}]}]}]}, {"name": "Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; hepatitis B surface antigen (HBsAg)", "billing_code_type": "CPT", "billing_code": "87340", "billing_code_type_version": "2022", "description": "IAAD IA HEPATITIS B SURFACE ANTIGEN", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 72.31, "npi": [1124024922]}]}, {"allowed_amount": 10.4, "providers": [{"billed_charge": 72.31, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 41.32, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 25.83, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 69.7, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 125.0, "npi": [1164701561]}]}, {"allowed_amount": 10.4, "providers": [{"billed_charge": 125.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.39, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 51.65, "npi": [1225110497]}]}, {"allowed_amount": 8.78, "providers": [{"billed_charge": 51.65, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.4, "providers": [{"billed_charge": 72.31, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 59.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.78, "providers": [{"billed_charge": 172.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.83, "providers": [{"billed_charge": 124.0, "npi": [1982606992]}]}]}]}, {"name": "Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza", "billing_code_type": "CPT", "billing_code": "87804", "billing_code_type_version": "2022", "description": "IAADIADOO INFLUENZA", "allowed_amounts": [{"tin": {"type": "ein", "value": "135212473"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 170.33, "providers": [{"billed_charge": 45.0, "npi": [1093098584]}]}]}, {"tin": {"type": "ein", "value": "137087733"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 118.15, "providers": [{"billed_charge": 95.0, "npi": [1003689829]}]}]}, {"tin": {"type": "ein", "value": "140742329"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 20.68, "providers": [{"billed_charge": 95.0, "npi": [1407635907]}]}]}, {"tin": {"type": "ein", "value": "149804774"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 115.37, "providers": [{"billed_charge": 34.0, "npi": [1548792898]}]}]}, {"tin": {"type": "ein", "value": "205805198"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 17.08, "providers": [{"billed_charge": 38.0, "npi": [1992986392]}]}]}, {"tin": {"type": "ein", "value": "300709677"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 35.5, "providers": [{"billed_charge": 71.0, "npi": [1992281422]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 24.84, "providers": [{"billed_charge": 629.98, "npi": [1043475668]}]}, {"allowed_amount": 25.5, "providers": [{"billed_charge": 629.98, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "454081388"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 18.91, "providers": [{"billed_charge": 78.0, "npi": [1780280024, 1831829027, 1609842582]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.52, "providers": [{"billed_charge": 65.0, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.52, "providers": [{"billed_charge": 40.0, "npi": [1205434248, 1255801163]}]}]}, {"tin": {"type": "ein", "value": "470902244"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 19.81, "providers": [{"billed_charge": 60.0, "npi": [1083479414]}]}]}, {"tin": {"type": "ein", "value": "591917016"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.46, "providers": [{"billed_charge": 35.0, "npi": [1821729914]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 17.3, "providers": [{"billed_charge": 49.0, "npi": [1477178747]}]}]}]}, {"name": "Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A", "billing_code_type": "CPT", "billing_code": "87880", "billing_code_type_version": "2022", "description": "IAADIADOO STREPTOCOCCUS GROUP A", "allowed_amounts": [{"tin": {"type": "ein", "value": "010790511"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 12.73, "providers": [{"billed_charge": 50.0, "npi": [1033195474]}]}]}, {"tin": {"type": "ein", "value": "050355097"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 15.47, "providers": [{"billed_charge": 20.0, "npi": [1083367429]}]}]}, {"tin": {"type": "ein", "value": "205805198"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.01, "providers": [{"billed_charge": 45.0, "npi": [1992986392]}]}]}, {"tin": {"type": "ein", "value": "300709677"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 19.46, "providers": [{"billed_charge": 66.0, "npi": [1992281422]}]}]}, {"tin": {"type": "ein", "value": "300993315"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 21.03, "providers": [{"billed_charge": 37.0, "npi": [1225894892]}]}]}, {"tin": {"type": "ein", "value": "460933667"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 29.61, "providers": [{"billed_charge": 57.0, "npi": [1780971945]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.49, "providers": [{"billed_charge": 65.0, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.37, "providers": [{"billed_charge": 35.0, "npi": [1205434248]}]}, {"allowed_amount": 16.49, "providers": [{"billed_charge": 35.0, "npi": [1205434248, 1255801163]}]}]}, {"tin": {"type": "ein", "value": "470902244"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 17.98, "providers": [{"billed_charge": 60.0, "npi": [1083479414]}]}]}, {"tin": {"type": "ein", "value": "591917016"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 14.53, "providers": [{"billed_charge": 29.0, "npi": [1821729914]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 13.93, "providers": [{"billed_charge": 49.0, "npi": [1396830535]}]}, {"allowed_amount": 16.44, "providers": [{"billed_charge": 49.0, "npi": [1558037820]}]}, {"allowed_amount": 16.67, "providers": [{"billed_charge": 49.0, "npi": [1477178747]}]}]}, {"tin": {"type": "ein", "value": "832057653"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 21.65, "providers": [{"billed_charge": 37.0, "npi": [1295102192]}]}]}, {"tin": {"type": "ein", "value": "842703642"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 13.4, "providers": [{"billed_charge": 50.0, "npi": [1265089734]}]}, {"allowed_amount": 16.4, "providers": [{"billed_charge": 50.0, "npi": [1265089734]}]}]}, {"tin": {"type": "ein", "value": "941156581"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 17.53, "providers": [{"billed_charge": 64.0, "npi": [1598815938]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique", "billing_code_type": "CPT", "billing_code": "87801", "billing_code_type_version": "2022", "description": "IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 59.67, "providers": [{"billed_charge": 70.2, "npi": [1598820235]}, {"billed_charge": 280.72, "npi": [1598820235]}, {"billed_charge": 280.8, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 59.67, "providers": [{"billed_charge": 90.0, "npi": [1184814014]}, {"billed_charge": 90.02, "npi": [1184814014]}, {"billed_charge": 135.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "452497248"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 300.88, "providers": [{"billed_charge": 1384.0, "npi": [1114473329]}]}]}, {"tin": {"type": "ein", "value": "453194060"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 59.67, "providers": [{"billed_charge": 100.0, "npi": [1508594136]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 70.72, "providers": [{"billed_charge": 491.4, "npi": [1285018523]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism", "billing_code_type": "CPT", "billing_code": "87798", "billing_code_type_version": "2022", "description": "IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.82, "providers": [{"billed_charge": 35.09, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.49, "providers": [{"billed_charge": 350.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "334777680"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 42.11, "npi": [1558150078]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 323.0, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 87.72, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 245.63, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "561565047"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 16.16, "providers": [{"billed_charge": 60.22, "npi": [1073591822]}]}]}, {"tin": {"type": "ein", "value": "621433252"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.82, "providers": [{"billed_charge": 35.09, "npi": [1104631415]}]}, {"allowed_amount": 29.83, "providers": [{"billed_charge": 35.09, "npi": [1104631415]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 40.0, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.82, "providers": [{"billed_charge": 105.27, "npi": [1841774429]}]}, {"allowed_amount": 29.83, "providers": [{"billed_charge": 105.27, "npi": [1841774429]}]}]}, {"tin": {"type": "ein", "value": "851099688"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 87.73, "npi": [1457977209]}]}, {"allowed_amount": 35.35, "providers": [{"billed_charge": 87.73, "npi": [1457977209]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 70.18, "npi": [1710667050]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique", "billing_code_type": "CPT", "billing_code": "87486", "billing_code_type_version": "2022", "description": "IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 87.72, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 60.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "621433252"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 35.09, "npi": [1104631415]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 105.27, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 105.27, "npi": [1841774429]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result", "billing_code_type": "CPT", "billing_code": "87624", "billing_code_type_version": "2022", "description": "IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 140.36, "npi": [1598820235]}]}, {"allowed_amount": 45.05, "providers": [{"billed_charge": 140.36, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 198.84, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "334777680"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 42.11, "npi": [1558150078]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 70.18, "npi": [1710667050]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique", "billing_code_type": "CPT", "billing_code": "87581", "billing_code_type_version": "2022", "description": "IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 87.72, "npi": [1598820235]}, {"billed_charge": 140.36, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 60.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "621433252"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 35.09, "npi": [1104631415]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 105.27, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 105.27, "npi": [1841774429]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets", "billing_code_type": "CPT", "billing_code": "87631", "billing_code_type_version": "2022", "description": "IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 142.63, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 1312.2, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 200.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "621433252"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 142.63, "npi": [1104631415]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 427.89, "npi": [1497423198]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 427.89, "npi": [1841774429]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique", "billing_code_type": "CPT", "billing_code": "87636", "billing_code_type_version": "2022", "description": "IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 570.52, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "540793767"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 477.0, "providers": [{"billed_charge": 477.0, "npi": [1962464016]}]}]}, {"tin": {"type": "ein", "value": "853363946"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 450.0, "npi": [1063187938]}]}]}, {"tin": {"type": "ein", "value": "941156581"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 151.21, "providers": [{"billed_charge": 523.0, "npi": [1598815938]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique", "billing_code_type": "CPT", "billing_code": "87635", "billing_code_type_version": "2022", "description": "IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "providers": [{"billed_charge": 75.0, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 64.09, "providers": [{"billed_charge": 159.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "336684993"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.94, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 17.94, "npi": [1285685909]}]}]}, {"tin": {"type": "ein", "value": "465330784"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "providers": [{"billed_charge": 100.0, "npi": [1932586427]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 153.93, "npi": [1497423198, 1447760814]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "providers": [{"billed_charge": 153.93, "npi": [1841774429]}]}]}, {"tin": {"type": "ein", "value": "853363946"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "providers": [{"billed_charge": 270.0, "npi": [1063187938]}]}]}, {"tin": {"type": "ein", "value": "873860935"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 43.61, "providers": [{"billed_charge": 150.0, "npi": [1033847876]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique", "billing_code_type": "CPT", "billing_code": "87637", "billing_code_type_version": "2022", "description": "IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 142.63, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 427.9, "providers": [{"billed_charge": 427.9, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 157.25, "providers": [{"billed_charge": 449.28, "npi": [1801992631]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 254.59, "providers": [{"billed_charge": 350.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 254.59, "providers": [{"billed_charge": 1400.0, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 100.14, "providers": [{"billed_charge": 667.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "590774199"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 499.0, "npi": [1881632818]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 427.89, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "853363946"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 121.24, "providers": [{"billed_charge": 500.0, "npi": [1063187938]}]}]}]}, {"name": "Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique", "billing_code_type": "CPT", "billing_code": "87500", "billing_code_type_version": "2022", "description": "INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE", "allowed_amounts": [{"tin": {"type": "ein", "value": "352481557"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 33.88, "providers": [{"billed_charge": 70.18, "npi": [1245441252]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 323.0, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453194060"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 50.0, "npi": [1508594136]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 39.75, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 98.0, "npi": [1841774429]}]}]}, {"tin": {"type": "ein", "value": "851099688"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 87.73, "npi": [1457977209]}]}, {"allowed_amount": 36.47, "providers": [{"billed_charge": 87.73, "npi": [1457977209]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 29.83, "providers": [{"billed_charge": 70.18, "npi": [1710667050]}]}]}]}, {"name": "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99223", "billing_code_type_version": "2022", "description": "1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "061137531"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 380.46, "providers": [{"billed_charge": 680.0, "npi": [1548405434]}]}]}, {"tin": {"type": "ein", "value": "103885068"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 450.0, "npi": [1922109149]}]}]}, {"tin": {"type": "ein", "value": "113167120"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 303.89, "providers": [{"billed_charge": 627.0, "npi": [1952669459]}]}]}, {"tin": {"type": "ein", "value": "131701473"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 15.22, "providers": [{"billed_charge": 1095.0, "npi": [1598044273]}]}]}, {"tin": {"type": "ein", "value": "148764067"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 36.