{"reporting_entity_name": "Oscar Health", "reporting_entity_type": "Health Insurance Issuer", "plan_id": "45845OH010", "last_updated_on": "2026-04-23", "version": "2.0.0", "out_of_network": [{"name": "Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)", "billing_code_type": "CPT", "billing_code": "A0427", "billing_code_type_version": "2022", "description": "Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)", "allowed_amounts": [{"tin": {"type": "ein", "value": "340894851"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 900.0, "npi": [1982636437]}]}]}, {"tin": {"type": "ein", "value": "340928475"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 1000.0, "npi": [1568581601]}]}]}, {"tin": {"type": "ein", "value": "341047668"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 500.0, "providers": [{"billed_charge": 500.0, "npi": [1548414071]}]}]}, {"tin": {"type": "ein", "value": "341301508"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 850.0, "npi": [1144301631]}]}]}, {"tin": {"type": "ein", "value": "341523694"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 950.0, "npi": [1790742781]}]}]}, {"tin": {"type": "ein", "value": "341668531"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 800.0, "npi": [1932151669]}]}]}, {"tin": {"type": "ein", "value": "346000165"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 750.0, "npi": [1871514034]}]}]}, {"tin": {"type": "ein", "value": "346000166"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 1100.0, "npi": [1700103785]}]}]}, {"tin": {"type": "ein", "value": "346000176"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 1000.0, "npi": [1730309006]}]}]}, {"tin": {"type": "ein", "value": "346000211"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 825.0, "npi": [1952354920]}]}]}, {"tin": {"type": "ein", "value": "346000322"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 750.0, "npi": [1720317050]}]}, {"allowed_amount": 542.67, "providers": [{"billed_charge": 750.0, "npi": [1720317050]}]}]}, {"tin": {"type": "ein", "value": "346000339"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 950.0, "npi": [1083603864]}]}]}, {"tin": {"type": "ein", "value": "346000348"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 800.0, "npi": [1619998788]}]}]}, {"tin": {"type": "ein", "value": "346000596"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 900.0, "npi": [1306902234]}]}]}, {"tin": {"type": "ein", "value": "346000646"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}, {"allowed_amount": 542.67, "providers": [{"billed_charge": 889.2, "npi": [1699867077]}]}]}, {"tin": {"type": "ein", "value": "346000779"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 1000.0, "npi": [1023175486]}]}]}, {"tin": {"type": "ein", "value": "346001195"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 800.0, "npi": [1588706808]}]}]}, {"tin": {"type": "ein", "value": "346001453"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 774.44, "npi": [1790997450]}]}]}, {"tin": {"type": "ein", "value": "346001474"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 950.0, "npi": [1124273198]}]}]}, {"tin": {"type": "ein", "value": "346001495"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 800.0, "npi": [1356439152]}]}]}, {"tin": {"type": "ein", "value": "346001633"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 800.0, "npi": [1942212733]}]}]}, {"tin": {"type": "ein", "value": "346001741"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 750.0, "npi": [1952446007]}]}]}, {"tin": {"type": "ein", "value": "346001844"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 1000.0, "npi": [1730329574]}]}]}, {"tin": {"type": "ein", "value": "346001861"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 950.0, "npi": [1063570141]}]}]}, {"tin": {"type": "ein", "value": "346002004"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.9, "providers": [{"billed_charge": 800.0, "npi": [1922114891]}]}]}, {"tin": {"type": "ein", "value": "346002162"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 800.0, "npi": [1841367539]}]}]}, {"tin": {"type": "ein", "value": "346002276"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 750.0, "npi": [1386780252]}]}]}, {"tin": {"type": "ein", "value": "346002305"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 750.0, "npi": [1396884896]}]}]}, {"tin": {"type": "ein", "value": "346002316"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 1200.0, "npi": [1437216660]}]}]}, {"tin": {"type": "ein", "value": "346002630"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 850.0, "npi": [1770515223]}]}]}, {"tin": {"type": "ein", "value": "346002710"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 1000.0, "npi": [1487606471]}]}]}, {"tin": {"type": "ein", "value": "346002925"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 650.0, "npi": [1225166481]}]}]}, {"tin": {"type": "ein", "value": "346003057"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 528.85, "providers": [{"billed_charge": 700.0, "npi": [1952586026]}]}, {"allowed_amount": 542.67, "providers": [{"billed_charge": 700.0, "npi": [1952586026]}]}]}, {"tin": {"type": "ein", "value": "346003073"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 1000.0, "npi": [1730112798]}]}]}, {"tin": {"type": "ein", "value": "346003691"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 800.0, "npi": [1093768152]}]}]}, {"tin": {"type": "ein", "value": "346004410"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 1000.0, "npi": [1316084510]}]}]}, {"tin": {"type": "ein", "value": "346006433"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 950.0, "npi": [1902800667]}]}]}, {"tin": {"type": "ein", "value": "346583270"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 513.93, "providers": [{"billed_charge": 1000.0, "npi": [1215029830]}]}]}, {"tin": {"type": "ein", "value": "596000319"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 579.77, "providers": [{"billed_charge": 950.0, "npi": [1649281924]}]}]}, {"tin": {"type": "ein", "value": "596000558"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 533.93, "providers": [{"billed_charge": 800.0, "npi": [1083674519]}]}]}, {"tin": {"type": "ein", "value": "731482725"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 581.86, "providers": [{"billed_charge": 1725.0, "npi": [1619943511]}]}]}]}, {"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": "204401957"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 54.73, "providers": [{"billed_charge": 