{"reporting_entity_name": "Oscar Health", "reporting_entity_type": "Health Insurance Issuer", "plan_id": "43490KS001", "last_updated_on": "2026-07-23", "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": "362867831"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 542.67, "providers": [{"billed_charge": 2292.82, "npi": [1588751598]}]}]}, {"tin": {"type": "ein", "value": "431097068"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 1706.96, "npi": [1457386385]}]}]}, {"tin": {"type": "ein", "value": "446000201"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 1200.0, "npi": [1730419227]}]}]}, {"tin": {"type": "ein", "value": "446000208"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 1422.0, "npi": [1396721502]}]}]}, {"tin": {"type": "ein", "value": "481194075"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 875.0, "npi": [1639157555]}]}]}, {"tin": {"type": "ein", "value": "481227663"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.77, "providers": [{"billed_charge": 1523.0, "npi": [1891063681]}]}]}, {"tin": {"type": "ein", "value": "486000798"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 399.43, "providers": [{"billed_charge": 870.0, "npi": [1215075411]}]}]}, {"tin": {"type": "ein", "value": "486025049"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 608.92, "providers": [{"billed_charge": 1030.0, "npi": [1447795778]}]}]}, {"tin": {"type": "ein", "value": "486026115"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 608.92, "providers": [{"billed_charge": 650.0, "npi": [1689720617]}]}]}, {"tin": {"type": "ein", "value": "486033520"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 688.0, "providers": [{"billed_charge": 895.0, "npi": [1437153038]}]}]}, {"tin": {"type": "ein", "value": "486034760"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 1030.38, "npi": [1093792046]}]}]}, {"tin": {"type": "ein", "value": "486036941"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 608.92, "providers": [{"billed_charge": 725.0, "npi": [1053880005]}]}]}, {"tin": {"type": "ein", "value": "486038022"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 600.77, "providers": [{"billed_charge": 695.75, "npi": [1639151897]}]}, {"allowed_amount": 608.92, "providers": [{"billed_charge": 695.75, "npi": [1639151897]}]}]}, {"tin": {"type": "ein", "value": "486038307"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 454.37, "providers": [{"billed_charge": 725.0, "npi": [1558361162]}, {"billed_charge": 825.0, "npi": [1558361162]}]}]}, {"tin": {"type": "ein", "value": "486039815"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 608.92, "providers": [{"billed_charge": 675.0, "npi": [1750322988]}]}]}, {"tin": {"type": "ein", "value": "770324739"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 2124.77, "providers": [{"billed_charge": 5665.0, "npi": [1578597803]}]}]}, {"tin": {"type": "ein", "value": "953743718"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 557.57, "providers": [{"billed_charge": 1362.96, "npi": [1578762308]}, {"billed_charge": 1486.12, "npi": [1578762308]}, {"billed_charge": 1581.18, "npi": [1578762308]}, {"billed_charge": 1784.08, "npi": [1578762308]}]}, {"allowed_amount": 600.77, "providers": [{"billed_charge": 1095.27, "npi": [1104830850]}, {"billed_charge": 1141.27, "npi": [1104830850]}, {"billed_charge": 1163.29, "npi": [1104830850]}, {"billed_charge": 1224.81, "npi": [1104830850]}, {"billed_charge": 1229.35, "npi": [1104830850]}, {"billed_charge": 1283.77, "npi": [1104830850]}, {"billed_charge": 1301.9, "npi": [1104830850]}, {"billed_charge": 1321.95, "npi": [1104830850]}, {"billed_charge": 1386.73, "npi": [1104830850]}, {"billed_charge": 1432.72, "npi": [1104830850]}, {"billed_charge": 1432.73, "npi": [1104830850]}, {"billed_charge": 1433.39, "npi": [1104830850]}, {"billed_charge": 1465.48, "npi": [1104830850]}, {"billed_charge": 1479.39, "npi": [1104830850]}, {"billed_charge": 1498.51, "npi": [1104830850]}, {"billed_charge": 1498.52, "npi": [1104830850]}, {"billed_charge": 1584.67, "npi": [1104830850]}, {"billed_charge": 1609.29, "npi": [1104830850]}, {"billed_charge": 1617.71, "npi": [1104830850]}, {"billed_charge": 1889.75, "npi": [1104830850]}]}]}]}, {"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": "446000201"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 433.73, "providers": [{"billed_charge": 1125.0, "npi": [1730419227]}]}]}, {"tin": {"type": "ein", "value": "481194075"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 433.73, "providers": [{"billed_charge": 875.0, "npi": [1639157555]}]}]}, {"tin": {"type": "ein", "value": "481227663"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 418.62, "providers": [{"billed_charge": 1314.0, "npi": [1184628455]}]}]}, {"tin": {"type": "ein", "value": "486025049"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 492.28, "providers": [{"billed_charge": 669.5, "npi": [1447795778]}]}]}, {"tin": {"type": "ein", "value": "486033520"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 585.44, "providers": [{"billed_charge": 762.0, "npi": [1437153038]}]}]}, {"tin": {"type": "ein", "value": "486034760"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 433.73, "providers": [{"billed_charge": 867.69, "npi": [1093792046]}]}]}, {"tin": {"type": "ein", "value": "486038022"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 492.28, "providers": [{"billed_charge": 544.5, "npi": [1639151897]}]}]}, {"tin": {"type": "ein", "value": "486038307"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 382.64, "providers": [{"billed_charge": 575.0, "npi": [1558361162]}, {"billed_charge": 675.0, "npi": [1558361162]}]}]}, {"tin": {"type": "ein", "value": "486039815"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 492.28, "providers": [{"billed_charge": 575.0, "npi": [1750322988]}]}]}, {"tin": {"type": "ein", "value": "880125707"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 1042.47, "providers": [{"billed_charge": 1288.63, "npi": [1235232562]}]}]}, {"tin": {"type": "ein", "value": "953743718"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 418.62, "providers": [{"billed_charge": 1056.46, "npi": [1104830850]}, {"billed_charge": 1102.46, "npi": [1104830850]}, {"billed_charge": 1124.48, "npi": [1104830850]}, {"billed_charge": 1174.06, "npi": [1104830850]}, {"billed_charge": 1343.13, "npi": [1104830850]}]}, {"allowed_amount": 433.73, "providers": [{"billed_charge": 991.46, "npi": [1578762308]}]}]}]}, {"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": "430975680"}, "billing_class": "professional", "service_codes": ["24", "22", "21"], "payments": [{"allowed_amount": 18.15, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 810.0, "npi": [1962724757]}]}, {"allowed_amount": 189.1, "billing_code_modifier": ["QX", "QK"], "providers": [{"billed_charge": 365.0, "npi": [1891326641]}, {"billed_charge": 446.0, "npi": [1457813925]}]}, {"allowed_amount": 215.64, "billing_code_modifier": ["QK,P3", "QX,P3"], "providers": [{"billed_charge": 365.0, "npi": [1316265333]}, {"billed_charge": 581.0, "npi": [1881607323]}]}, {"allowed_amount": 384.83, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 810.0, "npi": [1821199878]}]}, {"allowed_amount": 530.8, "billing_code_modifier": ["QZ,P3"], "providers": [{"billed_charge": 1080.0, "npi": [1821199878]}]}]}, {"tin": {"type": "ein", "value": "464070815"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 402.42, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 1866.0, "npi": [1689075392]}]}, {"allowed_amount": 481.46, "billing_code_modifier": ["QZ,P3"], "providers": [{"billed_charge": 2177.0, "npi": [1386644615]}]}, {"allowed_amount": 488.65, "billing_code_modifier": ["QZ,P3"], "providers": [{"billed_charge": 2177.0, "npi": [1437306636]}]}]}, {"tin": {"type": "ein", "value": "813536534"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 177.11, "billing_code_modifier": ["QX", "QY"], "providers": [{"billed_charge": 550.0, "npi": [1376962738, 1285106450]}]}, {"allowed_amount": 180.52, "billing_code_modifier": ["QX", "QY"], "providers": [{"billed_charge": 550.0, "npi": [1427387745, 1376962738]}]}, {"allowed_amount": 194.14, "billing_code_modifier": ["QX", "QY"], "providers": [{"billed_charge": 550.0, "npi": [1376962738, 1346229374]}]}, {"allowed_amount": 200.95, "billing_code_modifier": ["QX", "QY"], "providers": [{"billed_charge": 550.0, "npi": [1427387745, 1376962738]}]}]}, {"tin": {"type": "ein", "value": "834456088"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 517.39, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 1280.0, "npi": [1801277330]}]}]}, {"tin": {"type": "ein", "value": "882257520"}, "billing_class": "professional", "service_codes": ["24"], "payments": [{"allowed_amount": 18.15, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 720.0, "npi": [1235451246]}]}, {"allowed_amount": 338.39, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 720.0, "npi": [1891771036]}]}, {"allowed_amount": 364.93, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 720.0, "npi": [1932467263]}]}, {"allowed_amount": 378.2, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 720.0, "npi": [1932467263]}]}, {"allowed_amount": 384.83, "billing_code_modifier": ["QZ"], "providers": [{"billed_charge": 720.0, "npi": [1568731396]}]}]}]}, {"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": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.93, "providers": [{"billed_charge": 145.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 62.4, "providers": [{"billed_charge": 104.0, "npi": [1154400232, 1366515488]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.37, "providers": [{"billed_charge": 311.85, "npi": [1528301900]}]}, {"allowed_amount": 249.48, "providers": [{"billed_charge": 311.85, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.37, "providers": [{"billed_charge": 328.27, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.37, "providers": [{"billed_charge": 222.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 431.9, "providers": [{"billed_charge": 1234.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "812244474"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 9.46, "providers": [{"billed_charge": 16.92, "npi": [1558717827]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.37, "providers": [{"billed_charge": 408.39, "npi": [1750921029]}]}]}]}, {"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": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 48.0, "providers": [{"billed_charge": 80.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.32, "providers": [{"billed_charge": 190.46, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 11.68, "providers": [{"billed_charge": 41.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 194.6, "providers": [{"billed_charge": 556.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.32, "providers": [{"billed_charge": 224.53, "npi": [1750921029]}]}]}]}, {"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": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 16.72, "providers": [{"billed_charge": 140.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.08, "providers": [{"billed_charge": 186.0, "npi": [1245058916]}, {"billed_charge": 195.3, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 41.96, "providers": [{"billed_charge": 41.96, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "430652680"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.77, "providers": [{"billed_charge": 104.4, "npi": [1346251543]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.81, "providers": [{"billed_charge": 126.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 81.19, "providers": [{"billed_charge": 110.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 10.8, "providers": [{"billed_charge": 27.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 57.6, "providers": [{"billed_charge": 96.0, "npi": [1154400232, 1366515488]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 40.0, "providers": [{"billed_charge": 40.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.15, "providers": [{"billed_charge": 119.1, "npi": [1528301900]}]}, {"allowed_amount": 95.28, "providers": [{"billed_charge": 119.1, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.15, "providers": [{"billed_charge": 196.16, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.15, "providers": [{"billed_charge": 177.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.08, "providers": [{"billed_charge": 41.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.15, "providers": [{"billed_charge": 221.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "541669672"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 8.23, "providers": [{"billed_charge": 37.0, "npi": [1902900558]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 53.01, "providers": [{"billed_charge": 126.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 43.23, "providers": [{"billed_charge": 206.03, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 151.08, "providers": [{"billed_charge": 420.46, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.24, "providers": [{"billed_charge": 55.95, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 74.0, "providers": [{"billed_charge": 74.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "812244474"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 8.27, "providers": [{"billed_charge": 15.54, "npi": [1558717827]}]}]}, {"tin": {"type": "ein", "value": "820581670"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 8.84, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 50.0, "npi": [1790160612]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 74.0, "providers": [{"billed_charge": 74.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "900065118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 59.48, "providers": [{"billed_charge": 189.0, "npi": [1275566200]}]}]}]}, {"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": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 16.19, "providers": [{"billed_charge": 225.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 37.14, "providers": [{"billed_charge": 440.0, "npi": [1245058916]}, {"billed_charge": 462.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 85.7, "providers": [{"billed_charge": 85.7, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "430652680"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 44.91, "providers": [{"billed_charge": 198.5, "npi": [1346251543]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.24, "providers": [{"billed_charge": 240.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 167.62, "providers": [{"billed_charge": 230.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 12.8, "providers": [{"billed_charge": 32.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.0, "providers": [{"billed_charge": 130.0, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 55.0, "providers": [{"billed_charge": 55.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.09, "providers": [{"billed_charge": 535.32, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.09, "providers": [{"billed_charge": 381.8, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.09, "providers": [{"billed_charge": 289.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 37.14, "providers": [{"billed_charge": 65.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.09, "providers": [{"billed_charge": 396.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 145.85, "providers": [{"billed_charge": 400.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 60.43, "providers": [{"billed_charge": 489.25, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 274.82, "providers": [{"billed_charge": 871.59, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.14, "providers": [{"billed_charge": 62.1, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 500.15, "providers": [{"billed_charge": 1429.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 169.0, "providers": [{"billed_charge": 169.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "820581670"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 13.2, "billing_code_modifier": ["90"], "providers": [{"billed_charge": 97.0, "npi": [1790160612]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 31.09, "providers": [{"billed_charge": 823.85, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 169.0, "providers": [{"billed_charge": 169.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "900065118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 143.91, "providers": [{"billed_charge": 789.0, "npi": [1275566200]}]}]}]}, {"name": "Computed tomographic angiography (CTA), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing", "billing_code_type": "CPT", "billing_code": "70471", "billing_code_type_version": "2022", "description": "CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING", "allowed_amounts": [{"tin": {"type": "ein", "value": "260376717"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 228.0, "providers": [{"billed_charge": 456.0, "npi": [1245641109]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 236.5, "providers": [{"billed_charge": 473.0, "npi": [1104155258]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 200.0, "providers": [{"billed_charge": 400.0, "npi": [1902867336, 1861602088, 1275563884, 1528118106, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3980.38, "providers": [{"billed_charge": 7960.75, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 261.5, "providers": [{"billed_charge": 523.0, "npi": [1790149748, 1497779961, 1851564892]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 137.5, "providers": [{"billed_charge": 275.0, "npi": [1497728422, 1285297549, 1316942576, 1629365010, 1558579763, 1538507256, 1710981469]}]}]}, {"tin": {"type": "ein", "value": "874362493"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 150.0, "providers": [{"billed_charge": 300.0, "npi": [1841695889]}]}]}]}, {"name": "Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing", "billing_code_type": "CPT", "billing_code": "71275", "billing_code_type_version": "2022", "description": "CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST", "allowed_amounts": [{"tin": {"type": "ein", "value": "363097297"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 121.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 496.0, "npi": [1740210491]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 113.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 335.0, "npi": [1932370384, 1023004173]}]}, {"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 333.0, "npi": [1114422516]}, {"billed_charge": 335.0, "npi": [1811158967]}]}, {"allowed_amount": 162.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 335.0, "npi": [1447613005, 1811158967]}]}]}, {"tin": {"type": "ein", "value": "430917818"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 129.71, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 334.0, "npi": [1952692600]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 878.67, "providers": [{"billed_charge": 1745.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 123.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 256.0, "npi": [1376659953]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 340.0, "npi": [1497784896, 1518177252, 1902867336, 1861602088, 1326486127, 1508229808, 1790726495]}]}, {"allowed_amount": 162.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 340.0, "npi": [1497784896, 1790726495]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 3623.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 704.53, "providers": [{"billed_charge": 4776.34, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480758603"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 225.0, "npi": [1821527698]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 328.0, "npi": [1497779961, 1851564892, 1376511766]}]}, {"allowed_amount": 162.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 328.0, "npi": [1164537346, 1912096868, 1417972944, 1942867411, 1699062232, 1497779961]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 7404.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 84.