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1095.0, "npi": [1962652735]}]}]}, {"tin": {"type": "ein", "value": "201790156"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 237.98, "providers": [{"billed_charge": 348.0, "npi": [1386636025]}]}]}, {"tin": {"type": "ein", "value": "204700877"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.1, "providers": [{"billed_charge": 674.0, "npi": [1295132595]}]}]}, {"tin": {"type": "ein", "value": "205063365"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 750.0, "npi": [1316387376]}]}]}, {"tin": {"type": "ein", "value": "205069575"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 301.57, "providers": [{"billed_charge": 12000.0, "npi": [1770555930]}]}]}, {"tin": {"type": "ein", "value": "205100194"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 725.0, "npi": [1821198805]}]}]}, {"tin": {"type": "ein", "value": "205719625"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 600.0, "npi": [1245291996]}]}]}, {"tin": {"type": "ein", "value": "222775331"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 237.83, "providers": [{"billed_charge": 2127.4, "npi": [1871470443]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 301.57, "providers": [{"billed_charge": 550.0, "npi": [1033310404]}]}]}, {"tin": {"type": "ein", "value": "223667742"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 328.58, "providers": [{"billed_charge": 6600.0, "npi": [1669432159]}]}]}, {"tin": {"type": "ein", "value": "232266054"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 362.4, "providers": [{"billed_charge": 621.0, "npi": [1730717885]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 328.58, "providers": [{"billed_charge": 586.0, "npi": [1275808560]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 352.92, "providers": [{"billed_charge": 360.0, "npi": [1487073763]}]}]}, {"tin": {"type": "ein", "value": "262008360"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 900.0, "npi": [1164606158]}]}]}, {"tin": {"type": "ein", "value": "271369141"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 349.95, "providers": [{"billed_charge": 1318.0, "npi": [1518703461]}]}]}, {"tin": {"type": "ein", "value": "364844601"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 635.0, "npi": [1407014871]}]}]}, {"tin": {"type": "ein", "value": "394912033"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 456.0, "npi": [1710114301]}]}]}, {"tin": {"type": "ein", "value": "451499724"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 1900.0, "npi": [1245420470]}]}]}, {"tin": {"type": "ein", "value": "452041811"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 301.57, "providers": [{"billed_charge": 817.0, "npi": [1295432714, 1629432315]}]}, {"allowed_amount": 350.66, "providers": [{"billed_charge": 817.0, "npi": [1265085120, 1659013738, 1770743163, 1336630375]}, {"billed_charge": 858.0, "npi": [1841315702]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 303.89, "providers": [{"billed_charge": 879.0, "npi": [1588155436]}]}, {"allowed_amount": 387.5, "providers": [{"billed_charge": 879.0, "npi": [1023674751]}]}]}, {"tin": {"type": "ein", "value": "455028775"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 300.0, "providers": [{"billed_charge": 300.0, "npi": [1619142833]}]}]}, {"tin": {"type": "ein", "value": "461177406"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 450.0, "npi": [1730442658]}]}]}, {"tin": {"type": "ein", "value": "474552415"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 250.0, "npi": [1528260064]}]}]}, {"tin": {"type": "ein", "value": "752131429"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 217.02, "providers": [{"billed_charge": 694.0, "npi": [1164464152]}]}]}, {"tin": {"type": "ein", "value": "760459500"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 237.98, "providers": [{"billed_charge": 519.0, "npi": [1548520760]}]}]}, {"tin": {"type": "ein", "value": "821346098"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 900.0, "npi": [1689858011]}]}]}, {"tin": {"type": "ein", "value": "825469010"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 387.5, "providers": [{"billed_charge": 1067.0, "npi": [1932593670]}]}]}, {"tin": {"type": "ein", "value": "852130594"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 1095.0, "providers": [{"billed_charge": 1095.0, "npi": [1437618444]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 296.27, "providers": [{"billed_charge": 598.0, "npi": [1275672099]}]}]}, {"tin": {"type": "ein", "value": "870781773"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 237.98, "providers": [{"billed_charge": 295.0, "npi": [1427518919]}]}]}, {"tin": {"type": "ein", "value": "873968165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 3500.0, "npi": [1356516082]}]}]}, {"tin": {"type": "ein", "value": "874389273"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 301.57, "providers": [{"billed_charge": 1198.0, "npi": [1972328805, 1326268871, 1508968561, 1669286449, 1801612825]}]}]}, {"tin": {"type": "ein", "value": "881093200"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 301.57, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1875.0, "npi": [1992750715]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 547.5, "npi": [1366190753, 1942402243]}]}, {"allowed_amount": 387.5, "providers": [{"billed_charge": 547.5, "npi": [1134221062]}]}]}, {"tin": {"type": "ein", "value": "920697989"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 550.0, "npi": [1871884007]}]}]}, {"tin": {"type": "ein", "value": "922116659"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 242.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1107.0, "npi": [1699980052]}]}]}, {"tin": {"type": "ein", "value": "922465140"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 237.98, "providers": [{"billed_charge": 1107.0, "npi": [1326036799]}]}]}, {"tin": {"type": "ein", "value": "932402869"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 350.66, "providers": [{"billed_charge": 1230.0, "npi": [1003493842, 1578068060]}]}, {"allowed_amount": 387.5, "providers": [{"billed_charge": 1230.0, "npi": [1821865007]}]}]}]}, {"name": "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99222", "billing_code_type_version": "2022", "description": "1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "113167120"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 206.72, "providers": [{"billed_charge": 430.0, "npi": [1902000953]}]}, {"allowed_amount": 244.66, "providers": [{"billed_charge": 430.0, "npi": [1477917821]}]}, {"allowed_amount": 251.19, "providers": [{"billed_charge": 430.0, "npi": [1669431110]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 263.6, "providers": [{"billed_charge": 353.0, "npi": [1740414119]}]}]}, {"tin": {"type": "ein", "value": "135562308"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 244.66, "providers": [{"billed_charge": 875.0, "npi": [1861135964]}]}]}, {"tin": {"type": "ein", "value": "202088165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 449.0, "npi": [1861709347]}]}]}, {"tin": {"type": "ein", "value": "203002850"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 2000.0, "npi": [1952540072]}]}]}, {"tin": {"type": "ein", "value": "208440638"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 300.0, "npi": [1881647188]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["22", "23"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 423.0, "npi": [1740511385]}]}, {"allowed_amount": 244.66, "providers": [{"billed_charge": 423.0, "npi": [1164994521]}]}]}, {"tin": {"type": "ein", "value": "222633412"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 257.0, "providers": [{"billed_charge": 257.0, "npi": [1710966064]}]}]}, {"tin": {"type": "ein", "value": "223430454"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.69, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5000.0, "npi": [1073001434, 1295268506, 1689569683]}]}]}, {"tin": {"type": "ein", "value": "223828413"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 266.76, "providers": [{"billed_charge": 300.0, "npi": [1366411084]}]}]}, {"tin": {"type": "ein", "value": "223837962"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 263.6, "providers": [{"billed_charge": 3066.84, "npi": [1063828077]}]}, {"allowed_amount": 267.02, "providers": [{"billed_charge": 3066.84, "npi": [1194920637]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 190.02, "providers": [{"billed_charge": 398.0, "npi": [1811937857]}]}, {"allowed_amount": 266.76, "providers": [{"billed_charge": 398.0, "npi": [1831540616]}]}, {"allowed_amount": 267.02, "providers": [{"billed_charge": 398.0, "npi": [1922386317]}]}]}, {"tin": {"type": "ein", "value": "232919472"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 241.05, "providers": [{"billed_charge": 340.0, "npi": [1982059341]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 207.74, "providers": [{"billed_charge": 372.0, "npi": [1811940125]}]}, {"allowed_amount": 241.05, "providers": [{"billed_charge": 372.0, "npi": [1619430295]}]}]}, {"tin": {"type": "ein", "value": "262008360"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 244.66, "providers": [{"billed_charge": 700.0, "npi": [1891971305]}]}]}, {"tin": {"type": "ein", "value": "272577502"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 211.0, "providers": [{"billed_charge": 211.0, "npi": [1700974805]}]}]}, {"tin": {"type": "ein", "value": "364533513"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 790.0, "npi": [1306231279]}]}]}, {"tin": {"type": "ein", "value": "394912033"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 244.66, "providers": [{"billed_charge": 343.0, "npi": [1710114301]}]}]}, {"tin": {"type": "ein", "value": "510588867"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 145.23, "providers": [{"billed_charge": 145.23, "npi": [1205864899]}]}]}, {"tin": {"type": "ein", "value": "825469010"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 233.35, "providers": [{"billed_charge": 723.0, "npi": [1093150302]}]}]}, {"tin": {"type": "ein", "value": "874389273"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 198.69, "providers": [{"billed_charge": 904.0, "npi": [1366018467, 1881437853]}]}, {"allowed_amount": 207.74, "providers": [{"billed_charge": 904.0, "npi": [1972328805]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 244.66, "providers": [{"billed_charge": 411.03, "npi": [1316408024, 1942402243]}]}]}, {"tin": {"type": "ein", "value": "920697989"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 244.66, "providers": [{"billed_charge": 500.0, "npi": [1043667892]}]}]}, {"tin": {"type": "ein", "value": "932217099"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 263.6, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 606.0, "npi": [1497288120]}]}]}]}, {"name": "Iron", "billing_code_type": "CPT", "billing_code": "83540", "billing_code_type_version": "2022", "description": "ASSAY OF IRON", "allowed_amounts": [{"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 44.51, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 45.29, "npi": [1124024922]}]}, {"allowed_amount": 7.15, "providers": [{"billed_charge": 45.29, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 25.88, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 65.0, "npi": [1033281126]}]}, {"allowed_amount": 7.15, "providers": [{"billed_charge": 65.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 36.72, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.3, "providers": [{"billed_charge": 60.86, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 60.0, "npi": [1134277494, 1215038310]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.37, "providers": [{"billed_charge": 170.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 101.25, "npi": [1164701561]}]}, {"allowed_amount": 7.15, "providers": [{"billed_charge": 101.25, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 59.6, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 32.35, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 73.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 39.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 64.7, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.15, "providers": [{"billed_charge": 75.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.5, "providers": [{"billed_charge": 36.0, "npi": [1336763531]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.52, "providers": [{"billed_charge": 78.0, "npi": [1982606992]}]}]}]}, {"name": "Iron binding capacity", "billing_code_type": "CPT", "billing_code": "83550", "billing_code_type_version": "2022", "description": "IRON BINDING CAPACITY", "allowed_amounts": [{"tin": {"type": "ein", "value": "043248020"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 57.85, "npi": [1952347791]}]}]}, {"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 61.18, "npi": [1124024922]}]}, {"allowed_amount": 8.43, "providers": [{"billed_charge": 61.18, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 34.96, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 95.0, "npi": [1033281126]}]}, {"allowed_amount": 8.5, "providers": [{"billed_charge": 95.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.95, "providers": [{"billed_charge": 105.56, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 60.0, "npi": [1215038310, 1134277494]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 240.0, "npi": [1164701561]}]}, {"allowed_amount": 8.43, "providers": [{"billed_charge": 240.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 80.5, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 73.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 87.4, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.43, "providers": [{"billed_charge": 81.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.43, "providers": [{"billed_charge": 44.0, "npi": [1336763531]}]}]}]}, {"name": "Lactate dehydrogenase (LD), (LDH);", "billing_code_type": "CPT", "billing_code": "83615", "billing_code_type_version": "2022", "description": "LACTATE DEHYDROGENASE LDH", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.13, "providers": [{"billed_charge": 24.16, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 46.28, "providers": [{"billed_charge": 132.23, "npi": [1619341716]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.13, "providers": [{"billed_charge": 18.12, "npi": [1053584482]}]}, {"allowed_amount": 6.66, "providers": [{"billed_charge": 18.12, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.04, "providers": [{"billed_charge": 170.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 37.11, "providers": [{"billed_charge": 717.44, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.13, "providers": [{"billed_charge": 30.2, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.13, "providers": [{"billed_charge": 129.08, "npi": [1245720820]}]}, {"allowed_amount": 6.46, "providers": [{"billed_charge": 129.08, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.13, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}]}, {"name": "Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartholin's gland cyst Bone fragment(s), other than pathologic fracture Bursa/synovial cyst Carpal tunnel tissue Cartilage, shavings Cholesteatoma Colon, colostomy stoma Conjunctiva - biopsy/pterygium Cornea Diverticulum - esophagus/small intestine Dupuytren's contracture tissue Femoral head, other than fracture Fissure/fistula Foreskin, other than newborn Gallbladder Ganglion cyst Hematoma Hemorrhoids Hydatid of Morgagni Intervertebral disc Joint, loose body Meniscus Mucocele, salivary Neuroma - Morton's/traumatic Pilonidal cyst/sinus Polyps, inflammatory - nasal/sinusoidal Skin - cyst/tag/debridement Soft tissue, debridement Soft tissue, lipoma Spermatocele Tendon/tendon sheath Testicular appendage Thrombus or embolus Tonsil and/or adenoids Varicocele Vas deferens, other than sterilization Vein, varicosity", "billing_code_type": "CPT", "billing_code": "88304", "billing_code_type_version": "2022", "description": "LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "043452130"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 40.69, "providers": [{"billed_charge": 125.0, "npi": [1477522910]}]}]}, {"tin": {"type": "ein", "value": "112575949"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 40.69, "providers": [{"billed_charge": 195.0, "npi": [1205999067]}]}]}, {"tin": {"type": "ein", "value": "222810004"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 20.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1164735650]}]}]}, {"tin": {"type": "ein", "value": "232893988"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 40.69, "providers": [{"billed_charge": 72.0, "npi": [1750366688, 1609852177, 1972587004, 1992367056]}]}]}, {"tin": {"type": "ein", "value": "272373546"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 50.62, "providers": [{"billed_charge": 150.0, "npi": [1437474830]}]}, {"allowed_amount": 62.01, "providers": [{"billed_charge": 150.0, "npi": [1508248782]}]}, {"allowed_amount": 68.71, "providers": [{"billed_charge": 150.0, "npi": [1194950683, 1538510813]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 163.96, "providers": [{"billed_charge": 873.6, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "454228836"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 79.07, "providers": [{"billed_charge": 144.09, "npi": [1336733203]}]}]}, {"tin": {"type": "ein", "value": "650819138"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 40.69, "providers": [{"billed_charge": 100.0, "npi": [1801996707, 1003442948, 1942704614, 1740712181, 1255316121, 1104059773]}]}]}, {"tin": {"type": "ein", "value": "872708442"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 20.