128.3, "npi": [1215003348]}]}]}, {"tin": {"type": "ein", "value": "311340739"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 29.7, "providers": [{"billed_charge": 105.0, "npi": [1447359997]}]}]}, {"tin": {"type": "ein", "value": "311588499"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 16.42, "providers": [{"billed_charge": 135.0, "npi": [1851549273]}]}]}, {"tin": {"type": "ein", "value": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.0, "providers": [{"billed_charge": 31.0, "npi": [1255377149]}]}]}, {"tin": {"type": "ein", "value": "333995572"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.89, "providers": [{"billed_charge": 100.75, "npi": [1457146250]}]}]}, {"tin": {"type": "ein", "value": "340714357"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 10.15, "providers": [{"billed_charge": 51.0, "npi": [1861506560]}]}]}, {"tin": {"type": "ein", "value": "340714456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.55, "providers": [{"billed_charge": 35.0, "npi": [1487706016]}]}]}, {"tin": {"type": "ein", "value": "340733138"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.22, "providers": [{"billed_charge": 62.0, "npi": [1891718375]}]}]}, {"tin": {"type": "ein", "value": "340827442"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.89, "providers": [{"billed_charge": 134.0, "npi": [1164481677]}]}]}, {"tin": {"type": "ein", "value": "341260978"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.89, "providers": [{"billed_charge": 134.0, "npi": [1841264868]}]}]}, {"tin": {"type": "ein", "value": "341425870"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.89, "providers": [{"billed_charge": 134.0, "npi": [1972689172]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.82, "providers": [{"billed_charge": 85.0, "npi": [1700828852]}]}]}, {"tin": {"type": "ein", "value": "381459362"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.0, "providers": [{"billed_charge": 37.0, "npi": [1306825997]}]}]}, {"tin": {"type": "ein", "value": "461382538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.55, "providers": [{"billed_charge": 134.0, "npi": [1043641897]}]}]}, {"tin": {"type": "ein", "value": "464810201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.1, "providers": [{"billed_charge": 34.05, "npi": [1790101681]}]}]}, {"tin": {"type": "ein", "value": "590694358"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 56.18, "providers": [{"billed_charge": 80.0, "npi": [1720085137]}]}]}, {"tin": {"type": "ein", "value": "590791028"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 99.0, "providers": [{"billed_charge": 528.0, "npi": [1639197395]}]}]}, {"tin": {"type": "ein", "value": "591713947"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 66.9, "providers": [{"billed_charge": 209.0, "npi": [1104857119]}]}]}, {"tin": {"type": "ein", "value": "592951990"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 63.59, "providers": [{"billed_charge": 354.9, "npi": [1679678486]}]}]}, {"tin": {"type": "ein", "value": "610444707"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 17.84, "providers": [{"billed_charge": 17.84, "npi": [1265539498]}]}]}, {"tin": {"type": "ein", "value": "720502505"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 48.0, "providers": [{"billed_charge": 48.0, "npi": [1811973100]}]}]}, {"tin": {"type": "ein", "value": "736048282"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 63.7, "providers": [{"billed_charge": 132.0, "npi": [1700882578]}]}]}, {"tin": {"type": "ein", "value": "751037591"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 112.27, "providers": [{"billed_charge": 183.63, "npi": [1124305065]}]}]}, {"tin": {"type": "ein", "value": "810851756"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 54.0, "providers": [{"billed_charge": 271.0, "npi": [1750312997]}]}]}, {"tin": {"type": "ein", "value": "860800150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.0, "providers": [{"billed_charge": 36.0, "npi": [1154392231]}]}]}, {"tin": {"type": "ein", "value": "900389314"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 57.94, "providers": [{"billed_charge": 189.0, "npi": [1952560914]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.15, "providers": [{"billed_charge": 94.0, "npi": [1982606992]}]}]}]}, {"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": "204401957"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 58.24, "providers": [{"billed_charge": 170.29, "npi": [1215003348]}]}]}, {"tin": {"type": "ein", "value": "311588499"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 27.39, "providers": [{"billed_charge": 226.0, "npi": [1851549273]}]}]}, {"tin": {"type": "ein", "value": "333995572"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.68, "providers": [{"billed_charge": 264.5, "npi": [1457146250]}]}]}, {"tin": {"type": "ein", "value": "340714456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.64, "providers": [{"billed_charge": 78.0, "npi": [1487706016]}]}]}, {"tin": {"type": "ein", "value": "340733138"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 33.17, "providers": [{"billed_charge": 172.0, "npi": [1891718375]}]}]}, {"tin": {"type": "ein", "value": "340827442"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.68, "providers": [{"billed_charge": 254.0, "npi": [1164481677]}]}]}, {"tin": {"type": "ein", "value": "341260978"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.68, "providers": [{"billed_charge": 254.0, "npi": [1841264868]}]}]}, {"tin": {"type": "ein", "value": "341425870"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 14.68, "providers": [{"billed_charge": 254.0, "npi": [1972689172]}]}]}, {"tin": {"type": "ein", "value": "461382538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.64, "providers": [{"billed_charge": 254.0, "npi": [1043641897]}]}]}, {"tin": {"type": "ein", "value": "464810201"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.66, "providers": [{"billed_charge": 104.5, "npi": [1790101681]}]}]}, {"tin": {"type": "ein", "value": "590694358"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 113.75, "providers": [{"billed_charge": 123.0, "npi": [1720085137]}]}]}, {"tin": {"type": "ein", "value": "590791028"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 330.26, "providers": [{"billed_charge": 775.0, "npi": [1639197395]}]}]}, {"tin": {"type": "ein", "value": "591713947"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 225.11, "providers": [{"billed_charge": 454.0, "npi": [1104857119]}]}]}, {"tin": {"type": "ein", "value": "592951990"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 125.46, "providers": [{"billed_charge": 