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 205.0, "npi": [1447697321]}]}, {"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 205.0, "npi": [1891226304, 1497728422, 1104319664, 1629365010, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 162.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 325.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 646.95, "providers": [{"billed_charge": 1579.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 704.53, "providers": [{"billed_charge": 4014.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6774.6, "providers": [{"billed_charge": 19356.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 2870.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 704.53, "providers": [{"billed_charge": 7877.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 143.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 320.0, "npi": [1477751584, 1437513322, 1396061966, 1578096566, 1255780029]}]}]}]}, {"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": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 94.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 336.0, "npi": [1740244466]}]}, {"allowed_amount": 98.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 334.0, "npi": [1427685510]}, {"billed_charge": 336.0, "npi": [1679667422, 1811158967]}]}, {"allowed_amount": 113.92, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 336.0, "npi": [1023004173]}]}, {"allowed_amount": 139.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 334.0, "npi": [1114422516]}, {"billed_charge": 336.0, "npi": [1093712473, 1962710780]}]}, {"allowed_amount": 185.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 334.0, "npi": [1912987942]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 119.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 257.0, "npi": [1659321438, 1831194901, 1952347270, 1215135751]}]}, {"allowed_amount": 123.71, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 257.0, "npi": [1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 84.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 480.0, "npi": [1528448479]}]}, {"allowed_amount": 139.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 480.0, "npi": [1497784896, 1306340195, 1518177252, 1841280005, 1902867336, 1861602088, 1598883787, 1275563884, 1174662894, 1326486127, 1508229808, 1336597582, 1538303383, 1215166681, 1528118106, 1821009531, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2375.22, "providers": [{"billed_charge": 4200.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 12547.0, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 5223.6, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 8706.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 162.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 271.0, "npi": [1346496528]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2087.0, "providers": [{"billed_charge": 2087.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 98.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 281.0, "npi": [1942867411]}]}]}, {"tin": {"type": "ein", "value": "461485841"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 140.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 348.0, "npi": [1942594908]}]}]}, {"tin": {"type": "ein", "value": "462021581"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 124.81, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 351.0, "npi": [1770534869]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1146.42, "providers": [{"billed_charge": 6434.87, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 98.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 399.0, "npi": [1164537346, 1649659459, 1538368451, 1689613093, 1871750729, 1063507853, 1417972944, 1942867411]}]}, {"allowed_amount": 139.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 399.0, "npi": [1164537346, 1689607301, 1063507853, 1376511766, 1689613093, 1770515249, 1124113972, 1649659459, 1538368451, 1043266117, 1417972944, 1699062232, 1851564892, 1912096868, 1952862054, 1790149748, 1679598197, 1376694901, 1497779961, 1396762746]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 12547.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 84.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1447697321, 1194840918]}]}, {"allowed_amount": 139.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1891226304, 1497728422, 1871936518, 1073774923, 1285297549, 1588693949, 1316942576, 1104319664, 1629365010, 1558579763, 1265656979, 1538507256, 1447285465, 1710981469]}]}, {"allowed_amount": 235.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1316942576]}]}, {"allowed_amount": 265.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1871936518, 1497728422, 1447697321, 1316942667, 1073774923, 1316942576, 1629365010, 1558579763, 1306161237, 1194840918, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 98.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 325.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1146.42, "providers": [{"billed_charge": 6051.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1034.01, "providers": [{"billed_charge": 7554.75, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "581075840"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 149.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 402.0, "npi": [1245771484]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1278.09, "providers": [{"billed_charge": 16313.49, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 550.75, "providers": [{"billed_charge": 5642.95, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 147.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 297.0, "npi": [1457884785, 1548249246, 1346341583]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 3410.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 113.92, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 320.0, "npi": [1902164825, 1750648507, 1285838862]}]}, {"allowed_amount": 232.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 320.0, "npi": [1184646929]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1146.42, "providers": [{"billed_charge": 11837.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 139.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 400.0, "npi": [1477751584, 1841516226, 1437513322, 1629276555, 1396061966, 1215970736, 1760825814, 1548688567, 1578096566, 1255780029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 3410.0, "npi": [1639185457]}]}]}]}, {"name": "Computed tomography, abdomen and pelvis; without contrast material", "billing_code_type": "CPT", "billing_code": "74176", "billing_code_type_version": "2022", "description": "CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 137.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 317.0, "npi": [1093712473, 1114422516]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 114.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 250.0, "npi": [1659321438]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 80.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 390.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 118.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 390.0, "npi": [1174662894]}]}, {"allowed_amount": 137.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 390.0, "npi": [1518177252, 1841280005, 1861602088, 1598883787, 1275563884, 1336597582, 1174662894, 1215166681, 1528118106, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 803.13, "providers": [{"billed_charge": 5598.93, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 137.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 381.0, "npi": [1689613093, 1871750729, 1770515249, 1942867411, 1497779961, 1396762746, 1851564892]}]}, {"allowed_amount": 155.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 381.0, "npi": [1699062232, 1689613093]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 137.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 235.0, "npi": [1497728422, 1285297549, 1104319664, 1629365010, 1538507256, 1447285465]}]}, {"allowed_amount": 235.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 235.0, "npi": [1538507256, 1710981469]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 155.58, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 225.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 135.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 281.0, "npi": [1518932607]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 115.46, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 305.0, "npi": [1578541439]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 803.13, "providers": [{"billed_charge": 8071.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 137.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 385.0, "npi": [1841516226, 1396061966, 1215970736, 1578096566, 1548688567, 1760825814, 1255780029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 3210.0, "npi": [1639185457]}]}]}]}, {"name": "Computed tomography, cervical spine; without contrast material", "billing_code_type": "CPT", "billing_code": "72125", "billing_code_type_version": "2022", "description": "CT CERVICAL SPINE W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 71.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 186.0, "npi": [1023240561, 1962710780]}]}, {"allowed_amount": 89.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 186.0, "npi": [1962710780]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 66.47, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1659321438]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 46.38, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 217.0, "npi": [1528448479]}]}, {"allowed_amount": 71.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 217.0, "npi": [1497784896, 1518177252, 1902867336, 1174662894, 1538303383, 1528118106, 1023264157, 1790726495]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 4429.86, "providers": [{"billed_charge": 5537.32, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 439.99, "providers": [{"billed_charge": 3398.18, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480917002"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 71.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1336600303]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 439.99, "providers": [{"billed_charge": 2218.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 89.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 192.0, "npi": [1164537346]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 5090.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 46.38, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1447697321]}]}, {"allowed_amount": 66.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1629365010]}]}, {"allowed_amount": 71.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1891799557, 1588693949, 1285297549]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 439.99, "providers": [{"billed_charge": 3620.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 80.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 257.0, "npi": [1457884785, 1336397124]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 2096.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 66.44, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 187.0, "npi": [1467089771]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 439.99, "providers": [{"billed_charge": 7072.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 71.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 195.0, "npi": [1477751584, 1841516226]}]}]}]}, {"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": "260376717"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 171.0, "npi": [1245641109]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 65.4, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 158.0, "npi": [1740244466]}]}, {"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 158.0, "npi": [1023240561, 1093712473, 1962710780]}]}, {"allowed_amount": 76.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 158.0, "npi": [1962710780, 1811158967]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 56.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 105.0, "npi": [1376659953, 1811330145, 1659321438, 1952347270]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 39.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 180.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 180.0, "npi": [1497784896, 1306340195, 1518177252, 1841280005, 1902867336, 1861602088, 1174662894, 1336597582, 1508229808, 1396784658, 1538303383, 1528118106, 1821009531, 1023264157, 1790726495]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1594.8, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 2658.0, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 75.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 126.0, "npi": [1144401126]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3785.51, "providers": [{"billed_charge": 4731.89, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 477.5, "providers": [{"billed_charge": 2236.7, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480793798"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 166.0, "npi": [1083656102]}]}]}, {"tin": {"type": "ein", "value": "480860883"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 623.86, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1786.0, "npi": [1376548370]}]}]}, {"tin": {"type": "ein", "value": "480917002"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1477546745, 1336600303]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 477.5, "providers": [{"billed_charge": 2653.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 153.0, "npi": [1508205345, 1164537346, 1538368451, 1649659459, 1689613093, 1083729222, 1871750729, 1780028563, 1790149748, 1053346452, 1942867411, 1497779961, 1851564892]}]}, {"allowed_amount": 76.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 153.0, "npi": [1164537346, 1912096868, 1689613093, 1245296805, 1952862054, 1063507853, 1417972944, 1497779961, 1396762746]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 5214.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1629365010]}]}, {"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1891799557, 1790838407, 1316942667, 1285297549, 1316942576, 1558579763, 1265656979, 1538507256, 1447285465, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 76.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 477.5, "providers": [{"billed_charge": 2677.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 741.42, "providers": [{"billed_charge": 1675.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 4333.0, "providers": [{"billed_charge": 12380.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 73.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 210.0, "npi": [1487897369, 1336397124, 1144780438]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 477.5, "providers": [{"billed_charge": 9416.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 66.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 140.0, "npi": [1215970736, 1477751584, 1396061966]}]}]}, {"tin": {"type": "ein", "value": "862109896"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 68.11, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 156.0, "npi": [1083703359]}]}]}, {"tin": {"type": "ein", "value": "874362493"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 103.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 103.0, "npi": [1841695889, 1033508353]}]}]}]}, {"name": "Computed tomography, thorax, diagnostic; with contrast material(s)", "billing_code_type": "CPT", "billing_code": "71260", "billing_code_type_version": "2022", "description": "DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 88.27, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 216.0, "npi": [1093712473, 1962710780]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 79.34, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 182.0, "npi": [1922084490, 1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 88.27, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 219.0, "npi": [1497784896, 1518177252, 1841280005, 1275563884, 1174662894, 1326486127, 1508229808, 1538303383, 1215166681, 1821009531, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 389.07, "providers": [{"billed_charge": 4788.72, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 88.27, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 209.0, "npi": [1164537346, 1649659459, 1063507853, 1417972944, 1053346452, 1851564892]}]}, {"allowed_amount": 209.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 209.0, "npi": [1417972944, 1396762746]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 57.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1447697321, 1194840918]}]}, {"allowed_amount": 88.27, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1891226304, 1073774923, 1285297549, 1316942576, 1558579763, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 389.07, "providers": [{"billed_charge": 7988.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 88.27, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 210.0, "npi": [1477751584, 1841516226, 1578096566, 1548688567, 1255780029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 700.0, "providers": [{"billed_charge": 2346.0, "npi": [1639185457]}]}]}]}, {"name": "Computed tomography, thorax, diagnostic; without contrast material", "billing_code_type": "CPT", "billing_code": "71250", "billing_code_type_version": "2022", "description": "DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 77.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 197.0, "npi": [1114422516]}, {"billed_charge": 198.0, "npi": [1093712473]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 53.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 218.0, "npi": [1326201617]}]}, {"allowed_amount": 77.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 218.0, "npi": [1518177252, 1902867336, 1598883787, 1275563884, 1174662894, 1508229808, 1396784658, 1538303383, 1215166681, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 77.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1417972944, 1871750729, 1396762746, 1851564892]}]}, {"allowed_amount": 96.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1871750729, 1538368451, 1245296805]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 77.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1538507256, 1790912897, 1316942667, 1497728422]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 96.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 205.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 77.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 195.0, "npi": [1841516226, 1629276555]}]}]}]}, {"name": "Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)", "billing_code_type": "CPT", "billing_code": "71271", "billing_code_type_version": "2022", "description": "COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 85.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 205.0, "npi": [1497784896, 1861602088, 1275563884, 1215166681, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 85.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1770515249, 1396762746]}]}, {"allowed_amount": 96.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 194.0, "npi": [1871750729]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 85.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1891226304, 1790912897, 1073774923]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 79.63, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 247.0, "npi": [1346341583]}]}]}]}, {"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": "200718322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 345.02, "providers": [{"billed_charge": 1764.0, "npi": [1013336320, 1801018536, 1174262026, 1023696655, 1407397615, 1992062129]}]}]}, {"tin": {"type": "ein", "value": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1717.55, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4310.