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 198.0, "npi": [1417908468, 1316162621]}]}]}]}, {"name": "Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, biopsy, not requiring microscopic evaluation of surgical margins Breast, reduction mammoplasty Bronchus, biopsy Cell block, any source Cervix, biopsy Colon, biopsy Duodenum, biopsy Endocervix, curettings/biopsy Endometrium, curettings/biopsy Esophagus, biopsy Extremity, amputation, traumatic Fallopian tube, biopsy Fallopian tube, ectopic pregnancy Femoral head, fracture Fingers/toes, amputation, non-traumatic Gingiva/oral mucosa, biopsy Heart valve Joint, resection Kidney, biopsy Larynx, biopsy Leiomyoma(s), uterine myomectomy - without uterus Lip, biopsy/wedge resection Lung, transbronchial biopsy Lymph node, biopsy Muscle, biopsy Nasal mucosa, biopsy Nasopharynx/oropharynx, biopsy Nerve, biopsy Odontogenic/dental cyst Omentum, biopsy Ovary with or without tube, non-neoplastic Ovary, biopsy/wedge resection Parathyroid gland Peritoneum, biopsy Pituitary tumor Placenta, other than third trimester Pleura/pericardium - biopsy/tissue Polyp, cervical/endometrial Polyp, colorectal Polyp, stomach/small intestine Prostate, needle biopsy Prostate, TUR Salivary gland, biopsy Sinus, paranasal biopsy Skin, other than cyst/tag/debridement/plastic repair Small intestine, biopsy Soft tissue, other than tumor/mass/lipoma/debridement Spleen Stomach, biopsy Synovium Testis, other than tumor/biopsy/castration Thyroglossal duct/brachial cleft cyst Tongue, biopsy Tonsil, biopsy Trachea, biopsy Ureter, biopsy Urethra, biopsy Urinary bladder, biopsy Uterus, with or without tubes and ovaries, for prolapse Vagina, biopsy Vulva/labia, biopsy", "billing_code_type": "CPT", "billing_code": "88305", "billing_code_type_version": "2022", "description": "LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM", "allowed_amounts": [{"tin": {"type": "ein", "value": "043452130"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 204.0, "npi": [1477522910]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 204.0, "npi": [1477522910]}]}, {"allowed_amount": 83.6, "providers": [{"billed_charge": 204.0, "npi": [1477522910]}]}, {"allowed_amount": 167.2, "providers": [{"billed_charge": 204.0, "npi": [1477522910]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 324.72, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "133365998"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 180.0, "npi": [1568442549]}]}]}, {"tin": {"type": "ein", "value": "133377201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 13.33, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1279.98, "npi": [1134213598]}]}, {"allowed_amount": 26.66, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1279.98, "npi": [1134213598]}]}]}, {"tin": {"type": "ein", "value": "135598093"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 80.66, "providers": [{"billed_charge": 360.0, "npi": [1689899817, 1023118916]}]}]}, {"tin": {"type": "ein", "value": "161387862"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.12, "providers": [{"billed_charge": 214.92, "npi": [1255316121, 1740712181]}]}]}, {"tin": {"type": "ein", "value": "202879668"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 226.0, "npi": [1457747206]}]}]}, {"tin": {"type": "ein", "value": "205292168"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 34.43, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 95.0, "npi": [1487663860]}]}, {"allowed_amount": 34.44, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 95.0, "npi": [1487663860]}]}, {"allowed_amount": 67.11, "providers": [{"billed_charge": 160.0, "npi": [1487663860]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 160.0, "npi": [1487663860]}]}]}, {"tin": {"type": "ein", "value": "205405972"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 34.43, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 114.81, "npi": [1992812473]}]}, {"allowed_amount": 34.44, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 114.81, "npi": [1992812473]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 226.02, "npi": [1992812473]}]}, {"allowed_amount": 97.77, "providers": [{"billed_charge": 226.02, "npi": [1942469770]}]}, {"allowed_amount": 99.99, "providers": [{"billed_charge": 226.02, "npi": [1992812473]}]}]}, {"tin": {"type": "ein", "value": "205455398"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.12, "providers": [{"billed_charge": 284.0, "npi": [1134438427]}]}]}, {"tin": {"type": "ein", "value": "208473531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 74.2, "providers": [{"billed_charge": 389.1, "npi": [1427273598]}]}]}, {"tin": {"type": "ein", "value": "221916915"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 74.64, "providers": [{"billed_charge": 250.0, "npi": [1518032820]}]}]}, {"tin": {"type": "ein", "value": "222810004"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1164735650]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 220.0, "npi": [1396308326]}]}]}, {"tin": {"type": "ein", "value": "232893988"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 135.0, "npi": [1750366688, 1336141373, 1649686718, 1821221623]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 135.0, "npi": [1750366688, 1992367056, 1609852177, 1821221623, 1972587004, 1336141373]}]}]}, {"tin": {"type": "ein", "value": "263165503"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 18.02, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 320.0, "npi": [1922258722]}]}, {"allowed_amount": 54.06, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 320.0, "npi": [1922258722]}]}]}, {"tin": {"type": "ein", "value": "272373546"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 80.66, "providers": [{"billed_charge": 270.0, "npi": [1508248782]}]}, {"allowed_amount": 111.06, "providers": [{"billed_charge": 270.0, "npi": [1538510813, 1194950683, 1508837253, 1437474830]}]}, {"allowed_amount": 118.5, "providers": [{"billed_charge": 270.0, "npi": [1790722981]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 117.0, "npi": [1184814014]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 117.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "352037910"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 122.0, "npi": [1023098928]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 122.0, "npi": [1023098928, 1851317465, 1457335150]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 325.54, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 970.0, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "455014226"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 10.81, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 287.0, "npi": [1720426992]}]}, {"allowed_amount": 13.52, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 287.0, "npi": [1720426992]}]}, {"allowed_amount": 18.02, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 287.0, "npi": [1720426992]}]}, {"allowed_amount": 27.03, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 287.0, "npi": [1720426992]}]}, {"allowed_amount": 66.86, "providers": [{"billed_charge": 287.0, "npi": [1720426992]}]}]}, {"tin": {"type": "ein", "value": "621637129"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 204.0, "npi": [1467433292]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 204.0, "npi": [1467433292]}]}, {"allowed_amount": 70.05, "providers": [{"billed_charge": 204.0, "npi": [1467433292]}]}, {"allowed_amount": 109.19, "providers": [{"billed_charge": 204.0, "npi": [1467433292]}]}]}, {"tin": {"type": "ein", "value": "650819138"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.11, "providers": [{"billed_charge": 135.0, "npi": [1801996707, 1942704614, 1740712181, 1255316121, 1104059773]}]}, {"allowed_amount": 67.12, "providers": [{"billed_charge": 135.0, "npi": [1801996707, 1003442948, 1689051013, 1942704614, 1003040403, 1740712181, 1255316121, 1841302908, 1104059773, 1861952798]}]}]}, {"tin": {"type": "ein", "value": "822958832"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 67.12, "providers": [{"billed_charge": 300.0, "npi": [1023195880]}]}]}, {"tin": {"type": "ein", "value": "843964342"}, "billing_class": "professional", "service_codes": ["11", "81"], "payments": [{"allowed_amount": 34.43, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 750.0, "npi": [1366039638]}]}, {"allowed_amount": 43.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 800.0, "npi": [1104962372]}]}]}, {"tin": {"type": "ein", "value": "853877508"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 66.86, "providers": [{"billed_charge": 143.14, "npi": [1497423198]}]}]}, {"tin": {"type": "ein", "value": "872708442"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 43.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 330.0, "npi": [1841519006, 1497796262, 1750615720, 1154483436, 1417908468, 1316162621, 1346627486]}]}]}, {"tin": {"type": "ein", "value": "883727738"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 88.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 330.0, "npi": [1972769768, 1558774380]}]}]}]}, {"name": "Lipase", "billing_code_type": "CPT", "billing_code": "83690", "billing_code_type_version": "2022", "description": "ASSAY OF LIPASE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.86, "providers": [{"billed_charge": 27.56, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.86, "providers": [{"billed_charge": 36.36, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.37, "providers": [{"billed_charge": 272.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.37, "providers": [{"billed_charge": 110.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.37, "providers": [{"billed_charge": 24.36, "npi": [1467469023]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 30.55, "providers": [{"billed_charge": 289.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.44, "providers": [{"billed_charge": 155.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.86, "providers": [{"billed_charge": 235.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.32, "providers": [{"billed_charge": 707.67, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.86, "providers": [{"billed_charge": 27.56, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.08, "providers": [{"billed_charge": 141.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 150.09, "providers": [{"billed_charge": 581.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 55.98, "providers": [{"billed_charge": 586.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.77, "providers": [{"billed_charge": 285.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.86, "providers": [{"billed_charge": 68.9, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 63.37, "providers": [{"billed_charge": 195.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.1, "providers": [{"billed_charge": 618.0, "npi": [1437865953]}]}]}]}, {"name": "Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)", "billing_code_type": "CPT", "billing_code": "80061", "billing_code_type_version": "2022", "description": "LIPID PANEL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 53.56, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 75.0, "npi": [1033281126]}]}, {"allowed_amount": 11.74, "providers": [{"billed_charge": 75.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 75.88, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 39.2, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 175.0, "npi": [1134277494, 1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 40.17, "npi": [1053584482]}]}, {"allowed_amount": 11.74, "providers": [{"billed_charge": 40.17, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "208833340"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 31.0, "npi": [1922259753]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 33.48, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 90.68, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 13.39, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 180.0, "npi": [1164701561]}]}, {"allowed_amount": 14.78, "providers": [{"billed_charge": 180.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 194.76, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 100.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 66.95, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 93.73, "npi": [1285018523]}]}, {"allowed_amount": 14.78, "providers": [{"billed_charge": 93.73, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "561398929"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 88.5, "npi": [1811005150]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 286.7, "npi": [1245720820]}]}, {"allowed_amount": 11.8, "providers": [{"billed_charge": 286.7, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 169.43, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 56.62, "providers": [{"billed_charge": 853.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 106.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 40.17, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 69.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 133.9, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 100.0, "npi": [1336763531]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.38, "providers": [{"billed_charge": 26.78, "npi": [1710667050]}]}]}]}, {"name": "Magnesium", "billing_code_type": "CPT", "billing_code": "83735", "billing_code_type_version": "2022", "description": "ASSAY OF MAGNESIUM", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 46.9, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 26.8, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 37.96, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.28, "providers": [{"billed_charge": 212.0, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 20.1, "npi": [1053584482]}]}, {"allowed_amount": 6.71, "providers": [{"billed_charge": 20.1, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 22.08, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 20.89, "providers": [{"billed_charge": 184.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 6.7, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 100.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.98, "providers": [{"billed_charge": 659.5, "npi": [1043475668]}]}, {"allowed_amount": 43.1, "providers": [{"billed_charge": 659.5, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 49.28, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 33.5, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.68, "providers": [{"billed_charge": 64.33, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.21, "providers": [{"billed_charge": 75.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 68.82, "providers": [{"billed_charge": 114.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 61.07, "providers": [{"billed_charge": 341.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 83.22, "providers": [{"billed_charge": 504.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "811723202"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 68.82, "providers": [{"billed_charge": 126.0, "npi": [1063968196]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 39.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 67.0, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.68, "providers": [{"billed_charge": 124.