583.97, "npi": [1679678486]}]}]}, {"tin": {"type": "ein", "value": "610444707"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.72, "providers": [{"billed_charge": 136.79, "npi": [1265539498]}]}]}, {"tin": {"type": "ein", "value": "720502505"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 66.0, "providers": [{"billed_charge": 66.0, "npi": [1811973100]}]}]}, {"tin": {"type": "ein", "value": "736048282"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 203.11, "providers": [{"billed_charge": 275.0, "npi": [1700882578]}]}]}, {"tin": {"type": "ein", "value": "810851756"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 159.79, "providers": [{"billed_charge": 439.0, "npi": [1750312997]}]}]}, {"tin": {"type": "ein", "value": "860181654"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 40.72, "providers": [{"billed_charge": 581.0, "npi": [1811951429]}]}]}, {"tin": {"type": "ein", "value": "860800150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 140.19, "providers": [{"billed_charge": 375.0, "npi": [1154392231]}]}]}, {"tin": {"type": "ein", "value": "900389314"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 140.19, "providers": [{"billed_charge": 789.0, "npi": [1952560914]}]}]}, {"tin": {"type": "ein", "value": "943357013"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 11.66, "providers": [{"billed_charge": 127.0, "npi": [1982606992]}]}]}]}, {"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": "204374268"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 67.0, "providers": [{"billed_charge": 67.0, "npi": [1124607874]}]}]}, {"tin": {"type": "ein", "value": "261803679"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 11.97, "providers": [{"billed_charge": 15.0, "npi": [1427168848]}]}]}, {"tin": {"type": "ein", "value": "261869328"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.39, "providers": [{"billed_charge": 17.0, "npi": [1295889848]}]}]}, {"tin": {"type": "ein", "value": "271036057"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 21.26, "providers": [{"billed_charge": 137.0, "npi": [1790149342]}]}]}, {"tin": {"type": "ein", "value": "311603722"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 28.91, "providers": [{"billed_charge": 89.0, "npi": [1821626847]}]}]}, {"tin": {"type": "ein", "value": "341565327"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 25.38, "providers": [{"billed_charge": 83.25, "npi": [1093337339]}]}]}, {"tin": {"type": "ein", "value": "341651521"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.0, "providers": [{"billed_charge": 13.0, "npi": [1013024793]}]}]}, {"tin": {"type": "ein", "value": "341768928"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 25.38, "providers": [{"billed_charge": 30.0, "npi": [1174572101]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 2.65, "providers": [{"billed_charge": 54.0, "npi": [1609218502]}]}, {"allowed_amount": 9.88, "providers": [{"billed_charge": 54.0, "npi": [1538240528, 1992156145, 1710919675, 1437125267]}]}]}, {"tin": {"type": "ein", "value": "381360584"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.0, "providers": [{"billed_charge": 13.0, "npi": [1366883712]}]}]}, {"tin": {"type": "ein", "value": "432020322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 22.55, "providers": [{"billed_charge": 56.0, "npi": [1467861310]}]}]}, {"tin": {"type": "ein", "value": "455367757"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.85, "providers": [{"billed_charge": 19.0, "npi": [1346788155]}]}]}, {"tin": {"type": "ein", "value": "464249321"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 25.38, "providers": [{"billed_charge": 83.25, "npi": [1376292888]}]}]}, {"tin": {"type": "ein", "value": "471776582"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 25.38, "providers": [{"billed_charge": 83.25, "npi": [1598228751]}]}]}, {"tin": {"type": "ein", "value": "720276883"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.02, "providers": [{"billed_charge": 43.0, "npi": [1891744256]}]}]}, {"tin": {"type": "ein", "value": "822768899"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 21.0, "providers": [{"billed_charge": 21.0, "npi": [1033192059]}]}]}, {"tin": {"type": "ein", "value": "851056783"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.0, "providers": [{"billed_charge": 18.0, "npi": [1750360822, 1699982975]}]}]}, {"tin": {"type": "ein", "value": "932497563"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 22.43, "providers": [{"billed_charge": 64.0, "npi": [1447593603]}]}]}, {"tin": {"type": "ein", "value": "942460636"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 24.57, "providers": [{"billed_charge": 82.0, "npi": [1831679042]}]}]}, {"tin": {"type": "ein", "value": "990706075"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 15.0, "providers": [{"billed_charge": 15.0, "npi": [1003893595]}]}]}]}, {"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": "204374268"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 1286.0, "providers": [{"billed_charge": 1286.0, "npi": [1124607874]}]}]}, {"tin": {"type": "ein", "value": "204401957"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1067.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5385.27, "npi": [1215003348]}]}]}, {"tin": {"type": "ein", "value": "271036057"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 348.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2746.0, "npi": [1790149342]}]}]}, {"tin": {"type": "ein", "value": "271254834"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 281.19, "providers": [{"billed_charge": 690.0, "npi": [1922455245]}]}]}, {"tin": {"type": "ein", "value": "271369141"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 348.19, "providers": [{"billed_charge": 1415.0, "npi": [1184120008]}]}]}, {"tin": {"type": "ein", "value": "311229292"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 740.0, "npi": [1689014037]}]}]}, {"tin": {"type": "ein", "value": "311340739"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1257.7, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3387.0, "npi": [1447359997]}]}]}, {"tin": {"type": "ein", "value": "311405915"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 526.0, "npi": [1902992340]}]}]}, {"tin": {"type": "ein", "value": "311588499"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1125.4, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3574.0, "npi": [1851549273]}]}]}, {"tin": {"type": "ein", "value": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1804.