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "271371893"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 1534.0, "npi": [1104961002, 1811139967]}]}]}, {"tin": {"type": "ein", "value": "272774116"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 429.92, "providers": [{"billed_charge": 1468.0, "npi": [1649536632, 1205079803]}]}]}, {"tin": {"type": "ein", "value": "274752989"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 1027.58, "providers": [{"billed_charge": 2258.28, "npi": [1033569850]}]}]}, {"tin": {"type": "ein", "value": "331749850"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 250.0, "npi": [1326252545, 1205956919]}]}]}, {"tin": {"type": "ein", "value": "332071016"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 462.16, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1562.0, "npi": [1558774000]}]}]}, {"tin": {"type": "ein", "value": "363097297"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 314.61, "providers": [{"billed_charge": 678.0, "npi": [1255560785]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 845.0, "npi": [1144970203]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 295.02, "providers": [{"billed_charge": 686.0, "npi": [1689603771, 1730123548, 1083077630]}]}]}, {"tin": {"type": "ein", "value": "431832147"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 248.77, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1468.0, "npi": [1578095840, 1538272406, 1154431724, 1265164214]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 758.56, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1756.0, "npi": [1740442946, 1720087109, 1154558674, 1174720148, 1568704088]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 533.07, "npi": [1619069176, 1154855617]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 650.0, "npi": [1710117296]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 238.21, "providers": [{"billed_charge": 555.25, "npi": [1871756882]}]}]}, {"tin": {"type": "ein", "value": "472209130"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 257.15, "providers": [{"billed_charge": 400.0, "npi": [1699878504]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 429.92, "providers": [{"billed_charge": 1764.0, "npi": [1013336320, 1497250880, 1659001378, 1336362953, 1174262026, 1992062129, 1447874482, 1073672499, 1841224946, 1568806842, 1457314429]}]}]}, {"tin": {"type": "ein", "value": "481153331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 429.92, "providers": [{"billed_charge": 2039.0, "npi": [1740711001]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 492.8, "npi": [1548427057, 1972910651]}]}, {"allowed_amount": 257.15, "providers": [{"billed_charge": 492.8, "npi": [1568878130, 1730808908, 1841770773]}]}, {"allowed_amount": 338.63, "providers": [{"billed_charge": 492.8, "npi": [1972165793, 1366860058]}]}, {"allowed_amount": 360.07, "providers": [{"billed_charge": 492.8, "npi": [1740801059, 1730393000, 1801280086, 1801114202, 1659877470, 1598170367]}]}, {"allowed_amount": 429.92, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 492.8, "npi": [1093100398]}]}]}, {"tin": {"type": "ein", "value": "743083325"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 230.15, "providers": [{"billed_charge": 450.0, "npi": [1578660585, 1235236258]}]}]}, {"tin": {"type": "ein", "value": "870301301"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 395.14, "providers": [{"billed_charge": 1627.0, "npi": [1821289976, 1144411489]}]}]}, {"tin": {"type": "ein", "value": "880590424"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 429.92, "providers": [{"billed_charge": 1813.0, "npi": [1285131839]}]}]}, {"tin": {"type": "ein", "value": "883543992"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 248.58, "providers": [{"billed_charge": 550.0, "npi": [1639550452]}]}]}, {"tin": {"type": "ein", "value": "922099454"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 361.62, "providers": [{"billed_charge": 1217.0, "npi": [1083191092]}]}]}]}, {"name": "Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less", "billing_code_type": "CPT", "billing_code": "11042", "billing_code_type_version": "2022", "description": "DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<", "allowed_amounts": [{"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 35.55, "providers": [{"billed_charge": 157.0, "npi": [1962018234]}]}, {"allowed_amount": 71.09, "providers": [{"billed_charge": 157.0, "npi": [1962018234]}]}]}]}, {"name": "Diagnostic digital breast tomosynthesis; bilateral", "billing_code_type": "CPT", "billing_code": "77062", "billing_code_type_version": "2022", "description": "DIGITAL BREAST TOMOSYNTHESIS BILATERAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1497784896, 1518177252, 1336597582, 1174662894, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 108.0, "npi": [1871750729, 1083135180, 1851564892, 1063507853]}]}, {"allowed_amount": 45.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 108.0, "npi": [1083135180]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 38.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1326027657, 1841619871]}]}]}]}, {"name": "Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral", "billing_code_type": "CPT", "billing_code": "77066", "billing_code_type_version": "2022", "description": "DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 76.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 190.0, "npi": [1497784896, 1518177252, 1174662894, 1336597582, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 76.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1871750729, 1083135180, 1851564892, 1063507853]}]}, {"allowed_amount": 89.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 179.0, "npi": [1083135180]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 80.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 239.0, "npi": [1326027657, 1841619871]}]}]}]}, {"name": "Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral", "billing_code_type": "CPT", "billing_code": "77065", "billing_code_type_version": "2022", "description": "DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 155.0, "npi": [1497784896, 1518177252, 1336597582, 1174662894, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 146.0, "npi": [1871750729, 1083135180, 1063507853, 1124113972, 1851564892]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 53.73, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 143.0, "npi": [1184153769, 1831517770]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1841516226]}]}]}]}, {"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": "464163620"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 68.43, "providers": [{"billed_charge": 200.0, "npi": [1265854855]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 27.76, "providers": [{"billed_charge": 140.69, "npi": [1194782409]}]}, {"allowed_amount": 41.63, "providers": [{"billed_charge": 133.5, "npi": [1194782409]}, {"billed_charge": 148.4, "npi": [1194782409]}]}, {"allowed_amount": 83.27, "providers": [{"billed_charge": 133.5, "npi": [1194782409]}, {"billed_charge": 163.29, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 83.27, "providers": [{"billed_charge": 179.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 83.27, "providers": [{"billed_charge": 424.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 676.55, "providers": [{"billed_charge": 1933.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "721549752"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 89.01, "providers": [{"billed_charge": 1178.0, "npi": [1346230323]}]}]}]}, {"name": "Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study", "billing_code_type": "CPT", "billing_code": "93971", "billing_code_type_version": "2022", "description": "DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 29.15, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 55.0, "npi": [1922084490]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 27.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 145.0, "npi": [1497784896, 1336597582, 1538303383]}]}, {"allowed_amount": 39.02, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 145.0, "npi": [1790726495]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 191.11, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1138.89, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 27.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 79.0, "npi": [1689613093, 1245296805, 1629183884, 1770515249, 1679598197]}]}, {"allowed_amount": 39.02, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 79.0, "npi": [1376694901]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 27.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1316942576, 1629365010]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 717.89, "providers": [{"billed_charge": 717.89, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 23.24, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.75, "npi": [1790914521]}]}, {"allowed_amount": 25.71, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.75, "npi": [1811934896, 1598764664]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 29.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1487897369, 1336397124]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 27.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 80.0, "npi": [1477751584, 1629276555]}]}]}]}, {"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": "200718322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.71, "providers": [{"billed_charge": 68.0, "npi": [1013336320, 1699405381, 1801018536, 1407397615, 1023696655, 1992062129]}]}]}, {"tin": {"type": "ein", "value": "260593928"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 16.69, "providers": [{"billed_charge": 35.0, "npi": [1740289446]}]}]}, {"tin": {"type": "ein", "value": "272774116"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.1, "providers": [{"billed_charge": 56.0, "npi": [1861717696, 1841303245, 1588670962, 1609070804, 1649536632, 1205079803, 1861699134]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.71, "providers": [{"billed_charge": 38.75, "npi": [1811212202]}]}]}, {"tin": {"type": "ein", "value": "364874748"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 152.81, "providers": [{"billed_charge": 121.0, "npi": [1568032712]}]}]}, {"tin": {"type": "ein", "value": "412175615"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.86, "providers": [{"billed_charge": 26.0, "npi": [1265439400]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 11.94, "providers": [{"billed_charge": 22.0, "npi": [1700824331, 1215973102, 1558718767, 1346249554, 1386601235, 1508814559, 1982920534, 1891719993, 1720548571, 1831147420, 1336568799]}]}, {"allowed_amount": 12.3, "providers": [{"billed_charge": 22.0, "npi": [1639490030]}]}]}, {"tin": {"type": "ein", "value": "431832147"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.44, "providers": [{"billed_charge": 56.0, "npi": [1578095840, 1922746056, 1154431724, 1265164214, 1609901727]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.81, "providers": [{"billed_charge": 31.25, "npi": [1578500120]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 15.6, "providers": [{"billed_charge": 26.0, "npi": [1780821827]}]}, {"allowed_amount": 189.18, "providers": [{"billed_charge": 26.0, "npi": [1780821827]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 1.6, "providers": [{"billed_charge": 67.0, "npi": [1740442946]}]}, {"allowed_amount": 29.13, "providers": [{"billed_charge": 67.0, "npi": [1740442946, 1720087109, 1992782122, 1801024203, 1013470574, 1114367216, 1154558674, 1174720148, 1063833366, 1568704088]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 12.93, "providers": [{"billed_charge": 23.88, "npi": [1013973288]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.16, "providers": [{"billed_charge": 54.5, "npi": [1841248267, 1932308269]}]}, {"allowed_amount": 9.18, "providers": [{"billed_charge": 54.5, "npi": [1982721684]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.1, "providers": [{"billed_charge": 68.0, "npi": [1497250880, 1154881498, 1659001378, 1699405381, 1336362953, 1174262026, 1639178668, 1407397615, 1306422704, 1992062129, 1447874482, 1841224946, 1245506229, 1992200695, 1568806842, 1588927420, 1053059550]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 8.77, "providers": [{"billed_charge": 50.0, "npi": [1275140261]}]}, {"allowed_amount": 8.87, "providers": [{"billed_charge": 50.0, "npi": [1508430521]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 8.87, "providers": [{"billed_charge": 42.5, "npi": [1790914521]}]}, {"allowed_amount": 9.88, "providers": [{"billed_charge": 42.5, "npi": [1043255649, 1578537718, 1669694501, 1780067934]}]}, {"allowed_amount": 14.1, "providers": [{"billed_charge": 42.5, "npi": [1679150304, 1124334370, 1174987523, 1316408586, 1952728016, 1932372406, 1982192886, 1578571766, 1164579959, 1912326299, 1174560510, 1487232575]}]}]}, {"tin": {"type": "ein", "value": "593677604"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 33.89, "providers": [{"billed_charge": 64.8, "npi": [1275274508]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.56, "providers": [{"billed_charge": 26.0, "npi": [1255855607]}]}]}, {"tin": {"type": "ein", "value": "814390353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.1, "providers": [{"billed_charge": 68.0, "npi": [1497215602]}]}]}, {"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 9.88, "providers": [{"billed_charge": 24.0, "npi": [1710928940]}]}]}, {"tin": {"type": "ein", "value": "833542131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.1, "providers": [{"billed_charge": 141.34, "npi": [1134415557, 1821451501, 1205898285, 1790723955, 1104086586]}]}]}, {"tin": {"type": "ein", "value": "870301301"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.82, "providers": [{"billed_charge": 63.0, "npi": [1821289976, 1144411489]}]}]}, {"tin": {"type": "ein", "value": "880590424"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.56, "providers": [{"billed_charge": 69.0, "npi": [1609608348, 1073344628]}]}, {"allowed_amount": 14.1, "providers": [{"billed_charge": 69.0, "npi": [1265068928, 1982909891, 1154558674, 1790289502, 1285131839]}]}]}]}, {"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": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 104.55, "providers": [{"billed_charge": 465.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 134.98, "providers": [{"billed_charge": 430.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 172.6, "providers": [{"billed_charge": 390.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 435.6, "providers": [{"billed_charge": 726.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 773.51, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 509.37, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 380.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 134.98, "providers": [{"billed_charge": 245.61, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 598.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 118.2, "providers": [{"billed_charge": 859.11, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 672.7, "providers": [{"billed_charge": 1922.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 181.0, "npi": [1588657928]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 290.0, "providers": [{"billed_charge": 290.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.67, "providers": [{"billed_charge": 604.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 290.0, "providers": [{"billed_charge": 290.0, "npi": [1639185457]}]}]}]}, {"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": "200718322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 282.21, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1454.0, "npi": [1013336320, 1659001378, 1699405381, 1184069957, 1568826022, 1801018536, 1174262026, 1407397615, 1023696655, 1306422704, 1447874482, 1992062129, 1992200695, 1356695001, 1154881498, 1396313755, 1588927420, 1053059550]}]}]}, {"tin": {"type": "ein", "value": "262583411"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 936.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5161.88, "npi": [1659538858]}]}]}, {"tin": {"type": "ein", "value": "272774116"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 210.65, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1144.0, "npi": [1861717696, 1083858880, 1831505544, 1447825385, 1265019400, 1154431724, 1841303245, 1407099120, 1427161918, 1588670962, 1609070804, 1184011702, 1003829078, 1598864662, 1861699134]}]}]}, {"tin": {"type": "ein", "value": "274752989"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 786.32, "providers": [{"billed_charge": 1750.88, "npi": [1417511205]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 281.94, "providers": [{"billed_charge": 2750.0, "npi": [1245058916]}]}, {"allowed_amount": 639.11, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2887.5, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 282.21, "providers": [{"billed_charge": 621.6, "npi": [1962720540]}]}]}, {"tin": {"type": "ein", "value": "364395800"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 522.66, "providers": [{"billed_charge": 5071.52, "npi": [1104899442]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 505.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3674.89, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "430652656"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 269.86, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5551.0, "npi": [1487663506]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1213.47, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1749.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 238.65, "providers": [{"billed_charge": 503.0, "npi": [1376921767]}]}]}, {"tin": {"type": "ein", "value": "430998341"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 199.2, "providers": [{"billed_charge": 909.0, "npi": [1174302632]}]}, {"allowed_amount": 205.74, "providers": [{"billed_charge": 909.0, "npi": [1447810429]}]}, {"allowed_amount": 223.52, "providers": [{"billed_charge": 909.0, "npi": [1326543943, 1659365807]}]}]}, {"tin": {"type": "ein", "value": "431560263"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 294.07, "providers": [{"billed_charge": 521.0, "npi": [1033593629]}]}]}, {"tin": {"type": "ein", "value": "431832147"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 223.52, "providers": [{"billed_charge": 1144.0, "npi": [1922746056, 1003829078, 1265164214]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1863.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4658.0, "npi": [1366515488, 1154400232]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 382.99, "providers": [{"billed_charge": 1431.0, "npi": [1013470574]}]}, {"allowed_amount": 427.31, "providers": [{"billed_charge": 1431.0, "npi": [1801024203]}]}, {"allowed_amount": 531.99, "providers": [{"billed_charge": 1431.0, "npi": [1346538758, 1770545451, 1518330604, 1417180175, 1124677521, 1154851186]}]}, {"allowed_amount": 625.87, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1431.0, "npi": [1740442946, 1720087109, 1992782122, 1801024203, 1013470574, 1114367216, 1154558674, 1174720148, 1063833366, 1568704088]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3419.4, "npi": [1528301900]}]}, {"allowed_amount": 559.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3419.4, "npi": [1528301900]}]}, {"allowed_amount": 2735.52, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3419.4, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1690.36, "npi": [1194782409]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1690.36, "npi": [1194782409]}]}, {"allowed_amount": 559.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1690.36, "npi": [1194782409]}, {"billed_charge": 1690.37, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 105.