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.7, "providers": [{"billed_charge": 13.4, "npi": [1710667050]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 6.75, "providers": [{"billed_charge": 81.0, "npi": [1982606992]}]}]}]}, {"name": "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99203", "billing_code_type_version": "2022", "description": "OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "010790511"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 124.12, "providers": [{"billed_charge": 340.0, "npi": [1033195474]}]}]}, {"tin": {"type": "ein", "value": "042995053"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 170.35, "providers": [{"billed_charge": 240.0, "npi": [1174886469]}]}]}, {"tin": {"type": "ein", "value": "135562308"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 151.49, "providers": [{"billed_charge": 700.0, "npi": [1598100935]}]}]}, {"tin": {"type": "ein", "value": "232777286"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 171.1, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 287.0, "npi": [1538785423]}]}]}, {"tin": {"type": "ein", "value": "272872791"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 187.11, "providers": [{"billed_charge": 300.0, "npi": [1730491945]}]}]}, {"tin": {"type": "ein", "value": "273184128"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 123.13, "providers": [{"billed_charge": 500.0, "npi": [1508494204]}]}]}, {"tin": {"type": "ein", "value": "273818647"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 132.58, "providers": [{"billed_charge": 351.0, "npi": [1154377554]}]}]}, {"tin": {"type": "ein", "value": "332461082"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 141.29, "providers": [{"billed_charge": 399.0, "npi": [1669179933]}]}]}, {"tin": {"type": "ein", "value": "451055445"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 187.11, "providers": [{"billed_charge": 250.0, "npi": [1821387382]}]}]}, {"tin": {"type": "ein", "value": "454081388"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 181.42, "providers": [{"billed_charge": 350.0, "npi": [1780280024]}]}]}, {"tin": {"type": "ein", "value": "454460375"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 163.07, "providers": [{"billed_charge": 483.72, "npi": [1386334928]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 156.36, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 324.0, "npi": [1205434248, 1255801163]}]}]}, {"tin": {"type": "ein", "value": "465562958"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 141.29, "providers": [{"billed_charge": 250.0, "npi": [1073151668]}]}]}, {"tin": {"type": "ein", "value": "471758444"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 186.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 575.0, "npi": [1639253420]}]}]}, {"tin": {"type": "ein", "value": "591917016"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 108.38, "providers": [{"billed_charge": 216.6, "npi": [1821729914]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 163.07, "providers": [{"billed_charge": 326.0, "npi": [1841073251]}]}]}, {"tin": {"type": "ein", "value": "820797685"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 176.95, "providers": [{"billed_charge": 325.74, "npi": [1346453834]}]}]}, {"tin": {"type": "ein", "value": "824778299"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 173.0, "providers": [{"billed_charge": 173.0, "npi": [1801033675]}]}]}, {"tin": {"type": "ein", "value": "832057653"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 138.73, "providers": [{"billed_charge": 220.0, "npi": [1295102192]}]}]}, {"tin": {"type": "ein", "value": "842703642"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 165.11, "providers": [{"billed_charge": 300.0, "npi": [1265089734]}]}]}, {"tin": {"type": "ein", "value": "843679279"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 139.37, "providers": [{"billed_charge": 380.0, "npi": [1336613603]}]}]}, {"tin": {"type": "ein", "value": "845024428"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 140.0, "providers": [{"billed_charge": 140.0, "npi": [1154841088]}]}]}, {"tin": {"type": "ein", "value": "871737086"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 176.76, "providers": [{"billed_charge": 365.0, "npi": [1932105947]}]}]}, {"tin": {"type": "ein", "value": "931464109"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 154.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 171.96, "npi": [1073048179]}]}]}, {"tin": {"type": "ein", "value": "933821501"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 156.36, "providers": [{"billed_charge": 400.0, "npi": [1396452736]}]}]}]}, {"name": "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99204", "billing_code_type_version": "2022", "description": "OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "010790511"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 161.2, "providers": [{"billed_charge": 520.0, "npi": [1033195474]}]}]}, {"tin": {"type": "ein", "value": "133884168"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 190.19, "providers": [{"billed_charge": 510.0, "npi": [1154396893]}]}]}, {"tin": {"type": "ein", "value": "134000192"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 117.87, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 360.0, "npi": [1710010103]}]}]}, {"tin": {"type": "ein", "value": "135901258"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 78.0, "providers": [{"billed_charge": 365.0, "npi": [1649366832]}]}]}, {"tin": {"type": "ein", "value": "138686464"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 25.0, "providers": [{"billed_charge": 1088.0, "npi": [1982781209]}]}]}, {"tin": {"type": "ein", "value": "205805198"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 183.0, "providers": [{"billed_charge": 183.0, "npi": [1992986392]}]}]}, {"tin": {"type": "ein", "value": "223014220"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 212.48, "providers": [{"billed_charge": 385.0, "npi": [1518973296]}]}]}, {"tin": {"type": "ein", "value": "223741484"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 205.39, "providers": [{"billed_charge": 450.0, "npi": [1356820823]}]}]}, {"tin": {"type": "ein", "value": "223828480"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 264.68, "providers": [{"billed_charge": 365.98, "npi": [1639707169]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["10"], "payments": [{"allowed_amount": 283.27, "providers": [{"billed_charge": 350.0, "npi": [1316320237]}]}]}, {"tin": {"type": "ein", "value": "300709677"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 287.18, "providers": [{"billed_charge": 325.3, "npi": [1992281422]}]}]}, {"tin": {"type": "ein", "value": "332461082"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 283.27, "providers": [{"billed_charge": 595.0, "npi": [1932392131]}]}]}, {"tin": {"type": "ein", "value": "371829497"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 244.79, "providers": [{"billed_charge": 511.0, "npi": [1093251860]}]}]}, {"tin": {"type": "ein", "value": "383940414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 140.0, "providers": [{"billed_charge": 140.0, "npi": [1023786670]}]}]}, {"tin": {"type": "ein", "value": "395045993"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 311.85, "providers": [{"billed_charge": 571.0, "npi": [1710566195]}]}]}, {"tin": {"type": "ein", "value": "452919679"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 207.66, "providers": [{"billed_charge": 435.0, "npi": [1588601298]}]}]}, {"tin": {"type": "ein", "value": "454574670"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 235.74, "providers": [{"billed_charge": 290.0, "npi": [1558866145]}]}]}, {"tin": {"type": "ein", "value": "460933667"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 234.08, "providers": [{"billed_charge": 300.0, "npi": [1780971945]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 235.74, "providers": [{"billed_charge": 444.19, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 235.74, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 494.0, "npi": [1205434248, 1255801163]}]}]}, {"tin": {"type": "ein", "value": "470902244"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 255.21, "providers": [{"billed_charge": 315.0, "npi": [1083479414]}]}]}, {"tin": {"type": "ein", "value": "471198641"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 160.0, "providers": [{"billed_charge": 160.0, "npi": [1255067427]}]}]}, {"tin": {"type": "ein", "value": "591713947"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 173.34, "providers": [{"billed_charge": 1688.0, "npi": [1356883011]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 236.89, "providers": [{"billed_charge": 498.0, "npi": [1477178747]}]}, {"allowed_amount": 258.36, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 498.0, "npi": [1558037820]}]}]}, {"tin": {"type": "ein", "value": "593636166"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 170.0, "providers": [{"billed_charge": 170.0, "npi": [1992856801]}]}]}, {"tin": {"type": "ein", "value": "611661781"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 242.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 660.0, "npi": [1366443798]}]}, {"allowed_amount": 267.02, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 660.0, "npi": [1750805123]}]}]}, {"tin": {"type": "ein", "value": "824778299"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 225.89, "providers": [{"billed_charge": 240.0, "npi": [1801033675]}]}]}, {"tin": {"type": "ein", "value": "863419463"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 188.5, "providers": [{"billed_charge": 450.0, "npi": [1598842098]}]}]}, {"tin": {"type": "ein", "value": "871737086"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 267.02, "providers": [{"billed_charge": 475.0, "npi": [1912240227]}]}]}, {"tin": {"type": "ein", "value": "881539023"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 235.74, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 543.84, "npi": [1023547601]}]}]}, {"tin": {"type": "ein", "value": "923116313"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 234.08, "providers": [{"billed_charge": 268.0, "npi": [1679824551]}]}]}, {"tin": {"type": "ein", "value": "932530375"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 235.74, "providers": [{"billed_charge": 352.0, "npi": [1033406673]}]}]}]}, {"name": "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99213", "billing_code_type_version": "2022", "description": "OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "042986097"}, "billing_class": "professional", "service_codes": ["10"], "payments": [{"allowed_amount": 292.83, "providers": [{"billed_charge": 665.0, "npi": [1609846096]}]}]}, {"tin": {"type": "ein", "value": "050355097"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 96.31, "providers": [{"billed_charge": 137.0, "npi": [1083367429]}]}]}, {"tin": {"type": "ein", "value": "131740114"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.94, "providers": [{"billed_charge": 590.0, "npi": [1932389707]}]}]}, {"tin": {"type": "ein", "value": "142642622"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 50.0, "providers": [{"billed_charge": 256.0, "npi": [1912548579]}]}]}, {"tin": {"type": "ein", "value": "160743029"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 143.59, "providers": [{"billed_charge": 428.31, "npi": [1902800352]}]}]}, {"tin": {"type": "ein", "value": "203446330"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 81.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 81.31, "npi": [1982827507]}]}]}, {"tin": {"type": "ein", "value": "205229077"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.94, "providers": [{"billed_charge": 315.0, "npi": [1104243229]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 81.22, "providers": [{"billed_charge": 214.0, "npi": [1205341658]}]}, {"allowed_amount": 86.38, "providers": [{"billed_charge": 214.0, "npi": [1780659888, 1124650387]}]}, {"allowed_amount": 90.23, "providers": [{"billed_charge": 214.0, "npi": [1912029281]}]}]}, {"tin": {"type": "ein", "value": "221914172"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 111.99, "providers": [{"billed_charge": 168.0, "npi": [1366453409]}]}]}, {"tin": {"type": "ein", "value": "222052641"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 59.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 565.0, "npi": [1366679946]}]}, {"allowed_amount": 106.65, "providers": [{"billed_charge": 565.0, "npi": [1962688978]}]}]}, {"tin": {"type": "ein", "value": "222511879"}, "billing_class": "professional", "service_codes": ["49"], "payments": [{"allowed_amount": 89.99, "providers": [{"billed_charge": 90.69, "npi": [1851382238]}]}]}, {"tin": {"type": "ein", "value": "223368976"}, "billing_class": "professional", "service_codes": ["02"], "payments": [{"allowed_amount": 81.21, "providers": [{"billed_charge": 85.01, "npi": [1205088572]}]}]}, {"tin": {"type": "ein", "value": "223388881"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.94, "providers": [{"billed_charge": 181.0, "npi": [1184656373]}]}]}, {"tin": {"type": "ein", "value": "223487984"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 102.28, "providers": [{"billed_charge": 188.0, "npi": [1033856950]}]}]}, {"tin": {"type": "ein", "value": "223644535"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 81.22, "providers": [{"billed_charge": 221.0, "npi": [1184701492]}]}]}, {"tin": {"type": "ein", "value": "223837962"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.94, "providers": [{"billed_charge": 1141.56, "npi": [1851311096]}]}]}, {"tin": {"type": "ein", "value": "231352213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 230.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 322.0, "npi": [1376339226]}]}]}, {"tin": {"type": "ein", "value": "255841853"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 86.38, "providers": [{"billed_charge": 130.0, "npi": [1902631963]}]}]}, {"tin": {"type": "ein", "value": "262934756"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 106.65, "providers": [{"billed_charge": 596.0, "npi": [1942599741]}]}]}, {"tin": {"type": "ein", "value": "270034858"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 107.54, "providers": [{"billed_charge": 260.0, "npi": [1184959744]}]}]}, {"tin": {"type": "ein", "value": "272801896"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 106.48, "providers": [{"billed_charge": 350.0, "npi": [1750274262]}]}, {"allowed_amount": 115.28, "providers": [{"billed_charge": 350.0, "npi": [1720882137]}]}]}, {"tin": {"type": "ein", "value": "272872791"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 187.11, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 300.0, "npi": [1730491945]}]}]}, {"tin": {"type": "ein", "value": "300993315"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 115.87, "providers": [{"billed_charge": 350.0, "npi": [1174220867, 1225894892]}]}]}, {"tin": {"type": "ein", "value": "454069705"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.94, "providers": [{"billed_charge": 896.0, "npi": [1306082045]}]}]}, {"tin": {"type": "ein", "value": "454081388"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 116.96, "providers": [{"billed_charge": 250.0, "npi": [1780280024, 1609842582]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 117.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 196.29, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 116.62, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 225.0, "npi": [1205434248]}]}, {"allowed_amount": 117.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 225.0, "npi": [1205434248]}]}]}, {"tin": {"type": "ein", "value": "550492006"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 109.53, "providers": [{"billed_charge": 192.0, "npi": [1982312112]}]}]}, {"tin": {"type": "ein", "value": "562638450"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 102.28, "providers": [{"billed_charge": 175.0, "npi": [1538575758]}]}]}, {"tin": {"type": "ein", "value": "824778299"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 109.0, "providers": [{"billed_charge": 109.0, "npi": [1801033675]}]}]}, {"tin": {"type": "ein", "value": "831466906"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 113.27, "providers": [{"billed_charge": 260.0, "npi": [1225570187]}]}]}, {"tin": {"type": "ein", "value": "842703642"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 89.99, "providers": [{"billed_charge": 300.0, "npi": [1265089734]}]}, {"allowed_amount": 187.11, "providers": [{"billed_charge": 300.0, "npi": [1265089734]}]}]}, {"tin": {"type": "ein", "value": "853756788"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 104.05, "providers": [{"billed_charge": 500.0, "npi": [1720009590]}]}]}, {"tin": {"type": "ein", "value": "921071132"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 96.31, "providers": [{"billed_charge": 177.0, "npi": [1447582135]}]}]}, {"tin": {"type": "ein", "value": "993731680"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 106.65, "providers": [{"billed_charge": 402.0, "npi": [1053341438]}]}]}]}, {"name": "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99214", "billing_code_type_version": "2022", "description": "OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "010790511"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 137.32, "providers": [{"billed_charge": 341.0, "npi": [1033195474]}]}]}, {"tin": {"type": "ein", "value": "030885599"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 172.32, "providers": [{"billed_charge": 558.0, "npi": [1679752547]}]}]}, {"tin": {"type": "ein", "value": "091666348"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 124.78, "providers": [{"billed_charge": 1142.1, "npi": [1578889325]}]}]}, {"tin": {"type": "ein", "value": "126588757"}, "billing_class": "professional", "service_codes": ["19"], "payments": [{"allowed_amount": 53.0, "providers": [{"billed_charge": 170.0, "npi": [1417985391]}]}]}, {"tin": {"type": "ein", "value": "143503220"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 10.0, "providers": [{"billed_charge": 400.0, "npi": [1770546301]}]}]}, {"tin": {"type": "ein", "value": "153764739"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 172.32, "providers": [{"billed_charge": 558.0, "npi": [1790267714]}]}]}, {"tin": {"type": "ein", "value": "206665761"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 97.53, "providers": [{"billed_charge": 213.0, "npi": [1376857177]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 138.92, "providers": [{"billed_charge": 316.0, "npi": [1104533272, 1780659888]}]}]}, {"tin": {"type": "ein", "value": "222511879"}, "billing_class": "professional", "service_codes": ["49"], "payments": [{"allowed_amount": 131.17, "providers": [{"billed_charge": 131.17, "npi": [1851382238]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 142.85, "providers": [{"billed_charge": 420.0, "npi": [1730576117]}]}]}, {"tin": {"type": "ein", "value": "223388881"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 174.84, "providers": [{"billed_charge": 262.0, "npi": [1184656373]}]}]}, {"tin": {"type": "ein", "value": "223430454"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 458.65, "providers": [{"billed_charge": 637.0, "npi": [1295268506, 1821551110]}]}]}, {"tin": {"type": "ein", "value": "232380812"}, "billing_class": "professional", "service_codes": ["10"], "payments": [{"allowed_amount": 222.25, "providers": [{"billed_charge": 230.0, "npi": [1518039791]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["10"], "payments": [{"allowed_amount": 216.61, "providers": [{"billed_charge": 275.0, "npi": [1568704633]}]}]}, {"tin": {"type": "ein", "value": "232865181"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 163.87, "providers": [{"billed_charge": 311.0, "npi": [1295027936]}]}]}, {"tin": {"type": "ein", "value": "272373546"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 182.