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4144.0, "npi": [1255377149]}]}]}, {"tin": {"type": "ein", "value": "320582746"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 2263.0, "npi": [1295712784]}]}]}, {"tin": {"type": "ein", "value": "340714704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1132.98, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2940.0, "npi": [1245274950]}]}, {"allowed_amount": 1136.74, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2940.0, "npi": [1245274950]}]}]}, {"tin": {"type": "ein", "value": "340733138"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1278.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1409.0, "npi": [1891718375]}]}]}, {"tin": {"type": "ein", "value": "340827442"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1074.88, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1164481677]}]}]}, {"tin": {"type": "ein", "value": "341260978"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1074.88, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1841264868]}]}]}, {"tin": {"type": "ein", "value": "341425870"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1080.34, "providers": [{"billed_charge": 2796.0, "npi": [1972689172]}]}]}, {"tin": {"type": "ein", "value": "341565327"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 1699.88, "npi": [1043248875, 1093337339]}]}]}, {"tin": {"type": "ein", "value": "341847350"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 1699.88, "npi": [1629166392]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 570.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3230.0, "npi": [1700828852]}]}, {"allowed_amount": 821.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3230.0, "npi": [1700828852]}]}, {"allowed_amount": 913.25, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3230.0, "npi": [1700828852]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 217.14, "providers": [{"billed_charge": 426.0, "npi": [1417986241, 1275096141, 1548223894, 1841587631]}]}, {"allowed_amount": 267.5, "providers": [{"billed_charge": 426.0, "npi": [1013947357]}]}]}, {"tin": {"type": "ein", "value": "381459362"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 929.51, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2998.0, "npi": [1306825997]}]}]}, {"tin": {"type": "ein", "value": "432020322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 499.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1870.0, "npi": [1467861310]}]}]}, {"tin": {"type": "ein", "value": "461382538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1113.12, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2688.0, "npi": [1043641897]}]}]}, {"tin": {"type": "ein", "value": "464249321"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "providers": [{"billed_charge": 1699.88, "npi": [1376292888, 1417343724, 1639133309]}]}]}, {"tin": {"type": "ein", "value": "464614946"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 643.66, "providers": [{"billed_charge": 2423.0, "npi": [1619903168]}]}]}, {"tin": {"type": "ein", "value": "471776582"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1699.88, "npi": [1538184205]}]}]}, {"tin": {"type": "ein", "value": "475040973"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 518.85, "providers": [{"billed_charge": 2234.0, "npi": [1063496727]}]}]}, {"tin": {"type": "ein", "value": "590694358"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 460.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4254.0, "npi": [1720085137]}]}]}, {"tin": {"type": "ein", "value": "591713947"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1215.03, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2982.0, "npi": [1104857119]}]}]}, {"tin": {"type": "ein", "value": "593082909"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 518.85, "providers": [{"billed_charge": 1969.0, "npi": [1821529926]}]}]}, {"tin": {"type": "ein", "value": "611185194"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 529.57, "providers": [{"billed_charge": 1334.0, "npi": [1467498121]}]}]}, {"tin": {"type": "ein", "value": "720502505"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 819.12, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2119.0, "npi": [1811973100]}]}]}, {"tin": {"type": "ein", "value": "731666433"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1274.23, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5419.0, "npi": [1730179714]}]}]}, {"tin": {"type": "ein", "value": "736048282"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 840.85, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2750.0, "npi": [1700882578]}]}]}, {"tin": {"type": "ein", "value": "736048282"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 265.79, "providers": [{"billed_charge": 459.0, "npi": [1972536167]}]}]}, {"tin": {"type": "ein", "value": "810851756"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1133.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3089.0, "npi": [1750312997]}]}]}, {"tin": {"type": "ein", "value": "810872075"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 628.24, "providers": [{"billed_charge": 1486.0, "npi": [1134615917, 1174264071]}]}]}, {"tin": {"type": "ein", "value": "821870027"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 242.93, "providers": [{"billed_charge": 1020.0, "npi": [1548602667]}]}]}, {"tin": {"type": "ein", "value": "822768899"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 404.0, "providers": [{"billed_charge": 404.0, "npi": [1134701097]}]}]}, {"tin": {"type": "ein", "value": "860181654"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 703.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5378.0, "npi": [1811951429]}]}]}, {"tin": {"type": "ein", "value": "860593131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.13, "providers": [{"billed_charge": 1796.0, "npi": [1669113429]}]}]}, {"tin": {"type": "ein", "value": "860800150"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 677.