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1454.0, "npi": [1841224946]}]}, {"allowed_amount": 210.65, "providers": [{"billed_charge": 1454.0, "npi": [1013336320, 1174262026, 1568088847, 1659001378, 1568826022, 1801018536, 1821738667, 1639178668, 1306422704, 1992062129, 1447874482, 1073672499, 1245506229, 1568806842, 1588927420, 1235576125, 1497250880, 1750374724, 1184069957, 1699405381, 1336362953, 1063411916, 1912466905, 1356695001, 1154881498, 1821148123, 1053059550, 1235247842, 1447698915, 1407397615, 1841224946, 1851329908, 1992200695, 1467751032, 1457314429, 1649682303]}]}, {"allowed_amount": 1252.11, "providers": [{"billed_charge": 1454.0, "npi": [1073672499]}]}, {"allowed_amount": 1321.09, "providers": [{"billed_charge": 1454.0, "npi": [1568826022]}]}, {"allowed_amount": 1342.78, "providers": [{"billed_charge": 1454.0, "npi": [1750374724]}]}, {"allowed_amount": 1345.1, "providers": [{"billed_charge": 1454.0, "npi": [1053059550]}]}, {"allowed_amount": 1348.25, "providers": [{"billed_charge": 1454.0, "npi": [1588927420]}]}, {"allowed_amount": 1352.83, "providers": [{"billed_charge": 1454.0, "npi": [1235576125]}]}, {"allowed_amount": 1356.44, "providers": [{"billed_charge": 1454.0, "npi": [1659001378]}]}, {"allowed_amount": 1371.13, "providers": [{"billed_charge": 1454.0, "npi": [1154881498]}]}]}, {"tin": {"type": "ein", "value": "481153331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 196.86, "providers": [{"billed_charge": 1594.0, "npi": [1578660536]}]}, {"allowed_amount": 210.65, "providers": [{"billed_charge": 1594.0, "npi": [1821739962, 1205299575]}]}]}, {"tin": {"type": "ein", "value": "481169103"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 282.21, "providers": [{"billed_charge": 683.6, "npi": [1336536739]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2700.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4609.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 639.11, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1500.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 179.59, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 448.0, "npi": [1508430521]}]}, {"allowed_amount": 188.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 448.0, "npi": [1275140261]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2646.0, "npi": [1508883422]}]}, {"allowed_amount": 559.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2646.0, "npi": [1508883422]}]}, {"allowed_amount": 4066.04, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2646.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 210.65, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 365.0, "npi": [1447493218, 1174987523, 1194087239, 1316408586, 1144617515, 1457663213, 1093100398, 1770847634, 1245473107, 1982192886, 1164579959, 1235690744, 1578571766, 1932372406, 1912326299, 1174560510, 1487232575]}]}, {"allowed_amount": 212.17, "providers": [{"billed_charge": 365.0, "npi": [1821985227]}]}, {"allowed_amount": 281.91, "providers": [{"billed_charge": 365.0, "npi": [1811944457]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1472.83, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3556.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 656.46, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3868.7, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 576.6, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 5859.0, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "593677604"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 701.7, "providers": [{"billed_charge": 1528.0, "npi": [1275274508]}]}]}, {"tin": {"type": "ein", "value": "621179254"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 1043.62, "providers": [{"billed_charge": 1689.0, "npi": [1841226792]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3454.85, "providers": [{"billed_charge": 9871.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "721549752"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1468.7, "providers": [{"billed_charge": 6959.0, "npi": [1346230323]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2700.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1287.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 205.67, "providers": [{"billed_charge": 358.0, "npi": [1033618814]}]}, {"allowed_amount": 241.97, "providers": [{"billed_charge": 358.0, "npi": [1477796936, 1821042201, 1518254218]}]}]}, {"tin": {"type": "ein", "value": "753164164"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 205.07, "providers": [{"billed_charge": 726.0, "npi": [1972702215]}]}]}, {"tin": {"type": "ein", "value": "814390353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 210.65, "providers": [{"billed_charge": 1483.0, "npi": [1497215602]}]}]}, {"tin": {"type": "ein", "value": "825248763"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 105.33, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3522.0, "npi": [1891289419]}]}, {"allowed_amount": 210.65, "providers": [{"billed_charge": 3522.0, "npi": [1730759192, 1932425162]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4594.21, "npi": [1750921029]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4594.21, "npi": [1750921029]}]}, {"allowed_amount": 559.38, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 4594.21, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "833542131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 210.65, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3368.55, "npi": [1104086586, 1205898285]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2700.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1287.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 241.97, "providers": [{"billed_charge": 613.0, "npi": [1740442946, 1700220357, 1205024361, 1083683957, 1821042201]}]}]}, {"tin": {"type": "ein", "value": "880590424"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 205.41, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1488.0, "npi": [1609608348, 1003997925]}]}, {"allowed_amount": 210.65, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1488.0, "npi": [1265068928, 1982909891, 1154558674, 1790289502, 1285131839]}]}]}, {"tin": {"type": "ein", "value": "942494000"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 786.32, "providers": [{"billed_charge": 1415.0, "npi": [1649625526]}]}]}, {"tin": {"type": "ein", "value": "992417615"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 223.52, "providers": [{"billed_charge": 1004.0, "npi": [1972588663]}]}]}]}, {"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": "200718322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 114.48, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 589.0, "npi": [1841224946, 1699405381, 1184069957, 1407397615]}]}]}, {"tin": {"type": "ein", "value": "272774116"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 107.74, "providers": [{"billed_charge": 409.0, "npi": [1154431724]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 364.27, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1278.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 114.48, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 212.0, "npi": [1699064279]}]}]}, {"tin": {"type": "ein", "value": "430715842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 206.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 524.0, "npi": [1417991159]}]}]}, {"tin": {"type": "ein", "value": "430998341"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 83.45, "providers": [{"billed_charge": 367.0, "npi": [1821721127]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 143.61, "providers": [{"billed_charge": 210.0, "npi": [1790399681]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1100.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2280.0, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1057.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1377.54, "npi": [1093740128]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 93.9, "providers": [{"billed_charge": 277.85, "npi": [1992729974]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 758.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1895.0, "npi": [1154400232, 1366515488]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 111.6, "providers": [{"billed_charge": 186.0, "npi": [1851853089, 1568704930, 1760592836, 1063098853, 1992265946, 1629310156, 1871550830, 1346401361, 1548674484, 1730077942, 1871120824, 1568924090]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 127.52, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 582.0, "npi": [1114367216]}]}, {"allowed_amount": 216.77, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 582.0, "npi": [1770545451, 1518330604, 1417180175, 1124677521, 1154851186]}]}, {"allowed_amount": 255.03, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 582.0, "npi": [1063833366]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "providers": [{"billed_charge": 1435.28, "npi": [1528301900]}]}, {"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1435.28, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "464660005"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 435.74, "providers": [{"billed_charge": 5102.57, "npi": [1245785567]}]}]}, {"tin": {"type": "ein", "value": "471669781"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 332.29, "providers": [{"billed_charge": 1472.07, "npi": [1528463080]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 749.0, "npi": [1194782409]}]}, {"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 749.0, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480581968"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 83.27, "providers": [{"billed_charge": 161.0, "npi": [1649605478]}]}, {"allowed_amount": 83.56, "providers": [{"billed_charge": 161.0, "npi": [1427321843]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 107.74, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 589.0, "npi": [1497250880, 1750374724, 1184069957, 1568826022, 1821738667, 1063411916, 1407397615]}]}]}, {"tin": {"type": "ein", "value": "480860883"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 364.27, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 436.0, "npi": [1376548370]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1144.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1100.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2280.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1575.0, "npi": [1508883422]}]}, {"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1575.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 67.61, "providers": [{"billed_charge": 155.75, "npi": [1659634525]}]}, {"allowed_amount": 107.74, "providers": [{"billed_charge": 155.75, "npi": [1740786144, 1831155894, 1982192886]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 83.27, "providers": [{"billed_charge": 164.0, "npi": [1255855607]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 518.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 518.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 97.89, "providers": [{"billed_charge": 145.0, "npi": [1700220357]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2872.68, "npi": [1750921029]}]}, {"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2872.68, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "833542131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 107.74, "providers": [{"billed_charge": 1813.84, "npi": [1942248265, 1790723955, 1225240500, 1205095494]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 518.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 518.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 97.89, "providers": [{"billed_charge": 416.0, "npi": [1083683957]}]}]}, {"tin": {"type": "ein", "value": "900294051"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 99.32, "providers": [{"billed_charge": 177.0, "npi": [1942883731]}]}]}, {"tin": {"type": "ein", "value": "946003822"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 816.0, "providers": [{"billed_charge": 816.0, "npi": [1184662652]}]}]}]}, {"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": "200718322"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 292.02, "providers": [{"billed_charge": 1003.0, "npi": [1497250880, 1699405381, 1801018536, 1174262026, 1023696655, 1912466905, 1588927420, 1053059550]}]}]}, {"tin": {"type": "ein", "value": "272774116"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 81.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 776.0, "npi": [1073597209]}]}, {"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 776.0, "npi": [1083858880, 1932569571, 1831505544, 1720583628, 1588670962, 1154384626, 1235379124, 1598864662, 1649536632, 1679134969, 1922111418, 1205079803, 1093881500, 1477789725, 1861699134, 1609901727]}]}]}, {"tin": {"type": "ein", "value": "274338265"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 542.74, "providers": [{"billed_charge": 746.0, "npi": [1790758530]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 292.02, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 404.0, "npi": [1811212202]}]}]}, {"tin": {"type": "ein", "value": "341822821"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 170.97, "providers": [{"billed_charge": 1186.31, "npi": [1457062788]}]}]}, {"tin": {"type": "ein", "value": "383738197"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 936.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6046.0, "npi": [1518018191]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 261.8, "providers": [{"billed_charge": 276.0, "npi": [1184675159]}]}]}, {"tin": {"type": "ein", "value": "430652680"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 464.76, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1500.0, "npi": [1346251543]}]}]}, {"tin": {"type": "ein", "value": "430653611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 195.91, "providers": [{"billed_charge": 650.0, "npi": [1851418883]}]}]}, {"tin": {"type": "ein", "value": "430998341"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 154.27, "providers": [{"billed_charge": 627.0, "npi": [1467984161, 1013018555, 1609191964, 1659766731]}]}]}, {"tin": {"type": "ein", "value": "431832147"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 154.27, "providers": [{"billed_charge": 776.0, "npi": [1922448000, 1932132032, 1265019400, 1407099120, 1609901727, 1265164214, 1144236159]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1796.81, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2400.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 238.99, "providers": [{"billed_charge": 346.0, "npi": [1790399681]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3114.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440552485"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1057.66, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2200.0, "npi": [1578504056]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2798.0, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 172.56, "providers": [{"billed_charge": 448.26, "npi": [1366605149]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1283.6, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3209.0, "npi": [1154400232, 1366515488]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 190.2, "providers": [{"billed_charge": 317.0, "npi": [1760592836, 1104203561, 1972130607, 1871550095, 1346401361, 1962814863, 1588153654, 1457672982, 1174573786]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 981.42, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1529.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 287.0, "providers": [{"billed_charge": 287.0, "npi": [1710515366]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 366.3, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 987.0, "npi": [1427457597, 1770545451, 1518330604, 1972188779, 1417180175, 1124677521, 1154851186, 1073906426, 1639450109]}]}, {"allowed_amount": 430.94, "providers": [{"billed_charge": 987.0, "npi": [1740442946, 1720087109, 1992782122, 1801024203, 1013470574, 1114367216, 1174720148, 1063833366]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "providers": [{"billed_charge": 2152.31, "npi": [1528301900]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2152.31, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "464529066"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 195.91, "providers": [{"billed_charge": 301.3, "npi": [1497245112]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 990.0, "npi": [1194782409]}]}, {"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 990.0, "npi": [1194782409]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 990.0, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 81.19, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1003.0, "npi": [1407397615]}]}, {"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1003.0, "npi": [1013336320, 1174262026, 1801018536, 1821738667, 1447874482, 1073672499, 1588927420, 1235576125, 1497250880, 1750374724, 1184069957, 1336362953, 1063411916, 1356695001, 1154881498, 1821148123, 1447698915, 1407397615, 1841224946, 1851329908, 1992200695, 1457314429, 1649682303]}]}, {"allowed_amount": 865.75, "providers": [{"billed_charge": 1003.0, "npi": [1235576125]}]}, {"allowed_amount": 878.63, "providers": [{"billed_charge": 1003.0, "npi": [1184069957]}]}, {"allowed_amount": 880.4, "providers": [{"billed_charge": 1003.0, "npi": [1245506229]}]}, {"allowed_amount": 888.3, "providers": [{"billed_charge": 1003.0, "npi": [1447874482]}]}, {"allowed_amount": 898.47, "providers": [{"billed_charge": 1003.0, "npi": [1073672499]}]}, {"allowed_amount": 922.99, "providers": [{"billed_charge": 1003.0, "npi": [1699405381]}]}, {"allowed_amount": 936.75, "providers": [{"billed_charge": 1003.0, "npi": [1568826022]}]}]}, {"tin": {"type": "ein", "value": "481153331"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1098.0, "npi": [1740711001, 1821739962, 1205299575]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2139.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2798.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2400.0, "npi": [1508883422]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2400.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 146.09, "providers": [{"billed_charge": 240.0, "npi": [1316508591]}]}, {"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 240.0, "npi": [1174987523, 1316408586, 1770847634, 1912326299, 1124334370, 1144617515, 1326054453, 1831155894, 1487232575, 1194087239, 1952728016, 1245473107, 1740786144, 1679150304, 1447493218, 1982192886, 1578571766, 1235690744, 1174560510]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 200.46, "providers": [{"billed_charge": 345.0, "npi": [1427375930]}]}]}, {"tin": {"type": "ein", "value": "562488077"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2798.0, "npi": [1053353490]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1221.13, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3150.0, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2287.95, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 6537.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1032.0, "npi": [1588657928]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 817.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 817.0, "npi": [1316911878]}]}, {"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 817.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 141.53, "providers": [{"billed_charge": 238.0, "npi": [1033618814]}]}, {"allowed_amount": 166.5, "providers": [{"billed_charge": 238.0, "npi": [1700220357, 1477796936, 1518254218, 1912057647, 1821042201]}]}]}, {"tin": {"type": "ein", "value": "753164164"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 141.21, "providers": [{"billed_charge": 498.0, "npi": [1073774238, 1972702215]}]}]}, {"tin": {"type": "ein", "value": "814390353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 162.37, "providers": [{"billed_charge": 940.0, "npi": [1295130672]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 353.72, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3518.13, "npi": [1750921029]}]}, {"allowed_amount": 463.09, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 3518.13, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "833542131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 2461.65, "npi": [1134415557, 1205095494, 1942248265, 1821451501, 1205898285, 1114360435, 1225240500, 1790723955, 1104086586]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 817.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 817.0, "npi": [1639185457]}]}, {"allowed_amount": 2200.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 817.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 166.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 430.0, "npi": [1205024361, 1740442946, 1083683957, 1184011702]}]}]}, {"tin": {"type": "ein", "value": "860415065"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 138.88, "providers": [{"billed_charge": 1227.0, "npi": [1003158262]}]}]}, {"tin": {"type": "ein", "value": "880590424"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 141.