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 450.0, "npi": [1275135287]}]}]}, {"tin": {"type": "ein", "value": "272872791"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 164.0, "providers": [{"billed_charge": 300.0, "npi": [1730491945]}]}, {"allowed_amount": 210.78, "providers": [{"billed_charge": 300.0, "npi": [1730491945]}]}]}, {"tin": {"type": "ein", "value": "272920518"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 172.32, "providers": [{"billed_charge": 250.0, "npi": [1821320276]}]}]}, {"tin": {"type": "ein", "value": "331946468"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 172.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 334.0, "npi": [1538615794, 1841453263]}]}]}, {"tin": {"type": "ein", "value": "352589155"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 154.48, "providers": [{"billed_charge": 170.0, "npi": [1528165073]}]}]}, {"tin": {"type": "ein", "value": "383906267"}, "billing_class": "professional", "service_codes": ["02"], "payments": [{"allowed_amount": 124.78, "providers": [{"billed_charge": 313.0, "npi": [1093276560]}]}]}, {"tin": {"type": "ein", "value": "410949999"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 238.34, "providers": [{"billed_charge": 746.0, "npi": [1497708499]}]}]}, {"tin": {"type": "ein", "value": "452574498"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 210.23, "providers": [{"billed_charge": 525.0, "npi": [1699811026, 1407017767]}]}]}, {"tin": {"type": "ein", "value": "460697666"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 172.32, "providers": [{"billed_charge": 225.0, "npi": [1467434126]}]}]}, {"tin": {"type": "ein", "value": "460782127"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 204.0, "providers": [{"billed_charge": 204.0, "npi": [1548078363]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 172.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 290.98, "npi": [1942439625]}]}, {"allowed_amount": 187.11, "providers": [{"billed_charge": 290.98, "npi": [1437575891]}]}]}, {"tin": {"type": "ein", "value": "465036414"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 172.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 324.0, "npi": [1255801163]}]}]}, {"tin": {"type": "ein", "value": "465143606"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 133.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1269.0, "npi": [1396194197]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 25.0, "providers": [{"billed_charge": 322.0, "npi": [1487367785]}]}, {"allowed_amount": 172.66, "providers": [{"billed_charge": 322.0, "npi": [1396830535]}]}]}, {"tin": {"type": "ein", "value": "611661781"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 172.32, "providers": [{"billed_charge": 430.0, "npi": [1750805123]}]}]}, {"tin": {"type": "ein", "value": "824778299"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 165.0, "providers": [{"billed_charge": 165.0, "npi": [1801033675]}]}]}, {"tin": {"type": "ein", "value": "931467537"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 453.0, "providers": [{"billed_charge": 453.0, "npi": [1871937458]}]}]}, {"tin": {"type": "ein", "value": "941156581"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 196.18, "providers": [{"billed_charge": 388.0, "npi": [1598815938]}]}]}]}, {"name": "Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making. When using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.", "billing_code_type": "CPT", "billing_code": "80503", "billing_code_type_version": "2022", "description": "PATHOLOGY CLINICAL CONSULTATION SF MDM 5-20 MIN", "allowed_amounts": [{"tin": {"type": "ein", "value": "203100683"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 24.24, "providers": [{"billed_charge": 121.0, "npi": [1407201171]}]}]}, {"tin": {"type": "ein", "value": "872708442"}, "billing_class": "professional", "service_codes": ["22", "21", "23"], "payments": [{"allowed_amount": 24.24, "providers": [{"billed_charge": 100.0, "npi": [1417908468, 1316162621]}]}]}]}, {"name": "Phosphorus inorganic (phosphate);", "billing_code_type": "CPT", "billing_code": "84100", "billing_code_type_version": "2022", "description": "ASSAY OF PHOSPHORUS INORGANIC", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 33.18, "npi": [1124024922]}]}, {"allowed_amount": 4.72, "providers": [{"billed_charge": 33.18, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 18.96, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 35.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.48, "providers": [{"billed_charge": 170.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.69, "providers": [{"billed_charge": 656.14, "npi": [1043475668]}]}, {"allowed_amount": 37.67, "providers": [{"billed_charge": 656.14, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 23.7, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 23.7, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.72, "providers": [{"billed_charge": 33.18, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 27.97, "providers": [{"billed_charge": 66.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.96, "providers": [{"billed_charge": 288.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 29.48, "providers": [{"billed_charge": 352.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.03, "providers": [{"billed_charge": 47.4, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.72, "providers": [{"billed_charge": 59.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.97, "providers": [{"billed_charge": 57.0, "npi": [1982606992]}]}]}]}, {"name": "Prostate specific antigen (PSA); total", "billing_code_type": "CPT", "billing_code": "84153", "billing_code_type_version": "2022", "description": "ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 73.56, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 104.24, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 150.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 55.17, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 18.39, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 200.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 73.56, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 176.61, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 100.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 99.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 15.63, "providers": [{"billed_charge": 183.9, "npi": [1881226579]}]}]}]}, {"name": "Prothrombin time;", "billing_code_type": "CPT", "billing_code": "85610", "billing_code_type_version": "2022", "description": "PROTHROMBIN TIME", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.65, "providers": [{"billed_charge": 17.16, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.65, "providers": [{"billed_charge": 50.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.01, "providers": [{"billed_charge": 10.73, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 18.76, "providers": [{"billed_charge": 68.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "141338586"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 18.0, "providers": [{"billed_charge": 18.0, "npi": [1740233899]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.65, "providers": [{"billed_charge": 50.0, "npi": [1215038310]}]}, {"allowed_amount": 4.01, "providers": [{"billed_charge": 50.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 29.67, "providers": [{"billed_charge": 152.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.2, "providers": [{"billed_charge": 85.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 37.07, "providers": [{"billed_charge": 661.89, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.64, "providers": [{"billed_charge": 661.89, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.2, "providers": [{"billed_charge": 83.96, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 75.28, "providers": [{"billed_charge": 92.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 52.88, "providers": [{"billed_charge": 234.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 75.28, "providers": [{"billed_charge": 798.0, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.65, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "861718521"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.65, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 8.58, "npi": [1134277494]}]}]}]}, {"name": "Radiologic examination, chest; 2 views", "billing_code_type": "CPT", "billing_code": "71046", "billing_code_type_version": "2022", "description": "RADIOLOGIC EXAM CHEST 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "060646973"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 22.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 65.0, "npi": [1649448648]}]}]}, {"tin": {"type": "ein", "value": "111631781"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.45, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 210.0, "npi": [1154461622]}]}]}, {"tin": {"type": "ein", "value": "111631788"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 95.0, "npi": [1417119124]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 273.51, "providers": [{"billed_charge": 331.18, "npi": [1073535027]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 28.0, "npi": [1902868730]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 273.51, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 530.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "141338586"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.45, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 656.0, "npi": [1740233899]}]}]}, {"tin": {"type": "ein", "value": "141540066"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 39.5, "npi": [1225569700]}]}]}, {"tin": {"type": "ein", "value": "223473330"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 118.0, "npi": [1164756185, 1063613107]}]}]}, {"tin": {"type": "ein", "value": "231996150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 204.48, "providers": [{"billed_charge": 748.0, "npi": [1174822068]}]}]}, {"tin": {"type": "ein", "value": "232701565"}, "billing_class": "professional", "service_codes": ["19"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1336316991, 1679504229, 1053384487]}]}]}, {"tin": {"type": "ein", "value": "236291113"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.63, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 85.0, "npi": [1336464387]}]}]}, {"tin": {"type": "ein", "value": "262307339"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 83.0, "npi": [1922115435]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 42.59, "providers": [{"billed_charge": 63.7, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "582030692"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 20.36, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 51.0, "npi": [1831727353]}]}]}, {"tin": {"type": "ein", "value": "590774199"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 154.86, "providers": [{"billed_charge": 759.0, "npi": [1881632818]}]}]}, {"tin": {"type": "ein", "value": "591202496"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 44.0, "npi": [1124217021]}]}]}, {"tin": {"type": "ein", "value": "591226176"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.15, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 196.0, "npi": [1578517447]}]}]}, {"tin": {"type": "ein", "value": "752922687"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 96.65, "providers": [{"billed_charge": 2201.0, "npi": [1326078288]}]}]}, {"tin": {"type": "ein", "value": "800886397"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1366977092]}]}]}, {"tin": {"type": "ein", "value": "990547982"}, "billing_class": "professional", "service_codes": ["19", "22", "21", "23"], "payments": [{"allowed_amount": 18.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1770739260, 1427001437, 1396940342, 1689644213]}, {"billed_charge": 60.0, "npi": [1114963857]}]}]}]}, {"name": "Radiologic examination, chest; single view", "billing_code_type": "CPT", "billing_code": "71045", "billing_code_type_version": "2022", "description": "RADIOLOGIC EXAM CHEST SINGLE VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "026647722"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 4.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 51.0, "npi": [1740327121]}]}]}, {"tin": {"type": "ein", "value": "111631788"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.0, "npi": [1235699232]}]}]}, {"tin": {"type": "ein", "value": "112868878"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 181.55, "providers": [{"billed_charge": 305.0, "npi": [1407877137]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 235.49, "providers": [{"billed_charge": 1488.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 23.0, "npi": [1497048722]}]}]}, {"tin": {"type": "ein", "value": "133602653"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 1.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 56.0, "npi": [1568424026]}]}]}, {"tin": {"type": "ein", "value": "135702871"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 9.93, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 31.0, "npi": [1073520664]}]}]}, {"tin": {"type": "ein", "value": "223473330"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 99.0, "npi": [1912915497]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 106.32, "providers": [{"billed_charge": 374.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "231512747"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 263.95, "providers": [{"billed_charge": 440.0, "npi": [1881690212]}]}]}, {"tin": {"type": "ein", "value": "232266054"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 28.0, "npi": [1245527142]}]}]}, {"tin": {"type": "ein", "value": "232701565"}, "billing_class": "professional", "service_codes": ["21", "23"], "payments": [{"allowed_amount": 8.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1053384487]}]}, {"allowed_amount": 14.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1841584547]}]}, {"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1235171968, 1023003233, 1336374305, 1831330778, 1699729210]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1245276419, 1598991796]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 195.12, "providers": [{"billed_charge": 595.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 122.89, "providers": [{"billed_charge": 6095.93, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "264709927"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1306233911]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 122.89, "providers": [{"billed_charge": 5870.36, "npi": [1043475668]}]}, {"allowed_amount": 126.15, "providers": [{"billed_charge": 6095.93, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 48.0, "npi": [1679792998]}]}]}, {"tin": {"type": "ein", "value": "461485841"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.54, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1174715858]}]}]}, {"tin": {"type": "ein", "value": "560945618"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 28.0, "npi": [1750307559]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 202.97, "providers": [{"billed_charge": 345.