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4045.0, "npi": [1154392231]}]}]}, {"tin": {"type": "ein", "value": "860800150"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 259.13, "providers": [{"billed_charge": 1341.0, "npi": [1790947422]}]}]}, {"tin": {"type": "ein", "value": "921388406"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1870.0, "npi": [1871097253]}]}]}, {"tin": {"type": "ein", "value": "932497563"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 445.55, "providers": [{"billed_charge": 1350.0, "npi": [1447593603]}]}]}, {"tin": {"type": "ein", "value": "942460636"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 539.12, "providers": [{"billed_charge": 1737.0, "npi": [1831679042, 1801378229]}]}]}]}, {"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": "060646678"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 542.45, "providers": [{"billed_charge": 2167.0, "npi": [1629075734]}]}]}, {"tin": {"type": "ein", "value": "232798290"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1243.67, "providers": [{"billed_charge": 2230.0, "npi": [1760472799]}]}]}, {"tin": {"type": "ein", "value": "263536780"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 423.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1967.0, "npi": [1518104199]}]}]}, {"tin": {"type": "ein", "value": "264249848"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 152.0, "providers": [{"billed_charge": 152.0, "npi": [1639758543]}]}]}, {"tin": {"type": "ein", "value": "311405915"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 96.19, "providers": [{"billed_charge": 176.0, "npi": [1760748271]}]}]}, {"tin": {"type": "ein", "value": "340714357"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 434.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1608.0, "npi": [1861506560]}]}]}, {"tin": {"type": "ein", "value": "340714357"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 113.51, "providers": [{"billed_charge": 174.0, "npi": [1689068702]}]}, {"allowed_amount": 156.16, "providers": [{"billed_charge": 174.0, "npi": [1801392626]}]}]}, {"tin": {"type": "ein", "value": "340714612"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 238.63, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1090.0, "npi": [1841299039]}]}, {"allowed_amount": 423.31, "providers": [{"billed_charge": 1090.0, "npi": [1841299039]}]}]}, {"tin": {"type": "ein", "value": "340753531"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 423.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1056.0, "npi": [1154353993]}]}]}, {"tin": {"type": "ein", "value": "340827442"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 238.63, "providers": [{"billed_charge": 1090.0, "npi": [1164481677]}]}]}, {"tin": {"type": "ein", "value": "340864230"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 720.9, "providers": [{"billed_charge": 2403.0, "npi": [1801825997]}]}]}, {"tin": {"type": "ein", "value": "341779226"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 143.43, "providers": [{"billed_charge": 475.0, "npi": [1063633477]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 212.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1206.0, "npi": [1700828852]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 87.63, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 222.0, "npi": [1235245697]}]}]}, {"tin": {"type": "ein", "value": "351611050"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1307.71, "providers": [{"billed_charge": 5925.91, "npi": [1639122864]}]}]}, {"tin": {"type": "ein", "value": "582322328"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 767.17, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2099.9, "npi": [1528027240]}]}]}, {"tin": {"type": "ein", "value": "596012500"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1307.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2541.0, "npi": [1245294826]}]}]}, {"tin": {"type": "ein", "value": "860181654"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 911.91, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2257.0, "npi": [1811951429]}]}]}]}, {"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": "232798290"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1307.71, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3765.0, "npi": [1760472799]}]}]}, {"tin": {"type": "ein", "value": "311116049"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 271.21, "providers": [{"billed_charge": 604.0, "npi": [1801537964]}]}]}, {"tin": {"type": "ein", "value": "314379509"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 269.13, "providers": [{"billed_charge": 329.78, "npi": [1356574214]}]}]}, {"tin": {"type": "ein", "value": "333995572"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 423.31, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2864.25, "npi": [1457146250]}]}]}, {"tin": {"type": "ein", "value": "340714357"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1013.57, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2362.0, "npi": [1861506560]}]}, {"allowed_amount": 1040.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2481.0, "npi": [1861506560]}]}]}, {"tin": {"type": "ein", "value": "340714357"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 184.65, "billing_code_modifier": ["SA"], "providers": [{"billed_charge": 260.0, "npi": [1558324855]}]}]}, {"tin": {"type": "ein", "value": "340714456"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1013.57, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1139.0, "npi": [1487706016]}]}]}, {"tin": {"type": "ein", "value": "341565327"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 236.74, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1151.76, "npi": [1083654610, 1942725254]}]}]}, {"tin": {"type": "ein", "value": "346003129"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 791.94, "providers": [{"billed_charge": 791.94, "npi": [1437156247]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 370.97, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2120.0, "npi": [1700828852]}]}, {"allowed_amount": 570.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2120.0, "npi": [1700828852]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 149.66, "providers": [{"billed_charge": 306.0, "npi": [1609833060, 1386223279]}]}]}, {"tin": {"type": "ein", "value": "352574944"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 188.67, "providers": [{"billed_charge": 2392.0, "npi": [1366563249]}]}]}, {"tin": {"type": "ein", "value": "461382538"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1040.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1779.0, "npi": [1043641897]}]}]}, {"tin": {"type": "ein", "value": "463160463"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 240.96, "providers": [{"billed_charge": 1151.76, "npi": [1750724787]}]}]}, {"tin": {"type": "ein", "value": "471776582"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 182.48, "providers": [{"billed_charge": 1151.76, "npi": [1174015085]}]}]}, {"tin": {"type": "ein", "value": "590791028"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1033.17, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2102.0, "npi": [1639197395]}]}]}, {"tin": {"type": "ein", "value": "591237521"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 524.1, "providers": [{"billed_charge": 1358.0, "npi": [1427554930]}]}]}, {"tin": {"type": "ein", "value": "592951990"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1059.