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1026.0, "npi": [1609608348, 1073344628, 1003997925]}]}, {"allowed_amount": 162.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1026.0, "npi": [1265068928, 1790289502, 1225603319]}]}]}, {"tin": {"type": "ein", "value": "900065118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 444.58, "providers": [{"billed_charge": 2175.0, "npi": [1275566200]}]}]}, {"tin": {"type": "ein", "value": "946003822"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1266.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1266.0, "npi": [1184662652]}]}]}]}, {"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": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 251.09, "providers": [{"billed_charge": 1104.0, "npi": [1972535052]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 400.0, "providers": [{"billed_charge": 1073.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 443.6, "providers": [{"billed_charge": 1109.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 66.0, "providers": [{"billed_charge": 110.0, "npi": [1871550095]}]}]}, {"tin": {"type": "ein", "value": "452914664"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 126.39, "providers": [{"billed_charge": 343.0, "npi": [1124677521, 1770545451]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 445.0, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480581968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 252.75, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 347.0, "npi": [1700994977]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 400.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1072.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 945.0, "npi": [1508883422]}]}, {"allowed_amount": 1098.0, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 945.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 87.25, "providers": [{"billed_charge": 87.25, "npi": [1194087239]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 223.99, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 1581.32, "npi": [1750921029]}]}]}]}, {"name": "Gonadotropin, chorionic (hCG); qualitative", "billing_code_type": "CPT", "billing_code": "84703", "billing_code_type_version": "2022", "description": "GONADOTROPIN CHORIONIC QUALITATIVE", "allowed_amounts": [{"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.92, "providers": [{"billed_charge": 170.47, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 46.0, "providers": [{"billed_charge": 46.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.92, "providers": [{"billed_charge": 208.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 35.88, "providers": [{"billed_charge": 327.48, "npi": [1962461681]}]}]}]}, {"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": "362867831"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.76, "providers": [{"billed_charge": 21.65, "npi": [1588751598]}]}]}, {"tin": {"type": "ein", "value": "431097068"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.9, "providers": [{"billed_charge": 19.45, "npi": [1457386385]}]}]}, {"tin": {"type": "ein", "value": "446000201"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.9, "providers": [{"billed_charge": 10.0, "npi": [1730419227]}]}]}, {"tin": {"type": "ein", "value": "446000208"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.9, "providers": [{"billed_charge": 17.5, "npi": [1396721502]}]}]}, {"tin": {"type": "ein", "value": "481194075"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.9, "providers": [{"billed_charge": 15.0, "npi": [1639157555]}]}]}, {"tin": {"type": "ein", "value": "481227663"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.88, "providers": [{"billed_charge": 24.5, "npi": [1891063681, 1184628455]}]}]}, {"tin": {"type": "ein", "value": "486000798"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.07, "providers": [{"billed_charge": 17.0, "npi": [1215075411]}]}]}, {"tin": {"type": "ein", "value": "486025049"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.28, "providers": [{"billed_charge": 14.0, "npi": [1447795778]}]}]}, {"tin": {"type": "ein", "value": "486026115"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.28, "providers": [{"billed_charge": 16.0, "npi": [1689720617]}]}]}, {"tin": {"type": "ein", "value": "486033520"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.12, "providers": [{"billed_charge": 15.24, "npi": [1437153038]}]}]}, {"tin": {"type": "ein", "value": "486034760"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.9, "providers": [{"billed_charge": 18.67, "npi": [1093792046]}, {"billed_charge": 18.68, "npi": [1093792046]}]}]}, {"tin": {"type": "ein", "value": "486036941"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.28, "providers": [{"billed_charge": 16.0, "npi": [1053880005]}]}]}, {"tin": {"type": "ein", "value": "486038022"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.88, "providers": [{"billed_charge": 15.95, "npi": [1639151897]}]}, {"allowed_amount": 11.27, "providers": [{"billed_charge": 15.95, "npi": [1639151897]}]}, {"allowed_amount": 11.28, "providers": [{"billed_charge": 15.95, "npi": [1639151897]}]}]}, {"tin": {"type": "ein", "value": "486038307"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 8.22, "providers": [{"billed_charge": 15.0, "npi": [1558361162]}, {"billed_charge": 18.0, "npi": [1558361162]}]}]}, {"tin": {"type": "ein", "value": "486039815"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 11.28, "providers": [{"billed_charge": 15.0, "npi": [1750322988]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 5.91, "providers": [{"billed_charge": 14.78, "npi": [1871528901]}]}]}, {"tin": {"type": "ein", "value": "770324739"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 36.59, "providers": [{"billed_charge": 86.0, "npi": [1578597803]}]}]}, {"tin": {"type": "ein", "value": "880125707"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 16.18, "providers": [{"billed_charge": 38.35, "npi": [1235232562]}]}]}, {"tin": {"type": "ein", "value": "953743718"}, "billing_class": "professional", "service_codes": ["41"], "payments": [{"allowed_amount": 9.88, "providers": [{"billed_charge": 18.2, "npi": [1104830850]}]}, {"allowed_amount": 9.9, "providers": [{"billed_charge": 15.42, "npi": [1578762308]}]}]}]}, {"name": "Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed", "billing_code_type": "CPT", "billing_code": "77387", "billing_code_type_version": "2022", "description": "GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR", "allowed_amounts": [{"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 104.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 106.0, "npi": [1659720225, 1831418276, 1356392385]}]}]}]}, {"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": "271371893"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 20.22, "providers": [{"billed_charge": 737.0, "npi": [1588862353]}]}, {"allowed_amount": 123.83, "providers": [{"billed_charge": 737.0, "npi": [1518673367, 1396478426, 1912469586, 1861058455]}]}, {"allowed_amount": 148.88, "providers": [{"billed_charge": 737.0, "npi": [1356964076, 1063866374]}]}, {"allowed_amount": 152.74, "providers": [{"billed_charge": 737.0, "npi": [1689733701, 1780677831, 1639305832, 1104961002, 1669035531, 1780178541, 1497066799, 1578738191, 1871170258, 1255999223, 1508933565, 1063876894, 1659511038]}]}]}, {"tin": {"type": "ein", "value": "274185968"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 123.83, "providers": [{"billed_charge": 454.0, "npi": [1376810598]}]}, {"allowed_amount": 152.74, "providers": [{"billed_charge": 454.0, "npi": [1902899834, 1932194925]}]}]}, {"tin": {"type": "ein", "value": "331159776"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 152.74, "providers": [{"billed_charge": 175.0, "npi": [1538252622]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 20.22, "providers": [{"billed_charge": 405.0, "npi": [1851028369]}]}, {"allowed_amount": 110.75, "providers": [{"billed_charge": 411.0, "npi": [1063876894, 1497066799]}]}, {"allowed_amount": 148.88, "providers": [{"billed_charge": 405.0, "npi": [1134772106, 1619553526]}, {"billed_charge": 411.0, "npi": [1457766974]}]}, {"allowed_amount": 152.74, "providers": [{"billed_charge": 411.0, "npi": [1609045152, 1689733701, 1104961002, 1497066799, 1467005108]}]}, {"allowed_amount": 158.27, "providers": [{"billed_charge": 405.0, "npi": [1558968834, 1356804124, 1205892239, 1740668144, 1851028369, 1982264305, 1336240696, 1144970203, 1780236380]}]}, {"allowed_amount": 190.99, "providers": [{"billed_charge": 411.0, "npi": [1457766974]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 151.62, "providers": [{"billed_charge": 269.0, "npi": [1558535377, 1457884355, 1356834774, 1780124446]}]}, {"allowed_amount": 156.95, "providers": [{"billed_charge": 269.0, "npi": [1275821282, 1831332444]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 180.6, "providers": [{"billed_charge": 301.0, "npi": [1659021566]}]}]}, {"tin": {"type": "ein", "value": "460899960"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 445.22, "providers": [{"billed_charge": 940.36, "npi": [1962684282]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 110.8, "providers": [{"billed_charge": 222.47, "npi": [1568549269]}]}, {"allowed_amount": 152.74, "providers": [{"billed_charge": 222.47, "npi": [1154855617, 1023159522, 1033643572, 1255366902, 1932696119, 1619069176, 1992327449, 1144970203, 1598929945]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 152.74, "providers": [{"billed_charge": 500.0, "npi": [1891130936, 1447710546, 1710117296]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 114.68, "providers": [{"billed_charge": 312.0, "npi": [1417238494]}]}, {"allowed_amount": 148.88, "providers": [{"billed_charge": 312.0, "npi": [1427270750, 1235577511]}]}]}, {"tin": {"type": "ein", "value": "472538324"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 182.26, "providers": [{"billed_charge": 500.0, "npi": [1790071074]}]}]}, {"tin": {"type": "ein", "value": "475317446"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 311.3, "providers": [{"billed_charge": 313.46, "npi": [1437213998]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 148.88, "providers": [{"billed_charge": 193.47, "npi": [1184744609, 1740801059, 1417239013, 1376033894, 1578735056, 1134409105, 1801280086, 1659877470, 1598170367]}]}, {"allowed_amount": 158.27, "providers": [{"billed_charge": 193.47, "npi": [1902865769, 1972910651, 1467831693]}]}]}, {"tin": {"type": "ein", "value": "821368185"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 123.83, "providers": [{"billed_charge": 210.0, "npi": [1407344468]}]}, {"allowed_amount": 182.26, "providers": [{"billed_charge": 210.0, "npi": [1659959989]}]}]}, {"tin": {"type": "ein", "value": "993151146"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 182.26, "providers": [{"billed_charge": 748.0, "npi": [1952036220, 1205363926]}]}]}]}, {"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": "334448577"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 60.23, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 336.0, "npi": [1033099064]}]}]}, {"tin": {"type": "ein", "value": "461721865"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 34.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 200.0, "npi": [1205331832, 1063732493, 1770543134]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 257.6, "providers": [{"billed_charge": 736.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "710847813"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 50.57, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.57, "npi": [1578096533]}]}]}, {"tin": {"type": "ein", "value": "854208910"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 34.08, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 105.0, "npi": [1083176291, 1093159782, 1760914279, 1326466475, 1245468909, 1518087162, 1992021406]}]}, {"allowed_amount": 39.68, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 105.0, "npi": [1972947026]}]}]}]}, {"name": "Infusion, normal saline solution , 1000 cc", "billing_code_type": "CPT", "billing_code": "J7030", "billing_code_type_version": "2022", "description": "Infusion, normal saline solution , 1000 cc", "allowed_amounts": [{"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.15, "providers": [{"billed_charge": 57.54, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 90.42, "providers": [{"billed_charge": 258.35, "npi": [1063494177]}]}, {"allowed_amount": 103.76, "providers": [{"billed_charge": 296.45, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 103.76, "providers": [{"billed_charge": 296.45, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 61.79, "providers": [{"billed_charge": 102.98, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.97, "providers": [{"billed_charge": 35.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.18, "providers": [{"billed_charge": 30.0, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.18, "providers": [{"billed_charge": 100.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 90.42, "providers": [{"billed_charge": 258.35, "npi": [1154303337]}]}, {"allowed_amount": 103.76, "providers": [{"billed_charge": 296.45, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.18, "providers": [{"billed_charge": 57.85, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.98, "providers": [{"billed_charge": 62.79, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 113.9, "providers": [{"billed_charge": 325.42, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.0, "providers": [{"billed_charge": 60.0, "npi": [1316911878]}]}, {"allowed_amount": 60.0, "providers": [{"billed_charge": 60.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.18, "providers": [{"billed_charge": 80.63, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.71, "providers": [{"billed_charge": 27.75, "npi": [1639185457]}]}, {"allowed_amount": 27.75, "providers": [{"billed_charge": 27.75, "npi": [1639185457]}]}]}]}, {"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": "200824873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 345.0, "npi": [1063612554]}]}]}, {"tin": {"type": "ein", "value": "264263575"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.85, "providers": [{"billed_charge": 380.0, "npi": [1487092797]}]}]}, {"tin": {"type": "ein", "value": "271371893"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 29.76, "providers": [{"billed_charge": 1389.0, "npi": [1992208706]}]}, {"allowed_amount": 187.56, "providers": [{"billed_charge": 1389.0, "npi": [1518673367, 1790336519, 1255096558, 1912469586, 1629464631, 1861058455]}]}, {"allowed_amount": 209.66, "providers": [{"billed_charge": 1389.0, "npi": [1992208706, 1376711044, 1407599269, 1689733701, 1639305832, 1790314797, 1821430125, 1578738191, 1497066799, 1871170258, 1427498518, 1508933565, 1063876894]}]}, {"allowed_amount": 275.99, "providers": [{"billed_charge": 1389.0, "npi": [1356964076]}]}]}, {"tin": {"type": "ein", "value": "274185968"}, "billing_class": "professional", "service_codes": ["52", "51", "61", "21"], "payments": [{"allowed_amount": 187.56, "providers": [{"billed_charge": 812.0, "npi": [1356051676, 1467844340]}, {"billed_charge": 853.0, "npi": [1336592328]}]}, {"allowed_amount": 209.66, "providers": [{"billed_charge": 853.0, "npi": [1932194925]}]}]}, {"tin": {"type": "ein", "value": "331159776"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 187.56, "providers": [{"billed_charge": 330.0, "npi": [1710454855]}]}]}, {"tin": {"type": "ein", "value": "332787291"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 220.01, "providers": [{"billed_charge": 534.0, "npi": [1720516776]}]}]}, {"tin": {"type": "ein", "value": "363966745"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.85, "providers": [{"billed_charge": 480.0, "npi": [1336777184]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 29.76, "providers": [{"billed_charge": 765.0, "npi": [1851028369]}]}, {"allowed_amount": 187.56, "providers": [{"billed_charge": 773.0, "npi": [1245538891]}, {"billed_charge": 776.0, "npi": [1467292243, 1245538891, 1336883859, 1841905593]}]}, {"allowed_amount": 209.57, "providers": [{"billed_charge": 773.0, "npi": [1588862353, 1780677831]}]}, {"allowed_amount": 209.66, "providers": [{"billed_charge": 776.0, "npi": [1104961002]}]}, {"allowed_amount": 209.85, "providers": [{"billed_charge": 765.0, "npi": [1811375058, 1104433762]}]}, {"allowed_amount": 248.99, "providers": [{"billed_charge": 765.0, "npi": [1558968834, 1881114213, 1205892239, 1740668144, 1982264305, 1851028369, 1922680982, 1336240696, 1356804124]}]}, {"allowed_amount": 275.99, "providers": [{"billed_charge": 765.0, "npi": [1134772106, 1619553526]}, {"billed_charge": 776.0, "npi": [1457766974]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 223.19, "providers": [{"billed_charge": 509.0, "npi": [1457884355, 1720498413, 1558535377, 1134166770, 1083835771]}]}, {"allowed_amount": 231.41, "providers": [{"billed_charge": 509.0, "npi": [1275821282, 1760864730, 1831332444]}]}]}, {"tin": {"type": "ein", "value": "454006393"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 468.43, "providers": [{"billed_charge": 749.0, "npi": [1861718249]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 187.56, "providers": [{"billed_charge": 337.28, "npi": [1063043297, 1477260016, 1992314678, 1326585399, 1962734715, 1194996892]}]}, {"allowed_amount": 199.86, "providers": [{"billed_charge": 337.28, "npi": [1265450217]}]}, {"allowed_amount": 209.66, "providers": [{"billed_charge": 337.28, "npi": [1023159522, 1255366902, 1992327449, 1689776890, 1144970203, 1598929945]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 600.0, "npi": [1891130936, 1447710546, 1710117296]}]}, {"allowed_amount": 276.5, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 446.37, "npi": [1427007764]}]}]}, {"tin": {"type": "ein", "value": "465027835"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 300.63, "providers": [{"billed_charge": 2047.44, "npi": [1285252973]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 216.99, "providers": [{"billed_charge": 505.75, "npi": [1417238494]}]}]}, {"tin": {"type": "ein", "value": "472209130"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.85, "providers": [{"billed_charge": 478.0, "npi": [1952417644, 1699878504, 1982642476]}]}]}, {"tin": {"type": "ein", "value": "472538324"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 330.37, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 600.0, "npi": [1790071074]}]}]}, {"tin": {"type": "ein", "value": "475317446"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 472.07, "providers": [{"billed_charge": 472.07, "npi": [1962591313, 1437213998]}]}]}, {"tin": {"type": "ein", "value": "480767137"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 475.0, "npi": [1922489244]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 282.48, "providers": [{"billed_charge": 1441.0, "npi": [1073672499]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 199.86, "providers": [{"billed_charge": 365.81, "npi": [1952327553]}]}, {"allowed_amount": 209.85, "providers": [{"billed_charge": 365.81, "npi": [1841770773, 1710691886]}]}, {"allowed_amount": 239.47, "providers": [{"billed_charge": 365.81, "npi": [1982868097]}]}, {"allowed_amount": 248.99, "providers": [{"billed_charge": 365.81, "npi": [1982337184, 1467831693, 1366412751]}]}, {"allowed_amount": 269.92, "providers": [{"billed_charge": 365.81, "npi": [1972165793]}]}, {"allowed_amount": 275.99, "providers": [{"billed_charge": 365.81, "npi": [1184744609, 1699169540, 1417239013, 1376033894, 1386195469, 1578735056, 1659877470]}]}, {"allowed_amount": 276.5, "providers": [{"billed_charge": 365.81, "npi": [1346463825, 1811276934]}]}]}, {"tin": {"type": "ein", "value": "743083325"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 350.0, "npi": [1578660585]}]}]}, {"tin": {"type": "ein", "value": "821368185"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 330.37, "providers": [{"billed_charge": 460.0, "npi": [1386873743]}]}]}, {"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.85, "providers": [{"billed_charge": 449.0, "npi": [1881696136]}]}]}, {"tin": {"type": "ein", "value": "830528240"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 199.86, "providers": [{"billed_charge": 395.0, "npi": [1790712750]}]}]}, {"tin": {"type": "ein", "value": "833542131"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 282.48, "providers": [{"billed_charge": 2318.34, "npi": [1114360435, 1285627323, 1225240500]}]}]}, {"tin": {"type": "ein", "value": "863429621"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 478.0, "npi": [1295825685]}]}]}, {"tin": {"type": "ein", "value": "863916317"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.57, "providers": [{"billed_charge": 964.0, "npi": [1598881021]}]}]}, {"tin": {"type": "ein", "value": "882355153"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 195.