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 136.91, "providers": [{"billed_charge": 414.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "582030692"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 17.06, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1023579224]}]}]}, {"tin": {"type": "ein", "value": "591289802"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 37.0, "npi": [1295872240]}]}]}, {"tin": {"type": "ein", "value": "741688740"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 10.4, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 67.0, "npi": [1245793397]}]}, {"allowed_amount": 10.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 67.0, "npi": [1346243144]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 108.71, "providers": [{"billed_charge": 1643.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 191.45, "providers": [{"billed_charge": 416.0, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "831002191"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.87, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1053305680]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 249.22, "providers": [{"billed_charge": 780.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "844522008"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 176.0, "npi": [1164445417, 1326021163]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 20.31, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 54.0, "npi": [1629268537]}]}]}, {"tin": {"type": "ein", "value": "854092192"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 19.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1528056280]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 73.64, "providers": [{"billed_charge": 1153.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "922826272"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.45, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 74.0, "npi": [1164078853]}]}]}, {"tin": {"type": "ein", "value": "954368744"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 10.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 63.0, "npi": [1225667835]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 135.98, "providers": [{"billed_charge": 360.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "990547982"}, "billing_class": "professional", "service_codes": ["22", "21", "23"], "payments": [{"allowed_amount": 13.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1821040866]}]}, {"allowed_amount": 15.69, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 51.0, "npi": [1770739260]}]}, {"allowed_amount": 15.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1922661859, 1154312676, 1881630853, 1114963857, 1689644213, 1396940342, 1033155320, 1770739260]}, {"billed_charge": 51.0, "npi": [1770739260, 1689644213, 1366429383]}]}]}]}, {"name": "Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver)", "billing_code_type": "CPT", "billing_code": "88312", "billing_code_type_version": "2022", "description": "SPECIAL STAIN GROUP 1 MICROORGANISMS I&R", "allowed_amounts": [{"tin": {"type": "ein", "value": "133377201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.07, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1296.03, "npi": [1134213598]}]}, {"allowed_amount": 31.34, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1296.03, "npi": [1134213598]}]}]}, {"tin": {"type": "ein", "value": "205292168"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 82.97, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 115.0, "npi": [1487663860]}]}, {"allowed_amount": 82.98, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 115.0, "npi": [1487663860]}]}]}, {"tin": {"type": "ein", "value": "208473531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 112.63, "providers": [{"billed_charge": 462.32, "npi": [1427273598]}]}]}, {"tin": {"type": "ein", "value": "272373546"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 119.49, "providers": [{"billed_charge": 390.0, "npi": [1508248782]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.3, "providers": [{"billed_charge": 115.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "352037910"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.3, "providers": [{"billed_charge": 191.0, "npi": [1851317465]}]}]}, {"tin": {"type": "ein", "value": "455014226"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 46.3, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 454.0, "npi": [1720426992]}]}, {"allowed_amount": 92.61, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 454.0, "npi": [1720426992]}]}, {"allowed_amount": 112.52, "providers": [{"billed_charge": 454.0, "npi": [1720426992]}]}]}, {"tin": {"type": "ein", "value": "621637129"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 97.39, "providers": [{"billed_charge": 329.0, "npi": [1467433292]}]}]}, {"tin": {"type": "ein", "value": "650819138"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.3, "providers": [{"billed_charge": 164.0, "npi": [1801996707, 1841302908, 1740712181, 1942704614]}]}]}, {"tin": {"type": "ein", "value": "822958832"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 106.3, "providers": [{"billed_charge": 450.0, "npi": [1023195880]}]}]}, {"tin": {"type": "ein", "value": "843964342"}, "billing_class": "professional", "service_codes": ["11", "81"], "payments": [{"allowed_amount": 30.36, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 800.0, "npi": [1104962372]}]}, {"allowed_amount": 82.97, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 750.0, "npi": [1366039638]}]}]}]}, {"name": "Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry", "billing_code_type": "CPT", "billing_code": "88313", "billing_code_type_version": "2022", "description": "SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT", "allowed_amounts": [{"tin": {"type": "ein", "value": "133377201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 26.75, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1115.86, "npi": [1134213598]}]}]}, {"tin": {"type": "ein", "value": "135598093"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 14.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1306089925]}]}]}, {"tin": {"type": "ein", "value": "205405972"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 78.11, "providers": [{"billed_charge": 262.47, "npi": [1992812473]}]}]}, {"tin": {"type": "ein", "value": "221916915"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 59.83, "providers": [{"billed_charge": 245.0, "npi": [1518032820]}]}]}, {"tin": {"type": "ein", "value": "222810004"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 14.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1164735650]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 20.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 104.0, "npi": [1841555646]}]}]}, {"tin": {"type": "ein", "value": "331168930"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 78.46, "providers": [{"billed_charge": 85.0, "npi": [1184814014]}]}, {"allowed_amount": 78.47, "providers": [{"billed_charge": 85.0, "npi": [1184814014]}]}]}, {"tin": {"type": "ein", "value": "455014226"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 27.89, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 331.0, "npi": [1720426992]}]}, {"allowed_amount": 37.19, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 331.0, "npi": [1720426992]}]}, {"allowed_amount": 79.6, "providers": [{"billed_charge": 331.0, "npi": [1720426992]}]}]}, {"tin": {"type": "ein", "value": "621637129"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 64.86, "providers": [{"billed_charge": 244.0, "npi": [1467433292]}]}, {"allowed_amount": 78.46, "providers": [{"billed_charge": 244.0, "npi": [1467433292]}]}, {"allowed_amount": 78.47, "providers": [{"billed_charge": 244.0, "npi": [1467433292]}]}]}, {"tin": {"type": "ein", "value": "822958832"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 78.46, "providers": [{"billed_charge": 300.0, "npi": [1023195880]}]}]}, {"tin": {"type": "ein", "value": "843964342"}, "billing_class": "professional", "service_codes": ["11", "81"], "payments": [{"allowed_amount": 14.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 800.0, "npi": [1104962372]}]}, {"allowed_amount": 67.78, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 750.0, "npi": [1366039638]}]}]}]}, {"name": "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99233", "billing_code_type_version": "2022", "description": "SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "061137531"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 199.34, "providers": [{"billed_charge": 397.0, "npi": [1659727709]}]}]}, {"tin": {"type": "ein", "value": "089725552"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 170.0, "providers": [{"billed_charge": 170.0, "npi": [1558450775]}]}]}, {"tin": {"type": "ein", "value": "131701473"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 39.04, "providers": [{"billed_charge": 746.0, "npi": [1598044273]}]}]}, {"tin": {"type": "ein", "value": "145069403"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 39.04, "providers": [{"billed_charge": 746.0, "npi": [1235378027]}]}]}, {"tin": {"type": "ein", "value": "155767331"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 34.64, "providers": [{"billed_charge": 746.0, "npi": [1508154162]}]}, {"allowed_amount": 78.08, "providers": [{"billed_charge": 746.0, "npi": [1508154162]}]}]}, {"tin": {"type": "ein", "value": "202107109"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 201.64, "providers": [{"billed_charge": 265.0, "npi": [1093776759]}]}]}, {"tin": {"type": "ein", "value": "204700877"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 179.82, "providers": [{"billed_charge": 463.0, "npi": [1154880417, 1174109078]}]}]}, {"tin": {"type": "ein", "value": "205063365"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.21, "providers": [{"billed_charge": 700.0, "npi": [1528600186]}]}, {"allowed_amount": 201.64, "providers": [{"billed_charge": 700.0, "npi": [1316387376]}]}]}, {"tin": {"type": "ein", "value": "205100194"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 201.64, "providers": [{"billed_charge": 550.0, "npi": [1821198805, 1750419958]}]}]}, {"tin": {"type": "ein", "value": "223371727"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 156.64, "providers": [{"billed_charge": 746.0, "npi": [1770939274]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 375.0, "providers": [{"billed_charge": 375.0, "npi": [1174029565]}]}]}, {"tin": {"type": "ein", "value": "232809585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 175.94, "providers": [{"billed_charge": 190.0, "npi": [1487073763]}]}, {"allowed_amount": 190.0, "providers": [{"billed_charge": 190.0, "npi": [1518344472]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.21, "providers": [{"billed_charge": 338.0, "npi": [1720479843]}]}, {"allowed_amount": 182.79, "providers": [{"billed_charge": 338.0, "npi": [1275111593]}]}]}, {"tin": {"type": "ein", "value": "262008360"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.21, "providers": [{"billed_charge": 650.0, "npi": [1235652561]}]}, {"allowed_amount": 193.9, "providers": [{"billed_charge": 650.0, "npi": [1891971305]}]}, {"allowed_amount": 201.64, "providers": [{"billed_charge": 650.0, "npi": [1164606158]}]}]}, {"tin": {"type": "ein", "value": "262341344"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.8, "providers": [{"billed_charge": 250.0, "npi": [1134186489]}]}]}, {"tin": {"type": "ein", "value": "320558440"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 129.14, "providers": [{"billed_charge": 572.0, "npi": [1881140135]}]}]}, {"tin": {"type": "ein", "value": "367291468"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 39.04, "providers": [{"billed_charge": 746.0, "npi": [1942250501]}]}]}, {"tin": {"type": "ein", "value": "394912033"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 192.52, "providers": [{"billed_charge": 311.0, "npi": [1710114301]}]}, {"allowed_amount": 193.9, "providers": [{"billed_charge": 311.0, "npi": [1710114301]}]}]}, {"tin": {"type": "ein", "value": "451499724"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.9, "providers": [{"billed_charge": 1300.0, "npi": [1245420470]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.9, "providers": [{"billed_charge": 460.0, "npi": [1770063000, 1326675547, 1063795623]}]}]}, {"tin": {"type": "ein", "value": "461672913"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 197.39, "providers": [{"billed_charge": 6500.0, "npi": [1558893503]}]}]}, {"tin": {"type": "ein", "value": "474552415"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 180.0, "providers": [{"billed_charge": 180.0, "npi": [1528260064]}]}]}, {"tin": {"type": "ein", "value": "510588867"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 110.02, "providers": [{"billed_charge": 110.02, "npi": [1205864899]}]}]}, {"tin": {"type": "ein", "value": "752131429"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 147.59, "providers": [{"billed_charge": 357.0, "npi": [1164464152]}]}]}, {"tin": {"type": "ein", "value": "821346098"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 198.8, "providers": [{"billed_charge": 400.0, "npi": [1689858011]}]}]}, {"tin": {"type": "ein", "value": "870781773"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 125.0, "providers": [{"billed_charge": 125.0, "npi": [1427518919]}]}]}, {"tin": {"type": "ein", "value": "873968165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.9, "providers": [{"billed_charge": 3000.0, "npi": [1356516082]}]}]}, {"tin": {"type": "ein", "value": "874389273"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 177.21, "providers": [{"billed_charge": 820.0, "npi": [1669286449]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.9, "providers": [{"billed_charge": 372.87, "npi": [1366190753, 1942402243, 1780142455]}]}]}, {"tin": {"type": "ein", "value": "920697989"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.9, "providers": [{"billed_charge": 500.0, "npi": [1134327109]}]}]}, {"tin": {"type": "ein", "value": "922465140"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 129.14, "providers": [{"billed_charge": 572.0, "npi": [1194287813]}]}]}, {"tin": {"type": "ein", "value": "932402869"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 156.64, "providers": [{"billed_charge": 880.0, "npi": [1295398725]}]}, {"allowed_amount": 193.9, "providers": [{"billed_charge": 880.0, "npi": [1306238100, 1285297986, 1578068060]}]}]}]}, {"name": "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99232", "billing_code_type_version": "2022", "description": "SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "030440659"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 120.0, "providers": [{"billed_charge": 120.0, "npi": [1962509265]}]}]}, {"tin": {"type": "ein", "value": "050564570"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 102.91, "providers": [{"billed_charge": 300.0, "npi": [1972547156]}]}]}, {"tin": {"type": "ein", "value": "061137531"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 138.39, "providers": [{"billed_charge": 242.0, "npi": [1588857320, 1659727709]}]}]}, {"tin": {"type": "ein", "value": "113167120"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 224.0, "npi": [1902000953, 1962064956, 1376603639]}]}, {"allowed_amount": 139.55, "providers": [{"billed_charge": 224.0, "npi": [1922367861]}]}]}, {"tin": {"type": "ein", "value": "121804340"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 76.23, "providers": [{"billed_charge": 250.0, "npi": [1023583036]}]}]}, {"tin": {"type": "ein", "value": "201790156"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 83.53, "providers": [{"billed_charge": 160.0, "npi": [1386636025]}]}]}, {"tin": {"type": "ein", "value": "202088165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 240.0, "providers": [{"billed_charge": 240.0, "npi": [1528262904]}]}]}, {"tin": {"type": "ein", "value": "202107109"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 136.68, "providers": [{"billed_charge": 140.0, "npi": [1093776759]}]}]}, {"tin": {"type": "ein", "value": "205100194"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 136.68, "providers": [{"billed_charge": 475.0, "npi": [1821198805, 1750419958]}]}]}, {"tin": {"type": "ein", "value": "205719625"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 450.0, "npi": [1245291996]}]}]}, {"tin": {"type": "ein", "value": "208440638"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.3, "providers": [{"billed_charge": 250.0, "npi": [1881647188]}]}]}, {"tin": {"type": "ein", "value": "222052641"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 