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1946.01, "npi": [1679678486]}]}]}, {"tin": {"type": "ein", "value": "610444707"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 858.85, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2881.27, "npi": [1265539498]}]}]}, {"tin": {"type": "ein", "value": "751037591"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1029.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2122.8, "npi": [1124305065]}]}]}, {"tin": {"type": "ein", "value": "753002004"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 240.96, "providers": [{"billed_charge": 1151.76, "npi": [1831539675]}]}]}, {"tin": {"type": "ein", "value": "860593131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 178.45, "providers": [{"billed_charge": 1223.0, "npi": [1639531536]}]}]}, {"tin": {"type": "ein", "value": "900389314"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 418.64, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2175.0, "npi": [1952560914]}]}]}, {"tin": {"type": "ein", "value": "900942222"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 430.34, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2480.0, "npi": [1194766543]}]}]}, {"tin": {"type": "ein", "value": "921401004"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 181.49, "providers": [{"billed_charge": 1280.0, "npi": [1477539963]}]}]}, {"tin": {"type": "ein", "value": "922099454"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 473.31, "providers": [{"billed_charge": 678.0, "npi": [1669819272]}]}]}, {"tin": {"type": "ein", "value": "932497563"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 205.45, "providers": [{"billed_charge": 930.0, "npi": [1831624014]}]}]}, {"tin": {"type": "ein", "value": "942460636"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 370.08, "providers": [{"billed_charge": 1079.0, "npi": [1871565598]}, {"billed_charge": 1199.0, "npi": [1801378229]}]}, {"allowed_amount": 435.39, "providers": [{"billed_charge": 1111.0, "npi": [1578510376]}, {"billed_charge": 1199.0, "npi": [1861449936]}]}]}, {"tin": {"type": "ein", "value": "991799354"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 390.0, "providers": [{"billed_charge": 1581.0, "npi": [1114546629]}]}]}]}, {"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": "316001080"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 22.0, "npi": [1538169750]}]}]}, {"tin": {"type": "ein", "value": "340894851"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1982636437]}]}]}, {"tin": {"type": "ein", "value": "340928475"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1568581601]}]}]}, {"tin": {"type": "ein", "value": "341047668"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 6.98, "providers": [{"billed_charge": 6.98, "npi": [1548414071]}]}, {"allowed_amount": 7.01, "providers": [{"billed_charge": 7.01, "npi": [1548414071]}]}]}, {"tin": {"type": "ein", "value": "341301508"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1144301631]}]}]}, {"tin": {"type": "ein", "value": "341486238"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 15.0, "npi": [1467459909]}]}]}, {"tin": {"type": "ein", "value": "341523694"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1790742781]}]}]}, {"tin": {"type": "ein", "value": "341668531"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.76, "providers": [{"billed_charge": 15.0, "npi": [1932151669]}]}]}, {"tin": {"type": "ein", "value": "346000165"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 14.0, "npi": [1871514034]}]}]}, {"tin": {"type": "ein", "value": "346000166"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 18.0, "npi": [1700103785]}]}]}, {"tin": {"type": "ein", "value": "346000176"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.57, "npi": [1730309006]}, {"billed_charge": 15.73, "npi": [1730309006]}]}]}, {"tin": {"type": "ein", "value": "346000211"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 17.5, "npi": [1952354920]}]}]}, {"tin": {"type": "ein", "value": "346000322"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1720317050]}]}, {"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1720317050]}]}]}, {"tin": {"type": "ein", "value": "346000339"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1083603864]}]}]}, {"tin": {"type": "ein", "value": "346000348"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.0, "npi": [1619998788]}]}]}, {"tin": {"type": "ein", "value": "346000596"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1306902234]}]}]}, {"tin": {"type": "ein", "value": "346000646"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}, {"allowed_amount": 10.37, "providers": [{"billed_charge": 16.04, "npi": [1699867077]}]}]}, {"tin": {"type": "ein", "value": "346000779"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 16.0, "npi": [1023175486]}]}]}, {"tin": {"type": "ein", "value": "346000965"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.71, "npi": [1861477812]}]}]}, {"tin": {"type": "ein", "value": "346001195"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.5, "npi": [1588706808]}]}]}, {"tin": {"type": "ein", "value": "346001377"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.0, "npi": [1144241217]}]}, {"allowed_amount": 10.37, "providers": [{"billed_charge": 17.0, "npi": [1144241217]}]}]}, {"tin": {"type": "ein", "value": "346001453"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 13.23, "npi": [1790997450]}]}]}, {"tin": {"type": "ein", "value": "346001474"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 17.0, "npi": [1124273198]}]}]}, {"tin": {"type": "ein", "value": "346001495"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.76, "providers": [{"billed_charge": 17.0, "npi": [1356439152]}]}]}, {"tin": {"type": "ein", "value": "346001633"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1942212733]}]}]}, {"tin": {"type": "ein", "value": "346001741"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.0, "npi": [1952446007]}]}]}, {"tin": {"type": "ein", "value": "346001842"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 