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 723.8, "npi": [1033423553]}]}]}, {"tin": {"type": "ein", "value": "922116659"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 260.1, "providers": [{"billed_charge": 1107.0, "npi": [1194118950]}]}]}, {"tin": {"type": "ein", "value": "993151146"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 330.37, "providers": [{"billed_charge": 1415.0, "npi": [1396321907, 1457001091, 1538746334]}]}]}, {"tin": {"type": "ein", "value": "993984379"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.66, "providers": [{"billed_charge": 390.0, "npi": [1780677948]}]}]}]}, {"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": "202738286"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 142.34, "providers": [{"billed_charge": 260.0, "npi": [1285603704]}]}]}, {"tin": {"type": "ein", "value": "271371893"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 140.54, "providers": [{"billed_charge": 948.0, "npi": [1912469586]}]}, {"allowed_amount": 142.34, "providers": [{"billed_charge": 948.0, "npi": [1780677831, 1639305832, 1104961002, 1982840336, 1427498518]}]}]}, {"tin": {"type": "ein", "value": "274185968"}, "billing_class": "professional", "service_codes": ["51", "52", "21"], "payments": [{"allowed_amount": 140.54, "providers": [{"billed_charge": 551.0, "npi": [1356051676, 1467844340]}, {"billed_charge": 579.0, "npi": [1336592328]}]}, {"allowed_amount": 142.34, "providers": [{"billed_charge": 579.0, "npi": [1194704312]}]}, {"allowed_amount": 345.98, "providers": [{"billed_charge": 551.0, "npi": [1356051676, 1467844340]}]}]}, {"tin": {"type": "ein", "value": "363097297"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 191.05, "providers": [{"billed_charge": 420.0, "npi": [1205028578]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 142.34, "providers": [{"billed_charge": 523.0, "npi": [1558968834, 1356804124]}]}, {"allowed_amount": 156.94, "providers": [{"billed_charge": 523.0, "npi": [1811375058, 1104433762]}]}]}, {"tin": {"type": "ein", "value": "416011702"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 209.95, "providers": [{"billed_charge": 641.0, "npi": [1952989683]}]}]}, {"tin": {"type": "ein", "value": "431454831"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 135.42, "providers": [{"billed_charge": 231.0, "npi": [1750370615]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 173.04, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 344.0, "npi": [1144266248, 1881117091]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 204.6, "providers": [{"billed_charge": 341.0, "npi": [1831483882]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 140.54, "providers": [{"billed_charge": 254.55, "npi": [1477260016]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 98.85, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.82, "npi": [1013973288]}]}, {"allowed_amount": 140.54, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.82, "npi": [1740603935]}]}, {"allowed_amount": 142.34, "providers": [{"billed_charge": 332.82, "npi": [1720245442]}]}, {"allowed_amount": 156.94, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 332.82, "npi": [1003252453, 1063707438]}]}, {"allowed_amount": 167.86, "providers": [{"billed_charge": 332.82, "npi": [1689767535]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 146.65, "providers": [{"billed_charge": 413.0, "npi": [1689829038]}]}, {"allowed_amount": 147.32, "providers": [{"billed_charge": 413.0, "npi": [1871770313]}]}, {"allowed_amount": 156.94, "providers": [{"billed_charge": 413.0, "npi": [1992702492]}]}]}, {"tin": {"type": "ein", "value": "480767137"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 142.34, "providers": [{"billed_charge": 350.0, "npi": [1588191977, 1760879639]}]}, {"allowed_amount": 167.86, "providers": [{"billed_charge": 350.0, "npi": [1003263419, 1225008220, 1205923109]}]}, {"allowed_amount": 180.93, "providers": [{"billed_charge": 350.0, "npi": [1922489244]}]}]}, {"tin": {"type": "ein", "value": "481156958"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 156.94, "providers": [{"billed_charge": 236.0, "npi": [1740802685]}]}, {"allowed_amount": 224.02, "providers": [{"billed_charge": 236.0, "npi": [1538546973]}]}]}, {"tin": {"type": "ein", "value": "481164346"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 142.34, "providers": [{"billed_charge": 195.0, "npi": [1467794792]}]}]}, {"tin": {"type": "ein", "value": "481216340"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 153.02, "providers": [{"billed_charge": 268.0, "npi": [1164794368, 1295501872]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 135.42, "providers": [{"billed_charge": 247.16, "npi": [1790877660]}]}, {"allowed_amount": 142.34, "providers": [{"billed_charge": 247.16, "npi": [1134726466, 1417054404]}]}, {"allowed_amount": 156.94, "providers": [{"billed_charge": 247.16, "npi": [1619830114, 1497140420, 1124467972, 1780959536, 1821727124, 1841770773, 1336186329]}]}, {"allowed_amount": 207.31, "providers": [{"billed_charge": 247.16, "npi": [1033473426]}]}, {"allowed_amount": 247.16, "providers": [{"billed_charge": 247.16, "npi": [1851470645]}]}]}, {"tin": {"type": "ein", "value": "812951254"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 156.94, "providers": [{"billed_charge": 248.0, "npi": [1619075355, 1548674989]}]}]}, {"tin": {"type": "ein", "value": "830528240"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 135.42, "providers": [{"billed_charge": 266.0, "npi": [1790712750]}]}]}, {"tin": {"type": "ein", "value": "872020101"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 151.74, "providers": [{"billed_charge": 205.0, "npi": [1922236991]}]}]}, {"tin": {"type": "ein", "value": "942854057"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 206.38, "providers": [{"billed_charge": 314.0, "npi": [1669052585]}]}]}]}, {"name": "Injection, fentanyl citrate, 0.1 mg", "billing_code_type": "CPT", "billing_code": "J3010", "billing_code_type_version": "2022", "description": "Injection, fentanyl citrate, 0.1 mg", "allowed_amounts": [{"tin": {"type": "ein", "value": "440552485"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 8.35, "providers": [{"billed_charge": 20.0, "npi": [1578504056]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 18.65, "providers": [{"billed_charge": 31.08, "npi": [1366515488]}]}, {"allowed_amount": 22.1, "providers": [{"billed_charge": 36.83, "npi": [1154400232]}]}, {"allowed_amount": 49.76, "providers": [{"billed_charge": 82.94, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.41, "providers": [{"billed_charge": 54.1, "npi": [1194782409]}, {"billed_charge": 55.15, "npi": [1194782409]}, {"billed_charge": 55.2, "npi": [1194782409]}, {"billed_charge": 57.3, "npi": [1194782409]}, {"billed_charge": 57.4, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 35.51, "providers": [{"billed_charge": 101.45, "npi": [1154303337]}]}, {"allowed_amount": 40.23, "providers": [{"billed_charge": 114.95, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 11.0, "providers": [{"billed_charge": 11.0, "npi": [1306875745]}]}, {"allowed_amount": 12.7, "providers": [{"billed_charge": 12.7, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.41, "providers": [{"billed_charge": 45.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.87, "providers": [{"billed_charge": 60.52, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 5.25, "providers": [{"billed_charge": 15.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.41, "providers": [{"billed_charge": 31.33, "npi": [1750921029]}]}]}]}, {"name": "Injection, ketorolac tromethamine, per 15 mg", "billing_code_type": "CPT", "billing_code": "J1885", "billing_code_type_version": "2022", "description": "Injection, ketorolac tromethamine, per 15 mg", "allowed_amounts": [{"tin": {"type": "ein", "value": "141973790"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 0.48, "providers": [{"billed_charge": 25.0, "npi": [1548682941]}]}]}, {"tin": {"type": "ein", "value": "262583411"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 10.61, "providers": [{"billed_charge": 12.12, "npi": [1659538858]}]}]}, {"tin": {"type": "ein", "value": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 4.73, "providers": [{"billed_charge": 20.15, "npi": [1972535052]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.31, "providers": [{"billed_charge": 1.31, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 21.83, "providers": [{"billed_charge": 25.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.49, "providers": [{"billed_charge": 18.55, "npi": [1063494177]}]}, {"allowed_amount": 18.48, "providers": [{"billed_charge": 52.8, "npi": [1063494177]}]}, {"allowed_amount": 21.09, "providers": [{"billed_charge": 60.27, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.49, "providers": [{"billed_charge": 18.55, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 4.27, "providers": [{"billed_charge": 21.33, "npi": [1093740128]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 35.14, "providers": [{"billed_charge": 58.57, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.25, "providers": [{"billed_charge": 12.5, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 7.92, "providers": [{"billed_charge": 9.1, "npi": [1528301900]}, {"billed_charge": 12.12, "npi": [1528301900]}, {"billed_charge": 22.5, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 7.92, "providers": [{"billed_charge": 11.66, "npi": [1194782409]}, {"billed_charge": 21.43, "npi": [1194782409]}, {"billed_charge": 41.8, "npi": [1194782409]}, {"billed_charge": 47.2, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480860883"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 13.27, "providers": [{"billed_charge": 20.0, "npi": [1376548370]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2.61, "providers": [{"billed_charge": 7.45, "npi": [1154303337]}]}, {"allowed_amount": 4.38, "providers": [{"billed_charge": 12.5, "npi": [1154303337]}]}, {"allowed_amount": 6.49, "providers": [{"billed_charge": 18.52, "npi": [1154303337]}, {"billed_charge": 18.55, "npi": [1154303337]}]}, {"allowed_amount": 18.48, "providers": [{"billed_charge": 52.8, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 7.92, "providers": [{"billed_charge": 45.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.8, "providers": [{"billed_charge": 3.85, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.24, "providers": [{"billed_charge": 7.93, "npi": [1962461681]}, {"billed_charge": 18.92, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 6.4, "providers": [{"billed_charge": 6.4, "npi": [1316911878]}]}, {"allowed_amount": 12.5, "providers": [{"billed_charge": 12.5, "npi": [1316911878]}]}, {"allowed_amount": 23.85, "providers": [{"billed_charge": 23.85, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 7.92, "providers": [{"billed_charge": 32.53, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "850732004"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 0.59, "providers": [{"billed_charge": 1.0, "npi": [1508595869]}]}]}]}, {"name": "Injection, ondansetron hydrochloride, per 1 mg", "billing_code_type": "CPT", "billing_code": "J2405", "billing_code_type_version": "2022", "description": "Injection, ondansetron hydrochloride, per 1 mg", "allowed_amounts": [{"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.15, "providers": [{"billed_charge": 0.15, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.71, "providers": [{"billed_charge": 2.75, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.76, "providers": [{"billed_charge": 5.03, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440552485"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.57, "providers": [{"billed_charge": 2.75, "npi": [1578504056]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.83, "providers": [{"billed_charge": 6.39, "npi": [1154400232]}]}, {"allowed_amount": 5.86, "providers": [{"billed_charge": 9.77, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2.12, "providers": [{"billed_charge": 6.25, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2.58, "providers": [{"billed_charge": 10.45, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.09, "providers": [{"billed_charge": 3.13, "npi": [1154303337]}]}, {"allowed_amount": 1.67, "providers": [{"billed_charge": 4.76, "npi": [1154303337]}]}, {"allowed_amount": 2.17, "providers": [{"billed_charge": 6.19, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2.58, "providers": [{"billed_charge": 11.38, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.59, "providers": [{"billed_charge": 4.73, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.2, "providers": [{"billed_charge": 1.6, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.69, "providers": [{"billed_charge": 130.55, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.09, "providers": [{"billed_charge": 3.13, "npi": [1316911878]}]}, {"allowed_amount": 3.13, "providers": [{"billed_charge": 3.13, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 2.58, "providers": [{"billed_charge": 32.53, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.75, "providers": [{"billed_charge": 5.0, "npi": [1639185457]}]}]}]}, {"name": "Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)", "billing_code_type": "CPT", "billing_code": "96361", "billing_code_type_version": "2022", "description": "IV INFUSION HYDRATION EACH ADDITIONAL HOUR", "allowed_amounts": [{"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 112.62, "providers": [{"billed_charge": 150.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 111.84, "providers": [{"billed_charge": 165.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.27, "providers": [{"billed_charge": 246.79, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.27, "providers": [{"billed_charge": 304.12, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.27, "providers": [{"billed_charge": 255.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.27, "providers": [{"billed_charge": 293.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 72.13, "providers": [{"billed_charge": 132.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 49.73, "providers": [{"billed_charge": 348.63, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 20.0, "providers": [{"billed_charge": 50.0, "npi": [1316911878]}]}, {"allowed_amount": 210.0, "providers": [{"billed_charge": 210.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 70.27, "providers": [{"billed_charge": 353.58, "npi": [1750921029]}]}]}]}, {"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": "430922750"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 73.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1790218725]}]}, {"allowed_amount": 82.91, "providers": [{"billed_charge": 255.0, "npi": [1790218725]}]}]}, {"tin": {"type": "ein", "value": "461721865"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 36.45, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 250.0, "npi": [1871553305, 1811124753, 1063732493, 1770543134]}]}]}, {"tin": {"type": "ein", "value": "480777041"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 70.14, "providers": [{"billed_charge": 212.88, "npi": [1144233156]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 763.0, "providers": [{"billed_charge": 2180.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "710847813"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 60.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.7, "npi": [1578096533]}]}]}, {"tin": {"type": "ein", "value": "800564919"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 59.71, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 260.0, "npi": [1568921518]}]}]}, {"tin": {"type": "ein", "value": "854208910"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 36.45, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1083176291, 1790218725, 1093159782, 1760914279, 1326466475, 1245468909, 1518087162, 1992021406]}]}, {"allowed_amount": 51.04, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1972947026]}]}]}, {"tin": {"type": "ein", "value": "941742737"}, "billing_class": "professional", "service_codes": ["81"], "payments": [{"allowed_amount": 150.0, "providers": [{"billed_charge": 150.0, "npi": [1497929343]}]}]}]}, {"name": "Lipase", "billing_code_type": "CPT", "billing_code": "83690", "billing_code_type_version": "2022", "description": "ASSAY OF LIPASE", "allowed_amounts": [{"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 52.32, "providers": [{"billed_charge": 265.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.39, "providers": [{"billed_charge": 41.96, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 82.22, "providers": [{"billed_charge": 110.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 51.0, "providers": [{"billed_charge": 85.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 36.0, "providers": [{"billed_charge": 36.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.71, "providers": [{"billed_charge": 211.17, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.71, "providers": [{"billed_charge": 211.36, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.0, "providers": [{"billed_charge": 45.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.71, "providers": [{"billed_charge": 242.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 43.2, "providers": [{"billed_charge": 256.11, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 34.32, "providers": [{"billed_charge": 384.84, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 49.55, "providers": [{"billed_charge": 49.55, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 187.25, "providers": [{"billed_charge": 535.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 118.0, "providers": [{"billed_charge": 118.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 25.71, "providers": [{"billed_charge": 221.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 118.0, "providers": [{"billed_charge": 118.0, "npi": [1639185457]}]}]}]}, {"name": "Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml", "billing_code_type": "CPT", "billing_code": "Q9967", "billing_code_type_version": "2022", "description": "Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml", "allowed_amounts": [{"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.24, "providers": [{"billed_charge": 3.52, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.49, "providers": [{"billed_charge": 0.49, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.46, "providers": [{"billed_charge": 1.32, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.46, "providers": [{"billed_charge": 1.32, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 8.24, "providers": [{"billed_charge": 8.24, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.46, "providers": [{"billed_charge": 1.32, "npi": [1154303337]}]}, {"allowed_amount": 0.47, "providers": [{"billed_charge": 1.32, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.62, "providers": [{"billed_charge": 5.08, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 3.34, "providers": [{"billed_charge": 3.34, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.45, "providers": [{"billed_charge": 2.0, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.32, "providers": [{"billed_charge": 1.16, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.45, "providers": [{"billed_charge": 1.28, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.46, "providers": [{"billed_charge": 1.32, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1.32, "providers": [{"billed_charge": 1.32, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 0.46, "providers": [{"billed_charge": 1.32, "npi": [1639185457]}]}, {"allowed_amount": 0.47, "providers": [{"billed_charge": 1.32, "npi": [1639185457]}]}]}]}, {"name": "Magnesium", "billing_code_type": "CPT", "billing_code": "83735", "billing_code_type_version": "2022", "description": "ASSAY OF MAGNESIUM", "allowed_amounts": [{"tin": {"type": "ein", "value": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 11.28, "providers": [{"billed_charge": 100.