686.0, "npi": [1306663877]}]}]}, {"tin": {"type": "ein", "value": "222633412"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 136.0, "providers": [{"billed_charge": 136.0, "npi": [1710966064]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 102.91, "providers": [{"billed_charge": 250.0, "npi": [1033310404, 1689932493]}]}, {"allowed_amount": 250.0, "providers": [{"billed_charge": 250.0, "npi": [1174029565]}]}]}, {"tin": {"type": "ein", "value": "223430454"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 104.6, "providers": [{"billed_charge": 5000.0, "npi": [1174014385, 1720759665]}]}]}, {"tin": {"type": "ein", "value": "223762184"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.3, "providers": [{"billed_charge": 364.0, "npi": [1588014971, 1891350823]}]}]}, {"tin": {"type": "ein", "value": "223828413"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 136.68, "providers": [{"billed_charge": 165.0, "npi": [1366411084]}]}]}, {"tin": {"type": "ein", "value": "223837962"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.3, "providers": [{"billed_charge": 1599.78, "npi": [1811523756, 1063828077]}]}]}, {"tin": {"type": "ein", "value": "232266054"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.3, "providers": [{"billed_charge": 221.0, "npi": [1306425343]}]}]}, {"tin": {"type": "ein", "value": "232743545"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 102.64, "providers": [{"billed_charge": 208.0, "npi": [1942232236]}]}, {"allowed_amount": 126.83, "providers": [{"billed_charge": 208.0, "npi": [1023403573]}]}, {"allowed_amount": 128.48, "providers": [{"billed_charge": 208.0, "npi": [1275808560]}]}]}, {"tin": {"type": "ein", "value": "251857035"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 118.09, "providers": [{"billed_charge": 224.0, "npi": [1932661394, 1265993372, 1922665892]}]}, {"allowed_amount": 122.46, "providers": [{"billed_charge": 224.0, "npi": [1417497140]}]}, {"allowed_amount": 128.48, "providers": [{"billed_charge": 224.0, "npi": [1275111593]}]}, {"allowed_amount": 139.3, "providers": [{"billed_charge": 224.0, "npi": [1275111593]}]}]}, {"tin": {"type": "ein", "value": "264709927"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 109.25, "providers": [{"billed_charge": 276.0, "npi": [1669419388]}]}]}, {"tin": {"type": "ein", "value": "272577502"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 153.7, "providers": [{"billed_charge": 188.0, "npi": [1700974805]}]}]}, {"tin": {"type": "ein", "value": "394912033"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 208.0, "npi": [1710114301]}]}]}, {"tin": {"type": "ein", "value": "452041811"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 292.0, "npi": [1730751330, 1245784354, 1871224717, 1962066126]}]}, {"allowed_amount": 139.3, "providers": [{"billed_charge": 292.0, "npi": [1396235800]}, {"billed_charge": 307.0, "npi": [1164783205]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 322.0, "npi": [1588155436]}]}, {"allowed_amount": 139.3, "providers": [{"billed_charge": 322.0, "npi": [1629202981]}]}]}, {"tin": {"type": "ein", "value": "455028775"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 200.0, "npi": [1619142833]}]}]}, {"tin": {"type": "ein", "value": "461177406"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 136.68, "providers": [{"billed_charge": 350.0, "npi": [1730442658]}]}]}, {"tin": {"type": "ein", "value": "510588867"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 77.43, "providers": [{"billed_charge": 77.43, "npi": [1205864899]}]}]}, {"tin": {"type": "ein", "value": "812309917"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 133.11, "providers": [{"billed_charge": 379.82, "npi": [1912585027]}]}]}, {"tin": {"type": "ein", "value": "821346098"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.29, "providers": [{"billed_charge": 325.0, "npi": [1689858011]}]}, {"allowed_amount": 139.3, "providers": [{"billed_charge": 325.0, "npi": [1689858011]}]}]}, {"tin": {"type": "ein", "value": "853861695"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 104.46, "providers": [{"billed_charge": 265.0, "npi": [1669854873]}]}]}, {"tin": {"type": "ein", "value": "874778102"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.3, "providers": [{"billed_charge": 452.0, "npi": [1548656820]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.06, "providers": [{"billed_charge": 249.96, "npi": [1316408024, 1366190753, 1134221062]}]}]}, {"tin": {"type": "ein", "value": "920697989"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 133.11, "providers": [{"billed_charge": 450.0, "npi": [1043667892]}]}, {"allowed_amount": 134.06, "providers": [{"billed_charge": 450.0, "npi": [1578839775, 1033151451, 1043667892, 1871884007]}]}]}, {"tin": {"type": "ein", "value": "922699838"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 135.05, "providers": [{"billed_charge": 850.0, "npi": [1649217266]}]}]}, {"tin": {"type": "ein", "value": "932402869"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 102.91, "providers": [{"billed_charge": 700.0, "npi": [1033689526]}]}, {"allowed_amount": 134.06, "providers": [{"billed_charge": 700.0, "npi": [1285297986, 1306238100]}]}, {"allowed_amount": 139.3, "providers": [{"billed_charge": 700.0, "npi": [1821865007]}]}]}]}, {"name": "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded.", "billing_code_type": "CPT", "billing_code": "99231", "billing_code_type_version": "2022", "description": "SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES", "allowed_amounts": [{"tin": {"type": "ein", "value": "202088165"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 129.0, "providers": [{"billed_charge": 129.0, "npi": [1528262904]}]}]}, {"tin": {"type": "ein", "value": "205100194"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 76.63, "providers": [{"billed_charge": 425.0, "npi": [1821198805, 1750419958]}]}]}, {"tin": {"type": "ein", "value": "221775306"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 72.74, "providers": [{"billed_charge": 160.0, "npi": [1306182761]}]}]}, {"tin": {"type": "ein", "value": "221958585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 72.74, "providers": [{"billed_charge": 175.0, "npi": [1205021060]}]}]}, {"tin": {"type": "ein", "value": "223342098"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 63.21, "providers": [{"billed_charge": 330.0, "npi": [1295120228]}, {"billed_charge": 400.0, "npi": [1871936237]}]}]}, {"tin": {"type": "ein", "value": "223376459"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 155.0, "providers": [{"billed_charge": 155.0, "npi": [1174029565]}]}]}, {"tin": {"type": "ein", "value": "223762184"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 63.21, "providers": [{"billed_charge": 219.0, "npi": [1588014971, 1891350823]}]}]}, {"tin": {"type": "ein", "value": "223828413"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 76.63, "providers": [{"billed_charge": 100.0, "npi": [1366411084]}]}]}, {"tin": {"type": "ein", "value": "223837962"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 63.21, "providers": [{"billed_charge": 870.66, "npi": [1801423033, 1811523756, 1346697109]}]}]}, {"tin": {"type": "ein", "value": "453023019"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 72.74, "providers": [{"billed_charge": 182.0, "npi": [1083315162, 1801550678]}]}]}, {"tin": {"type": "ein", "value": "643268417"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 63.21, "providers": [{"billed_charge": 309.0, "npi": [1780116566]}]}]}, {"tin": {"type": "ein", "value": "884200747"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 76.7, "providers": [{"billed_charge": 154.47, "npi": [1134221062]}]}]}]}, {"name": "Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)", "billing_code_type": "CPT", "billing_code": "86592", "billing_code_type_version": "2022", "description": "SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "061520109"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 29.0, "npi": [1629082920]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 17.08, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 100.0, "npi": [1134277494]}]}]}, {"tin": {"type": "ein", "value": "223620531"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 10.68, "npi": [1376587113]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 15.58, "providers": [{"billed_charge": 267.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 95.0, "npi": [1164701561]}]}, {"allowed_amount": 4.25, "providers": [{"billed_charge": 95.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 39.3, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 21.35, "npi": [1134277494]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.25, "providers": [{"billed_charge": 29.89, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.63, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}]}, {"name": "Testosterone; total", "billing_code_type": "CPT", "billing_code": "84403", "billing_code_type_version": "2022", "description": "ASSAY OF TESTOSTERONE TOTAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 103.24, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 146.28, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 77.43, "npi": [1053584482]}]}, {"allowed_amount": 26.0, "providers": [{"billed_charge": 77.43, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 25.81, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 55.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 237.45, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 129.05, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 180.67, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 129.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 258.1, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 21.94, "providers": [{"billed_charge": 51.62, "npi": [1710667050]}]}]}]}, {"name": "Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)", "billing_code_type": "CPT", "billing_code": "96375", "billing_code_type_version": "2022", "description": "THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG", "allowed_amounts": [{"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 583.25, "providers": [{"billed_charge": 1757.5, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 583.25, "providers": [{"billed_charge": 787.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "133964321"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 148.33, "providers": [{"billed_charge": 463.0, "npi": [1932280666]}]}]}, {"tin": {"type": "ein", "value": "133971298"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 175.48, "providers": [{"billed_charge": 501.38, "npi": [1801992631]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 152.27, "providers": [{"billed_charge": 787.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 144.33, "providers": [{"billed_charge": 380.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 140.07, "providers": [{"billed_charge": 634.81, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 143.79, "providers": [{"billed_charge": 634.81, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 88.36, "providers": [{"billed_charge": 113.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.49, "providers": [{"billed_charge": 343.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 73.45, "providers": [{"billed_charge": 723.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 261.96, "providers": [{"billed_charge": 567.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 258.73, "providers": [{"billed_charge": 465.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 105.84, "providers": [{"billed_charge": 391.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 65.49, "providers": [{"billed_charge": 1138.03, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "824372339"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 67.14, "providers": [{"billed_charge": 437.91, "npi": [1740772268]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 108.55, "providers": [{"billed_charge": 176.0, "npi": [1821250762]}]}, {"allowed_amount": 176.0, "providers": [{"billed_charge": 176.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 54.61, "providers": [{"billed_charge": 440.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 117.66, "providers": [{"billed_charge": 416.0, "npi": [1427806025]}]}]}]}, {"name": "Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug", "billing_code_type": "CPT", "billing_code": "96374", "billing_code_type_version": "2022", "description": "THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG", "allowed_amounts": [{"tin": {"type": "ein", "value": "131624070"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 329.0, "providers": [{"billed_charge": 1757.5, "npi": [1477616571]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 329.0, "providers": [{"billed_charge": 2346.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "132997301"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 329.0, "providers": [{"billed_charge": 2000.0, "npi": [1104982917]}]}]}, {"tin": {"type": "ein", "value": "133964321"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 169.04, "providers": [{"billed_charge": 965.0, "npi": [1932280666]}]}]}, {"tin": {"type": "ein", "value": "141340100"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 173.53, "providers": [{"billed_charge": 1173.0, "npi": [1598755324]}]}]}, {"tin": {"type": "ein", "value": "261442063"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.86, "providers": [{"billed_charge": 1738.06, "npi": [1821101239]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.86, "providers": [{"billed_charge": 1738.06, "npi": [1043475668]}]}, {"allowed_amount": 141.51, "providers": [{"billed_charge": 1738.06, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 357.0, "providers": [{"billed_charge": 357.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 141.55, "providers": [{"billed_charge": 620.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "592650456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 167.78, "providers": [{"billed_charge": 521.0, "npi": [1144228446]}]}]}, {"tin": {"type": "ein", "value": "650260078"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 79.81, "providers": [{"billed_charge": 723.0, "npi": [1710931522]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 234.58, "providers": [{"billed_charge": 636.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 262.16, "providers": [{"billed_charge": 435.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "800764192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 188.14, "providers": [{"billed_charge": 695.0, "npi": [1033475959]}]}]}, {"tin": {"type": "ein", "value": "811723202"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 161.53, "providers": [{"billed_charge": 377.0, "npi": [1063968196]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 234.58, "providers": [{"billed_charge": 1138.03, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 247.92, "providers": [{"billed_charge": 861.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 315.12, "providers": [{"billed_charge": 843.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "883577015"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 114.51, "providers": [{"billed_charge": 1121.0, "npi": [1437865953]}]}]}, {"tin": {"type": "ein", "value": "956006143"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 93.96, "providers": [{"billed_charge": 840.0, "npi": [1801653969]}]}]}, {"tin": {"type": "ein", "value": "992646504"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 203.4, "providers": [{"billed_charge": 416.0, "npi": [1427806025]}]}]}]}, {"name": "Thromboplastin time, partial (PTT); plasma or whole blood", "billing_code_type": "CPT", "billing_code": "85730", "billing_code_type_version": "2022", "description": "THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 24.04, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 64.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113387538"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.62, "providers": [{"billed_charge": 15.03, "npi": [1336361575]}]}]}, {"tin": {"type": "ein", "value": "131740104"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 16.89, "providers": [{"billed_charge": 96.0, "npi": [1346213469]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 50.0, "npi": [1215038310]}]}, {"allowed_amount": 5.62, "providers": [{"billed_charge": 50.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 30.66, "providers": [{"billed_charge": 219.