15.0, "npi": [1265762710]}]}]}, {"tin": {"type": "ein", "value": "346001844"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1730329574]}]}]}, {"tin": {"type": "ein", "value": "346001861"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1063570141]}]}]}, {"tin": {"type": "ein", "value": "346002004"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 18.36, "providers": [{"billed_charge": 20.0, "npi": [1922114891]}]}]}, {"tin": {"type": "ein", "value": "346002138"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 17.0, "npi": [1801828314]}]}]}, {"tin": {"type": "ein", "value": "346002162"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.0, "npi": [1841367539]}]}]}, {"tin": {"type": "ein", "value": "346002276"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 12.0, "npi": [1386780252]}]}, {"allowed_amount": 9.76, "providers": [{"billed_charge": 12.0, "npi": [1386780252]}]}]}, {"tin": {"type": "ein", "value": "346002305"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 12.0, "npi": [1396884896]}]}]}, {"tin": {"type": "ein", "value": "346002316"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 16.0, "npi": [1437216660]}]}]}, {"tin": {"type": "ein", "value": "346002630"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 14.0, "npi": [1770515223]}]}]}, {"tin": {"type": "ein", "value": "346002695"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 12.0, "npi": [1740344274]}]}]}, {"tin": {"type": "ein", "value": "346002710"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 16.0, "npi": [1487606471]}]}]}, {"tin": {"type": "ein", "value": "346002925"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 11.92, "npi": [1225166481]}]}]}, {"tin": {"type": "ein", "value": "346003057"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.0, "npi": [1952586026]}]}, {"allowed_amount": 10.37, "providers": [{"billed_charge": 15.0, "npi": [1952586026]}]}]}, {"tin": {"type": "ein", "value": "346003073"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 17.0, "npi": [1730112798]}]}]}, {"tin": {"type": "ein", "value": "346003087"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 18.0, "npi": [1083604631]}]}]}, {"tin": {"type": "ein", "value": "346003691"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.5, "npi": [1093768152]}]}]}, {"tin": {"type": "ein", "value": "346004410"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.49, "providers": [{"billed_charge": 15.83, "npi": [1316084510]}]}, {"allowed_amount": 10.37, "providers": [{"billed_charge": 16.28, "npi": [1316084510]}]}]}, {"tin": {"type": "ein", "value": "346006433"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 10.37, "providers": [{"billed_charge": 16.0, "npi": [1902800667]}]}]}, {"tin": {"type": "ein", "value": "346583270"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.51, "providers": [{"billed_charge": 15.92, "npi": [1215029830]}]}]}, {"tin": {"type": "ein", "value": "371646302"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 20.81, "providers": [{"billed_charge": 24.94, "npi": [1467725911]}]}]}, {"tin": {"type": "ein", "value": "596000319"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.82, "providers": [{"billed_charge": 13.0, "npi": [1649281924]}]}]}, {"tin": {"type": "ein", "value": "596000558"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.04, "providers": [{"billed_charge": 15.0, "npi": [1083674519]}]}]}, {"tin": {"type": "ein", "value": "731482725"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.58, "providers": [{"billed_charge": 17.0, "npi": [1619943511]}]}]}, {"tin": {"type": "ein", "value": "822592413"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.15, "providers": [{"billed_charge": 9.15, "npi": [1447763693]}]}]}]}, {"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": "204881619"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 20.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 23.0, "npi": [1922078443]}]}]}, {"tin": {"type": "ein", "value": "260799572"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 10.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 31.0, "npi": [1679696793]}]}]}, {"tin": {"type": "ein", "value": "262157500"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 22.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 27.0, "npi": [1225425291]}]}]}, {"tin": {"type": "ein", "value": "310745303"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.15, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 176.0, "npi": [1861745770, 1326346503]}]}, {"allowed_amount": 16.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 176.0, "npi": [1922250471]}]}]}, {"tin": {"type": "ein", "value": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 263.0, "providers": [{"billed_charge": 263.0, "npi": [1255377149]}]}]}, {"tin": {"type": "ein", "value": "340714704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 162.72, "providers": [{"billed_charge": 590.0, "npi": [1245274950]}]}, {"allowed_amount": 163.26, "providers": [{"billed_charge": 590.0, "npi": [1245274950]}]}]}, {"tin": {"type": "ein", "value": "341425870"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 128.5, "providers": [{"billed_charge": 375.0, "npi": [1972689172]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 117.97, "providers": [{"billed_charge": 348.0, "npi": [1700828852]}]}]}, {"tin": {"type": "ein", "value": "346004382"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 10.69, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 23.0, "npi": [1831431253]}]}]}, {"tin": {"type": "ein", "value": "381459362"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 85.44, "providers": [{"billed_charge": 306.0, "npi": [1306825997]}]}]}, {"tin": {"type": "ein", "value": "590694358"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 122.7, "providers": [{"billed_charge": 565.0, "npi": [1720085137]}]}]}, {"tin": {"type": "ein", "value": "591262719"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.68, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 51.0, "npi": [1093931313]}]}]}, {"tin": {"type": "ein", "value": "592951990"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 352.14, "providers": [{"billed_charge": 674.53, "npi": [1679678486]}]}]}, {"tin": {"type": "ein", "value": "720276883"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.51, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 23.0, "npi": [1619925229]}]}]}, {"tin": {"type": "ein", "value": "720502505"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 118.26, "providers": [{"billed_charge": 151.0, "npi": [1811973100]}]}]}, {"tin": {"type": "ein", "value": "731666433"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 137.75, "providers": [{"billed_charge": 