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 28.73, "providers": [{"billed_charge": 223.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 49.8, "providers": [{"billed_charge": 83.0, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.84, "providers": [{"billed_charge": 211.36, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.84, "providers": [{"billed_charge": 90.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.84, "providers": [{"billed_charge": 182.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 245.7, "providers": [{"billed_charge": 702.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.84, "providers": [{"billed_charge": 238.67, "npi": [1750921029]}]}]}]}, {"name": "Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material", "billing_code_type": "CPT", "billing_code": "70551", "billing_code_type_version": "2022", "description": "MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 116.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 310.0, "npi": [1497784896, 1306340195, 1902867336, 1174662894, 1538303383, 1528118106, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 417.53, "providers": [{"billed_charge": 2976.6, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 116.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1508205345, 1538368451, 1790149748]}]}, {"allowed_amount": 132.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1417972944, 1689613093]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 68.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1447697321]}]}, {"allowed_amount": 116.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1891226304, 1629365010, 1265656979, 1316942576]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 132.01, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 300.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 116.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 245.0, "npi": [1629276555]}]}]}]}, {"name": "Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences", "billing_code_type": "CPT", "billing_code": "70553", "billing_code_type_version": "2022", "description": "MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "260376717"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 143.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 461.0, "npi": [1245641109]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 163.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 421.0, "npi": [1881837748]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 155.25, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 290.0, "npi": [1952347270]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 163.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 430.0, "npi": [1306340195, 1902867336, 1598883787, 1215166681, 1821009531, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 163.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 414.0, "npi": [1508205345, 1689607301, 1376694901, 1245296805]}]}, {"allowed_amount": 204.68, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 414.0, "npi": [1508205345, 1942867411, 1689613093]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 163.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1891226304, 1629365010, 1265656979]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 163.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 390.0, "npi": [1396793923]}]}]}]}, {"name": "Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material", "billing_code_type": "CPT", "billing_code": "72141", "billing_code_type_version": "2022", "description": "MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 68.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 315.0, "npi": [1326201617]}]}, {"allowed_amount": 113.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 315.0, "npi": [1306340195, 1902867336, 1174662894, 1508229808, 1538303383, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 113.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 267.0, "npi": [1942867411, 1689607301, 1538368451]}]}, {"allowed_amount": 132.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 267.0, "npi": [1508205345, 1942867411, 1689607301]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 113.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1891226304, 1265656979]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 92.93, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 261.0, "npi": [1306003579]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 113.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 265.0, "npi": [1942454897]}]}]}]}, {"name": "Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material", "billing_code_type": "CPT", "billing_code": "72148", "billing_code_type_version": "2022", "description": "MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 68.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 360.0, "npi": [1326201617]}]}, {"allowed_amount": 113.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 360.0, "npi": [1497784896, 1306340195, 1598883787, 1174662894, 1538303383]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 113.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 267.0, "npi": [1508205345, 1649659459, 1689607301, 1942867411, 1053346452, 1790149748]}]}, {"allowed_amount": 132.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 267.0, "npi": [1417972944, 1942867411]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 68.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1447697321]}]}, {"allowed_amount": 113.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1891226304, 1629365010, 1558579763, 1265656979, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 132.62, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 300.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 113.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 250.0, "npi": [1629276555]}]}]}]}, {"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": "390872080"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 137.05, "providers": [{"billed_charge": 398.5, "npi": [1154675544]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 255.32, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 573.5, "npi": [1093740128]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "professional", "service_codes": ["23", "20"], "payments": [{"allowed_amount": 87.93, "providers": [{"billed_charge": 159.69, "npi": [1174536940]}]}, {"allowed_amount": 119.27, "providers": [{"billed_charge": 215.93, "npi": [1033972591]}]}]}, {"tin": {"type": "ein", "value": "440584290"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 133.23, "providers": [{"billed_charge": 215.93, "npi": [1255733895]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 182.4, "providers": [{"billed_charge": 304.0, "npi": [1366515488, 1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["22", "20"], "payments": [{"allowed_amount": 64.66, "providers": [{"billed_charge": 177.0, "npi": [1790542546]}]}, {"allowed_amount": 106.2, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 177.0, "npi": [1225390370, 1568195816, 1881122828, 1902028558, 1740230192, 1861825754, 1083846588, 1174085054]}]}]}, {"tin": {"type": "ein", "value": "480721405"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 89.02, "providers": [{"billed_charge": 110.0, "npi": [1265414270]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 102.17, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 153.0, "npi": [1730270398]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 95.0, "providers": [{"billed_charge": 95.0, "npi": [1063416477]}]}]}, {"tin": {"type": "ein", "value": "486026835"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 98.43, "providers": [{"billed_charge": 120.0, "npi": [1700831443]}]}]}, {"tin": {"type": "ein", "value": "770685580"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 88.54, "providers": [{"billed_charge": 330.0, "npi": [1063183168]}]}, {"allowed_amount": 118.67, "providers": [{"billed_charge": 330.0, "npi": [1780455139]}]}]}, {"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["22", "11"], "payments": [{"allowed_amount": 15.37, "providers": [{"billed_charge": 166.0, "npi": [1962018234]}]}, {"allowed_amount": 76.31, "providers": [{"billed_charge": 166.0, "npi": [1659720225]}]}, {"allowed_amount": 79.63, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 166.0, "npi": [1962018234]}]}, {"allowed_amount": 108.0, "providers": [{"billed_charge": 269.0, "npi": [1881696136]}]}]}, {"tin": {"type": "ein", "value": "850732004"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 108.15, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 166.0, "npi": [1710370697, 1508595869]}]}]}, {"tin": {"type": "ein", "value": "853756788"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 105.42, "providers": [{"billed_charge": 500.0, "npi": [1710972534, 1881220846]}]}]}, {"tin": {"type": "ein", "value": "953625072"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 82.02, "providers": [{"billed_charge": 179.0, "npi": [1053548644]}]}]}]}, {"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": "261716724"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 149.0, "providers": [{"billed_charge": 149.0, "npi": [1669635835]}]}]}, {"tin": {"type": "ein", "value": "390872080"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 175.82, "providers": [{"billed_charge": 736.5, "npi": [1861466153]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 167.57, "providers": [{"billed_charge": 252.0, "npi": [1134555279]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["22", "20"], "payments": [{"allowed_amount": 149.4, "providers": [{"billed_charge": 249.0, "npi": [1457713000, 1225429608, 1053850701, 1548995343, 1730440561, 1689054553, 1801052923, 1659327070]}]}]}, {"tin": {"type": "ein", "value": "455203604"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 113.28, "providers": [{"billed_charge": 306.0, "npi": [1467715490]}]}]}, {"tin": {"type": "ein", "value": "481115529"}, "billing_class": "professional", "service_codes": ["50"], "payments": [{"allowed_amount": 125.32, "providers": [{"billed_charge": 240.0, "npi": [1457975625]}]}]}, {"tin": {"type": "ein", "value": "481169103"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 138.72, "providers": [{"billed_charge": 300.8, "npi": [1962029835]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 167.76, "providers": [{"billed_charge": 191.66, "npi": [1669015384]}]}]}, {"tin": {"type": "ein", "value": "770685580"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 167.53, "providers": [{"billed_charge": 350.0, "npi": [1154555761]}]}]}, {"tin": {"type": "ein", "value": "810879174"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 148.56, "providers": [{"billed_charge": 635.0, "npi": [1679685838]}]}]}, {"tin": {"type": "ein", "value": "820581670"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 138.72, "providers": [{"billed_charge": 385.0, "npi": [1194175018]}]}, {"allowed_amount": 273.68, "providers": [{"billed_charge": 385.0, "npi": [1790160612]}]}]}, {"tin": {"type": "ein", "value": "822072058"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 94.25, "providers": [{"billed_charge": 244.0, "npi": [1962018234]}]}, {"allowed_amount": 117.73, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 244.0, "npi": [1962018234]}]}, {"allowed_amount": 120.21, "providers": [{"billed_charge": 244.0, "npi": [1659720225]}]}]}, {"tin": {"type": "ein", "value": "822402237"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 163.0, "providers": [{"billed_charge": 198.0, "npi": [1558474486]}]}]}, {"tin": {"type": "ein", "value": "834556434"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 190.0, "providers": [{"billed_charge": 190.0, "npi": [1811924228]}]}]}, {"tin": {"type": "ein", "value": "850732004"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 153.28, "providers": [{"billed_charge": 244.0, "npi": [1932730579, 1396412516]}]}]}]}, {"name": "Radiologic examination, abdomen; 1 view", "billing_code_type": "CPT", "billing_code": "74018", "billing_code_type_version": "2022", "description": "RADIOLOGIC EXAM ABDOMEN 1 VIEW", "allowed_amounts": [{"tin": {"type": "ein", "value": "416011702"}, "billing_class": "professional", "service_codes": ["11", "21"], "payments": [{"allowed_amount": 14.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 55.0, "npi": [1982815817]}]}, {"allowed_amount": 50.82, "providers": [{"billed_charge": 194.0, "npi": [1063492759]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 14.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1174662894, 1538303383]}]}, {"allowed_amount": 29.93, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1326201617, 1528448479]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 14.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1043266117]}]}, {"allowed_amount": 14.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1538368451, 1043266117, 1942867411, 1679598197, 1376694901]}]}, {"allowed_amount": 16.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1679598197]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 14.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1316942576, 1558579763, 1285297549, 1497728422]}]}, {"allowed_amount": 29.93, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1447697321]}]}, {"allowed_amount": 35.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1538507256, 1487064945, 1629365010]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 16.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1588639025, 1831163005, 1346341583]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 12.24, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1518370113]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.98, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1477751584, 1437513322, 1629276555, 1396061966, 1548688567]}]}]}]}, {"name": "Radiologic examination, ankle; complete, minimum of 3 views", "billing_code_type": "CPT", "billing_code": "73610", "billing_code_type_version": "2022", "description": "RADEX ANKLE COMPLETE MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "363097297"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1245260066]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.15, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1841276664]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 8.13, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1821009531, 1598883787, 1538303383]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 151.39, "providers": [{"billed_charge": 334.79, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 29.04, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 64.0, "npi": [1730270398]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1497779961, 1689613093, 1376511766]}]}, {"allowed_amount": 15.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1497779961, 1689613093, 1164546479]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 11.15, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1487897369]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1396061966]}]}]}]}, {"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": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1578547931]}]}, {"allowed_amount": 17.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1346225166]}]}]}, {"tin": {"type": "ein", "value": "430652656"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 72.04, "providers": [{"billed_charge": 457.0, "npi": [1487663506]}]}]}, {"tin": {"type": "ein", "value": "430653611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 70.0, "npi": [1326675869]}]}]}, {"tin": {"type": "ein", "value": "430917818"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1952692600]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 169.1, "providers": [{"billed_charge": 400.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.4, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 48.0, "npi": [1811330145, 1952347270, 1932595626, 1922084490, 1831194901]}]}, {"allowed_amount": 14.78, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 48.0, "npi": [1306372495]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 9.46, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1306340195, 1518177252, 1902867336, 1336597582, 1740406446, 1174662894, 1396784658, 1538303383, 1215166681, 1528118106, 1821009531, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "440565393"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 1081.0, "npi": [1942241799]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 315.6, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 526.0, "npi": [1366515488, 1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 19.8, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1760865984, 1104949304, 1144401126]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 155.7, "providers": [{"billed_charge": 492.94, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480917002"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1205451697]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 2.06, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1699062232]}]}, {"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1164537346, 1649659459, 1912096868, 1689607301, 1689613093, 1538368451, 1871750729, 1063507853, 1942867411, 1790149748, 1780028563, 1497779961, 1396762746]}]}, {"allowed_amount": 19.7, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1649659459, 1689613093, 1083729222, 1245296805, 1871750729, 1417972944, 1780028563, 1194741652, 1376694901, 1053346452, 1699062232, 1497779961]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 1081.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 9.46, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1447697321]}]}, {"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1871936518, 1497728422, 1073774923, 1285297549, 1316942576, 1104319664, 1265656979, 1306161237, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 155.7, "providers": [{"billed_charge": 587.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "593209688"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 41.21, "providers": [{"billed_charge": 90.0, "npi": [1033565023]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 17.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 43.0, "npi": [1841619871]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 155.7, "providers": [{"billed_charge": 548.0, "npi": [1588657928]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 39.0, "npi": [1578541439]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 155.7, "providers": [{"billed_charge": 1198.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 16.83, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1255780029, 1548688567]}]}]}, {"tin": {"type": "ein", "value": "870622942"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 18.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 43.0, "npi": [1548443716]}]}]}]}, {"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": "201477608"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.58, "providers": [{"billed_charge": 25.91, "npi": [1497713291]}]}]}, {"tin": {"type": "ein", "value": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 92.37, "providers": [{"billed_charge": 460.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "362169147"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.53, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 20.0, "npi": [1518985977]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1023004173, 1184822231]}]}, {"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1093712473, 1114422516, 1003806381]}]}, {"allowed_amount": 18.