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "382084239"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 59.19, "npi": [1518903350]}]}]}, {"tin": {"type": "ein", "value": "383870608"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 52.47, "providers": [{"billed_charge": 659.96, "npi": [1871859306]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 47.21, "providers": [{"billed_charge": 659.96, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 30.05, "npi": [1942652946]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 67.36, "providers": [{"billed_charge": 71.0, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "760545192"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 63.23, "providers": [{"billed_charge": 279.0, "npi": [1497871628]}]}]}, {"tin": {"type": "ein", "value": "812857619"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 47.21, "providers": [{"billed_charge": 147.0, "npi": [1710491253]}]}]}, {"tin": {"type": "ein", "value": "821635538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 67.36, "providers": [{"billed_charge": 924.0, "npi": [1073043592]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "861718521"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.11, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 12.02, "npi": [1134277494]}]}]}]}, {"name": "Thyroxine; free", "billing_code_type": "CPT", "billing_code": "84439", "billing_code_type_version": "2022", "description": "ASSAY OF FREE THYROXINE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 36.08, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 51.08, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 125.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 27.06, "npi": [1053584482]}]}, {"allowed_amount": 9.04, "providers": [{"billed_charge": 27.06, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 9.02, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 140.0, "npi": [1164701561]}]}, {"allowed_amount": 8.98, "providers": [{"billed_charge": 140.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 83.0, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 45.1, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 45.1, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 63.14, "npi": [1285018523]}]}, {"allowed_amount": 8.98, "providers": [{"billed_charge": 63.14, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "710897031"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 167.28, "npi": [1366479099]}]}]}, {"tin": {"type": "ein", "value": "823021953"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 27.06, "npi": [1447760814]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 49.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "833972614"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 12.79, "providers": [{"billed_charge": 281.0, "npi": [1821250762]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 90.2, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 7.67, "providers": [{"billed_charge": 107.0, "npi": [1336763531]}]}]}]}, {"name": "Thyroxine; total", "billing_code_type": "CPT", "billing_code": "84436", "billing_code_type_version": "2022", "description": "ASSAY OF THYROXINE TOTAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 27.48, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 35.0, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 96.7, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 34.35, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 147.01, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 39.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 5.84, "providers": [{"billed_charge": 13.74, "npi": [1710667050]}]}]}]}, {"name": "Transferase; alanine amino (ALT) (SGPT)", "billing_code_type": "CPT", "billing_code": "84460", "billing_code_type_version": "2022", "description": "TRANSFERASE ALANINE AMINO ALT SGPT", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.51, "providers": [{"billed_charge": 37.1, "npi": [1124024922]}]}, {"allowed_amount": 5.11, "providers": [{"billed_charge": 37.1, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.51, "providers": [{"billed_charge": 113.25, "npi": [1245720820]}]}, {"allowed_amount": 5.53, "providers": [{"billed_charge": 113.25, "npi": [1245720820]}]}]}]}, {"name": "Transferase; aspartate amino (AST) (SGOT)", "billing_code_type": "CPT", "billing_code": "84450", "billing_code_type_version": "2022", "description": "TRANSFERASE ASPARTATE AMINO AST SGOT", "allowed_amounts": [{"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.4, "providers": [{"billed_charge": 110.71, "npi": [1245720820]}]}, {"allowed_amount": 4.74, "providers": [{"billed_charge": 110.71, "npi": [1245720820]}]}]}]}, {"name": "Triiodothyronine T3; free", "billing_code_type": "CPT", "billing_code": "84481", "billing_code_type_version": "2022", "description": "ASSAY OF TRIIODOTHYRONINE T3 FREE", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 67.76, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 96.0, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 125.0, "npi": [1215038310]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 50.82, "npi": [1053584482]}]}, {"allowed_amount": 16.47, "providers": [{"billed_charge": 50.82, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 16.94, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 260.0, "npi": [1164701561]}]}, {"allowed_amount": 16.34, "providers": [{"billed_charge": 260.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 84.7, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 118.58, "npi": [1285018523]}]}, {"allowed_amount": 16.34, "providers": [{"billed_charge": 118.58, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 89.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 169.4, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 138.0, "npi": [1336763531]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 14.4, "providers": [{"billed_charge": 33.88, "npi": [1710667050]}]}]}]}, {"name": "Triiodothyronine T3; total (TT-3)", "billing_code_type": "CPT", "billing_code": "84480", "billing_code_type_version": "2022", "description": "ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.05, "providers": [{"billed_charge": 56.72, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.05, "providers": [{"billed_charge": 80.32, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.05, "providers": [{"billed_charge": 72.1, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.05, "providers": [{"billed_charge": 130.45, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 12.05, "providers": [{"billed_charge": 69.0, "npi": [1972094423]}]}]}]}, {"name": "Uric acid; blood", "billing_code_type": "CPT", "billing_code": "84550", "billing_code_type_version": "2022", "description": "ASSAY OF BLOOD/URIC ACID", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 18.08, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 25.44, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 75.0, "npi": [1215038310, 1134277494]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 13.56, "npi": [1053584482]}]}, {"allowed_amount": 4.99, "providers": [{"billed_charge": 13.56, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 4.52, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 42.3, "npi": [1164701561]}]}, {"allowed_amount": 4.53, "providers": [{"billed_charge": 42.3, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 41.58, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 22.6, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 22.6, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 31.64, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "593205549"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 96.66, "npi": [1245720820]}]}, {"allowed_amount": 4.25, "providers": [{"billed_charge": 96.66, "npi": [1245720820]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 33.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 29.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 45.2, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 4.53, "providers": [{"billed_charge": 75.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.84, "providers": [{"billed_charge": 9.04, "npi": [1710667050]}]}]}]}, {"name": "Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy", "billing_code_type": "CPT", "billing_code": "81001", "billing_code_type_version": "2022", "description": "URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY", "allowed_amounts": [{"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 12.68, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 17.92, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "132655001"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 7.28, "providers": [{"billed_charge": 15.04, "npi": [1073535027, 1467469023]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 75.0, "npi": [1215038310, 1134277494]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 5.24, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 32.01, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.67, "providers": [{"billed_charge": 110.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "250965420"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.64, "providers": [{"billed_charge": 135.0, "npi": [1952311508]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 120.0, "npi": [1164701561]}, {"billed_charge": 140.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 30.0, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 3.17, "npi": [1225110497, 1942652946]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.51, "providers": [{"billed_charge": 30.45, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "571098556"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 38.0, "providers": [{"billed_charge": 38.0, "npi": [1770280299]}]}]}, {"tin": {"type": "ein", "value": "581966795"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.82, "providers": [{"billed_charge": 68.0, "npi": [1962403865]}]}]}, {"tin": {"type": "ein", "value": "593527036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.0, "providers": [{"billed_charge": 23.0, "npi": [1740276518]}]}]}, {"tin": {"type": "ein", "value": "610445850"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 12.62, "providers": [{"billed_charge": 12.68, "npi": [1467492421]}]}]}, {"tin": {"type": "ein", "value": "741152597"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 82.63, "providers": [{"billed_charge": 379.5, "npi": [1730132234]}]}]}, {"tin": {"type": "ein", "value": "812857619"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.56, "providers": [{"billed_charge": 134.0, "npi": [1710491253]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 44.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 19.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "843016042"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 3.51, "providers": [{"billed_charge": 75.0, "npi": [1598315574]}]}]}, {"tin": {"type": "ein", "value": "851099688"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 7.93, "npi": [1457977209]}]}]}, {"tin": {"type": "ein", "value": "922818817"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 2.69, "providers": [{"billed_charge": 6.34, "npi": [1710667050]}]}]}]}, {"name": "Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy", "billing_code_type": "CPT", "billing_code": "81003", "billing_code_type_version": "2022", "description": "URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY", "allowed_amounts": [{"tin": {"type": "ein", "value": "231352685"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.73, "providers": [{"billed_charge": 125.0, "npi": [1851370910]}]}]}, {"tin": {"type": "ein", "value": "240795623"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.85, "providers": [{"billed_charge": 65.0, "npi": [1568459436]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 120.0, "npi": [1164701561]}]}, {"allowed_amount": 2.27, "providers": [{"billed_charge": 120.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "332461082"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 3.48, "providers": [{"billed_charge": 9.0, "npi": [1932392131]}]}]}, {"tin": {"type": "ein", "value": "450666163"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 20.0, "providers": [{"billed_charge": 20.0, "npi": [1245047471]}]}]}, {"tin": {"type": "ein", "value": "452147328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 73.56, "providers": [{"billed_charge": 655.28, "npi": [1043475668]}]}]}, {"tin": {"type": "ein", "value": "452497248"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 52.97, "providers": [{"billed_charge": 284.06, "npi": [1114473329]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 13.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "460782127"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 4.3, "providers": [{"billed_charge": 32.0, "npi": [1548078363]}]}]}, {"tin": {"type": "ein", "value": "463427848"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 2.87, "providers": [{"billed_charge": 25.0, "npi": [1942439625]}]}]}, {"tin": {"type": "ein", "value": "540519577"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.09, "providers": [{"billed_charge": 32.0, "npi": [1942288527]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.99, "providers": [{"billed_charge": 69.0, "npi": [1871592113]}]}]}, {"tin": {"type": "ein", "value": "591726273"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 56.58, "providers": [{"billed_charge": 209.0, "npi": [1184709057]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 19.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "831907863"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 13.0, "npi": [1841774429]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 22.5, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 1.91, "providers": [{"billed_charge": 33.0, "npi": [1336763531]}]}]}, {"tin": {"type": "ein", "value": "844475996"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 40.42, "providers": [{"billed_charge": 42.0, "npi": [1073047981]}]}]}, {"tin": {"type": "ein", "value": "923116313"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 4.33, "providers": [{"billed_charge": 17.0, "npi": [1679824551]}]}]}]}, {"name": "Vitamin D; 25 hydroxy, includes fraction(s), if performed", "billing_code_type": "CPT", "billing_code": "82306", "billing_code_type_version": "2022", "description": "25 HYDROXY INCLUDES FRACTIONS IF PERFORMED", "allowed_amounts": [{"tin": {"type": "ein", "value": "043455945"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 207.2, "npi": [1124024922]}]}]}, {"tin": {"type": "ein", "value": "112019482"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 118.4, "npi": [1598820235]}]}]}, {"tin": {"type": "ein", "value": "112981841"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 150.0, "npi": [1033281126]}]}]}, {"tin": {"type": "ein", "value": "113558495"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 164.48, "npi": [1194744185]}]}]}, {"tin": {"type": "ein", "value": "161536202"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 58.3, "npi": [1396746673]}]}]}, {"tin": {"type": "ein", "value": "201117882"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 260.0, "npi": [1215038310, 1134277494]}]}]}, {"tin": {"type": "ein", "value": "203734391"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 88.8, "npi": [1053584482]}]}, {"allowed_amount": 32.67, "providers": [{"billed_charge": 88.8, "npi": [1053584482]}]}]}, {"tin": {"type": "ein", "value": "221972075"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 40.0, "npi": [1093749087]}]}]}, {"tin": {"type": "ein", "value": "232948774"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 92.76, "npi": [1548280852]}]}]}, {"tin": {"type": "ein", "value": "233079507"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 29.6, "npi": [1043271539]}]}]}, {"tin": {"type": "ein", "value": "273092954"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 84.0, "npi": [1164701561]}, {"billed_charge": 350.0, "npi": [1164701561]}, {"billed_charge": 370.0, "npi": [1164701561]}]}, {"allowed_amount": 32.67, "providers": [{"billed_charge": 370.0, "npi": [1164701561]}]}]}, {"tin": {"type": "ein", "value": "452705627"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 250.0, "npi": [1902250186]}]}]}, {"tin": {"type": "ein", "value": "453350742"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 148.0, "npi": [1982975421]}]}]}, {"tin": {"type": "ein", "value": "473737659"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 148.0, "npi": [1225110497]}]}]}, {"tin": {"type": "ein", "value": "474332775"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 207.2, "npi": [1285018523]}]}]}, {"tin": {"type": "ein", "value": "813598096"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 300.0, "npi": [1336616960]}]}]}, {"tin": {"type": "ein", "value": "830604071"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 149.0, "npi": [1972094423]}]}]}, {"tin": {"type": "ein", "value": "842842319"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 296.0, "npi": [1881226579]}]}]}, {"tin": {"type": "ein", "value": "844324679"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 25.16, "providers": [{"billed_charge": 263.0, "npi": [1336763531]}]}]}]}]}