1357.0, "npi": [1730179714]}]}]}, {"tin": {"type": "ein", "value": "736048282"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.4, "providers": [{"billed_charge": 403.0, "npi": [1700882578]}]}]}, {"tin": {"type": "ein", "value": "751037591"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 330.61, "providers": [{"billed_charge": 366.74, "npi": [1124305065]}]}]}, {"tin": {"type": "ein", "value": "751459885"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.51, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 248.0, "npi": [1023077401]}]}]}, {"tin": {"type": "ein", "value": "822768899"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.46, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 59.0, "npi": [1447468939]}]}]}, {"tin": {"type": "ein", "value": "861212843"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 8.85, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1265457485]}]}]}]}, {"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": "020539708"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.0, "providers": [{"billed_charge": 134.0, "npi": [1649213430]}]}]}, {"tin": {"type": "ein", "value": "201891777"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 168.29, "providers": [{"billed_charge": 219.98, "npi": [1164918538, 1184283517]}]}, {"allowed_amount": 175.57, "providers": [{"billed_charge": 219.98, "npi": [1699330266]}]}]}, {"tin": {"type": "ein", "value": "203274708"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 157.17, "providers": [{"billed_charge": 278.0, "npi": [1801863667]}]}]}, {"tin": {"type": "ein", "value": "261803679"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 157.17, "providers": [{"billed_charge": 181.0, "npi": [1275730657]}]}]}, {"tin": {"type": "ein", "value": "341768928"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 165.67, "providers": [{"billed_charge": 190.0, "npi": [1275057325]}]}]}, {"tin": {"type": "ein", "value": "341891563"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 150.66, "providers": [{"billed_charge": 319.0, "npi": [1770557241, 1558356535]}]}]}, {"tin": {"type": "ein", "value": "341933718"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 150.66, "providers": [{"billed_charge": 250.0, "npi": [1831188168]}]}]}, {"tin": {"type": "ein", "value": "472285143"}, "billing_class": "professional", "service_codes": ["61", "21"], "payments": [{"allowed_amount": 157.17, "providers": [{"billed_charge": 264.0, "npi": [1134245913]}]}, {"allowed_amount": 165.67, "providers": [{"billed_charge": 278.0, "npi": [1134245913, 1023646239]}]}]}, {"tin": {"type": "ein", "value": "743174109"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 95.0, "providers": [{"billed_charge": 95.0, "npi": [1881661072]}]}]}, {"tin": {"type": "ein", "value": "752536818"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 168.2, "providers": [{"billed_charge": 267.68, "npi": [1174882880]}]}]}, {"tin": {"type": "ein", "value": "812792506"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 168.2, "providers": [{"billed_charge": 227.0, "npi": [1427251107]}]}]}, {"tin": {"type": "ein", "value": "862922354"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 157.17, "providers": [{"billed_charge": 201.0, "npi": [1760467112]}]}, {"allowed_amount": 165.67, "providers": [{"billed_charge": 201.0, "npi": [1265442776]}]}, {"allowed_amount": 175.57, "providers": [{"billed_charge": 201.0, "npi": [1760467112, 1558784744]}]}, {"allowed_amount": 195.01, "providers": [{"billed_charge": 201.0, "npi": [1265442776]}]}]}]}, {"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": "201891777"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 105.7, "providers": [{"billed_charge": 138.7, "npi": [1548747439]}]}, {"allowed_amount": 118.07, "providers": [{"billed_charge": 147.52, "npi": [1164918538, 1548747439]}]}]}, {"tin": {"type": "ein", "value": "203274708"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 110.59, "providers": [{"billed_charge": 194.0, "npi": [1801863667]}]}]}, {"tin": {"type": "ein", "value": "261803679"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 110.59, "providers": [{"billed_charge": 126.0, "npi": [1730149154, 1518349885]}]}]}, {"tin": {"type": "ein", "value": "273763093"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 118.07, "providers": [{"billed_charge": 177.28, "npi": [1700090735]}]}]}, {"tin": {"type": "ein", "value": "340714585"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 93.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 600.0, "npi": [1578922456, 1457799256]}, {"billed_charge": 636.0, "npi": [1740710615]}]}, {"allowed_amount": 97.67, "providers": [{"billed_charge": 573.0, "npi": [1770019218]}]}]}, {"tin": {"type": "ein", "value": "341768928"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 123.53, "providers": [{"billed_charge": 135.0, "npi": [1144309824]}]}]}, {"tin": {"type": "ein", "value": "341933718"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 105.7, "providers": [{"billed_charge": 175.0, "npi": [1831188168]}]}]}, {"tin": {"type": "ein", "value": "341966269"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 123.53, "providers": [{"billed_charge": 175.0, "npi": [1891719415]}]}]}, {"tin": {"type": "ein", "value": "472285143"}, "billing_class": "professional", "service_codes": ["61", "21"], "payments": [{"allowed_amount": 110.59, "providers": [{"billed_charge": 174.0, "npi": [1134245913]}, {"billed_charge": 174.23, "npi": [1578143632, 1154909273, 1114541380]}]}, {"allowed_amount": 116.56, "providers": [{"billed_charge": 186.58, "npi": [1558996744]}, {"billed_charge": 187.0, "npi": [1134245913, 1023646239, 1780856377]}]}, {"allowed_amount": 123.53, "providers": [{"billed_charge": 186.58, "npi": [1154909273]}]}]}, {"tin": {"type": "ein", "value": "475317373"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 123.53, "providers": [{"billed_charge": 228.81, "npi": [1124894779]}]}]}, {"tin": {"type": "ein", "value": "743174109"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 75.0, "providers": [{"billed_charge": 75.0, "npi": [1881661072]}]}]}, {"tin": {"type": "ein", "value": "752536818"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 99.22, "providers": [{"billed_charge": 186.19, "npi": [1437498078]}]}]}, {"tin": {"type": "ein", "value": "813736599"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 107.0, "providers": [{"billed_charge": 107.0, "npi": [1700657533]}]}]}, {"tin": {"type": "ein", "value": "990706075"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 100.0, "providers": [{"billed_charge": 100.0, "npi": [1003893595]}]}]}]}]}