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1912987942]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 11.99, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1710954896, 1235166620]}]}, {"allowed_amount": 12.33, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1558396952, 1922084490]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 8.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1174662894]}]}, {"allowed_amount": 8.56, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1497784896, 1306340195, 1518177252, 1841280005, 1902867336, 1598883787, 1174662894, 1336597582, 1508229808, 1396784658, 1538303383, 1518917368, 1215166681, 1528118106, 1821009531, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 940.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "462021581"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.85, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1396108023]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.09, "providers": [{"billed_charge": 742.82, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.09, "providers": [{"billed_charge": 364.57, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480758603"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1821210139]}]}]}, {"tin": {"type": "ein", "value": "480793798"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 9.52, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1780623272]}]}]}, {"tin": {"type": "ein", "value": "480917002"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1477546745]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.09, "providers": [{"billed_charge": 136.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 7.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1689607301, 1245296805, 1942867411, 1376694901, 1497779961]}]}, {"allowed_amount": 13.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1649659459, 1538368451, 1689613093, 1245296805, 1912096868, 1043266117, 1871750729, 1417972944, 1942867411, 1053346452, 1679598197, 1376511766, 1699062232, 1497779961]}]}, {"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1689607301, 1063507853, 1780028563, 1194741652, 1376511766, 1245296805, 1689613093, 1770515249, 1649659459, 1538368451, 1083729222, 1942867411, 1699062232, 1851564892, 1912096868, 1790149748, 1376694901, 1679598197, 1497779961, 1396762746]}]}, {"allowed_amount": 14.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1699062232, 1538368451]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 803.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 8.56, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1447697321]}]}, {"allowed_amount": 11.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1629365010]}]}, {"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1790912897, 1891799557, 1871936518, 1790838407, 1285297549, 1629365010, 1265656979, 1497728422, 1104319664, 1558579763, 1588693949, 1891226304, 1679718209, 1316942667, 1073774923, 1306161237, 1902801129, 1316942576, 1487064945, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 13.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 121.09, "providers": [{"billed_charge": 432.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 208.36, "providers": [{"billed_charge": 345.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 95.92, "providers": [{"billed_charge": 995.88, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 765.1, "providers": [{"billed_charge": 2186.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 15.96, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1487897369, 1588639025, 1548249246, 1841619871]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 268.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 11.17, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1518370113, 1811140361]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 14.14, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1477751584, 1841516226, 1437513322, 1629276555, 1396061966, 1215970736, 1942454897, 1760825814, 1548688567, 1255780029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 268.0, "providers": [{"billed_charge": 268.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "862109896"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 14.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1508391210]}]}]}, {"tin": {"type": "ein", "value": "870622942"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.55, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1548443716]}]}]}, {"tin": {"type": "ein", "value": "874362493"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 36.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1841695889]}]}]}, {"tin": {"type": "ein", "value": "942854057"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 14.55, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 28.14, "npi": [1750744421]}]}]}]}, {"name": "Radiologic examination, foot; complete, minimum of 3 views", "billing_code_type": "CPT", "billing_code": "73630", "billing_code_type_version": "2022", "description": "RADEX FOOT COMPLETE MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "370899405"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.09, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 97.0, "npi": [1083711659]}]}]}, {"tin": {"type": "ein", "value": "390872080"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 280.22, "providers": [{"billed_charge": 521.0, "npi": [1861466153]}]}]}, {"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.85, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 33.0, "npi": [1841276664]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.84, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1558396952]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 11.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1306340195, 1275563884, 1508229808, 1215166681, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 11.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 31.0, "npi": [1780028563, 1790149748, 1689607301, 1376511766]}]}, {"allowed_amount": 13.85, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 31.0, "npi": [1417972944, 1689613093]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 25.0, "npi": [1538507256, 1790838407]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 14.64, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 12.85, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 42.0, "npi": [1346341583]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 322.0, "providers": [{"billed_charge": 322.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 10.72, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1356791206]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 11.32, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1396061966]}]}]}]}, {"name": "Radiologic examination, hand; minimum of 3 views", "billing_code_type": "CPT", "billing_code": "73130", "billing_code_type_version": "2022", "description": "RADEX HAND MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.39, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 52.0, "npi": [1235166620, 1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1306340195, 1902867336, 1174662894, 1326486127, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 15.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 26.0, "npi": [1598299463]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1649659459, 1417972944, 1780028563, 1942867411, 1053346452]}]}, {"allowed_amount": 15.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1699062232, 1942867411, 1194741652]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 13.5, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1285297549]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 15.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 37.5, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 91.56, "providers": [{"billed_charge": 449.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 14.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1336397124, 1346341583]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 323.0, "providers": [{"billed_charge": 323.0, "npi": [1639185457]}]}]}]}, {"name": "Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views", "billing_code_type": "CPT", "billing_code": "73502", "billing_code_type_version": "2022", "description": "RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "430652656"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 127.01, "providers": [{"billed_charge": 192.0, "npi": [1487663506]}]}]}, {"tin": {"type": "ein", "value": "430652680"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 127.01, "providers": [{"billed_charge": 358.7, "npi": [1346251543]}]}]}, {"tin": {"type": "ein", "value": "430653611"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 74.0, "npi": [1285729657]}]}]}, {"tin": {"type": "ein", "value": "431109990"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1588701130]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 17.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1497784896, 1306340195, 1598883787, 1396784658, 1215166681, 1528118106, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 17.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1538368451]}]}, {"allowed_amount": 20.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1417972944, 1770515249]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 17.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 25.0, "npi": [1790912897, 1497728422, 1871936518, 1629365010, 1558579763]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 220.56, "providers": [{"billed_charge": 492.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 15.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 55.0, "npi": [1588639025, 1841619871]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 17.91, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1841516226]}]}]}]}, {"name": "Radiologic examination, knee; 3 views", "billing_code_type": "CPT", "billing_code": "73562", "billing_code_type_version": "2022", "description": "RADIOLOGIC EXAMINATION KNEE 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1881837748]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 13.35, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.0, "npi": [1710954896, 1932595626, 1235166620]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 38.0, "npi": [1497784896, 1841280005, 1336597582, 1396784658, 1023264157]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 106.04, "providers": [{"billed_charge": 572.01, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480581968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 177.06, "providers": [{"billed_charge": 221.0, "npi": [1700994977]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1417972944, 1871750729, 1780028563, 1689613093]}]}, {"allowed_amount": 17.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1164537346, 1851564892, 1164546479]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 1141.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 25.0, "npi": [1629365010]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 17.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 106.04, "providers": [{"billed_charge": 821.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 14.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 48.0, "npi": [1518932607]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 354.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1538522537]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 106.04, "providers": [{"billed_charge": 1200.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 11.18, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1477751584, 1396061966]}]}]}]}, {"name": "Radiologic examination, shoulder; complete, minimum of 2 views", "billing_code_type": "CPT", "billing_code": "73030", "billing_code_type_version": "2022", "description": "RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 13.68, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1164470779]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 12.9, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1932595626]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 13.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1497784896, 1306340195, 1841280005, 1902867336, 1598883787, 1174662894, 1336597582, 1740406446, 1538303383, 1821009531]}, {"billed_charge": 80.0, "npi": [1497784896]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 196.28, "providers": [{"billed_charge": 487.17, "npi": [1093740128]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 107.27, "providers": [{"billed_charge": 488.83, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 13.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1780028563]}]}, {"allowed_amount": 17.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1649659459, 1083729222, 1417972944, 1770515249, 1780028563, 1376694901]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 8.78, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1447697321]}]}, {"allowed_amount": 12.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1104319664]}]}, {"allowed_amount": 13.65, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 35.0, "npi": [1902801129, 1588693949, 1497728422]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 17.03, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 50.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 107.27, "providers": [{"billed_charge": 552.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 349.0, "providers": [{"billed_charge": 349.0, "npi": [1639185457]}]}]}]}, {"name": "Radiologic examination, spine, lumbosacral; 2 or 3 views", "billing_code_type": "CPT", "billing_code": "72100", "billing_code_type_version": "2022", "description": "RADEX SPINE LUMBOSACRAL 2/3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "141973790"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 31.25, "providers": [{"billed_charge": 107.0, "npi": [1548682941]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 17.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 45.0, "npi": [1508229808, 1215166681, 1306340195, 1174662894]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 17.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1770515249, 1538368451, 1245296805, 1942867411]}]}, {"allowed_amount": 20.29, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 41.0, "npi": [1871750729, 1649659459, 1790149748, 1770515249]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 17.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1316942576, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 103.34, "providers": [{"billed_charge": 841.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 15.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 52.0, "npi": [1841619871]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 15.07, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 40.0, "npi": [1124278379, 1073715884]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 103.34, "providers": [{"billed_charge": 1345.0, "npi": [1750921029]}]}]}]}, {"name": "Radiologic examination, wrist; complete, minimum of 3 views", "billing_code_type": "CPT", "billing_code": "73110", "billing_code_type_version": "2022", "description": "RADEX WRIST COMPLETE MINIMUM 3 VIEWS", "allowed_amounts": [{"tin": {"type": "ein", "value": "431560263"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 23.3, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 34.0, "npi": [1780847715]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23", "21"], "payments": [{"allowed_amount": 12.39, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.0, "npi": [1558396952, 1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 11.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 36.0, "npi": [1215166681]}]}]}, {"tin": {"type": "ein", "value": "440552485"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 234.93, "providers": [{"billed_charge": 620.0, "npi": [1578504056]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 446.4, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 744.0, "npi": [1366515488, 1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 15.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 26.0, "npi": [1346496528, 1104949304, 1013968213, 1679503528]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1649659459]}]}, {"allowed_amount": 14.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 32.0, "npi": [1396762746, 1376694901]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 1290.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 25.0, "npi": [1316942576, 1902801129, 1265656979, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 85.73, "providers": [{"billed_charge": 1374.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 11.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 30.0, "npi": [1760825814]}]}]}]}, {"name": "Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)", "billing_code_type": "CPT", "billing_code": "77063", "billing_code_type_version": "2022", "description": "SCREENING DIGITAL BREAST TOMOSYNTHESIS BI", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 39.83, "providers": [{"billed_charge": 75.0, "npi": [1013151810]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 49.39, "providers": [{"billed_charge": 115.0, "npi": [1497784896, 1518177252, 1598883787, 1174662894, 1336597582, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 47.87, "providers": [{"billed_charge": 108.0, "npi": [1790149748, 1871750729, 1083135180, 1851564892]}]}, {"allowed_amount": 49.39, "providers": [{"billed_charge": 108.0, "npi": [1871750729, 1083135180, 1063507853, 1124113972, 1851564892]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 50.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 49.39, "providers": [{"billed_charge": 75.0, "npi": [1447285465, 1164426797]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 47.87, "providers": [{"billed_charge": 85.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 48.8, "providers": [{"billed_charge": 120.0, "npi": [1487897369, 1144780438, 1841619871]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 40.48, "providers": [{"billed_charge": 106.0, "npi": [1447785480]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 49.39, "providers": [{"billed_charge": 105.0, "npi": [1215970736, 1841516226, 1548688567]}]}]}]}, {"name": "Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed", "billing_code_type": "CPT", "billing_code": "77067", "billing_code_type_version": "2022", "description": "SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 50.31, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 217.0, "npi": [1013151810]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 145.0, "npi": [1497784896, 1518177252, 1598883787, 1336597582, 1174662894, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 59.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1790149748, 1871750729, 1083135180, 1851564892]}]}, {"allowed_amount": 61.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 221.0, "npi": [1871750729, 1083135180, 1063507853, 1124113972, 1851564892]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 115.0, "npi": [1447285465, 1164426797]}]}, {"allowed_amount": 115.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 115.0, "npi": [1164426797]}]}, {"allowed_amount": 145.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 115.0, "npi": [1447285465]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 59.89, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 260.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 60.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 192.0, "npi": [1487897369, 1144780438, 1841619871]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 50.43, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 133.0, "npi": [1447785480]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.79, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 225.0, "npi": [1215970736, 1841516226, 1548688567]}]}]}]}, {"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": "271371893"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 128.05, "providers": [{"billed_charge": 718.0, "npi": [1912469586]}]}, {"allowed_amount": 139.44, "providers": [{"billed_charge": 718.0, "npi": [1356964076]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 718.0, "npi": [1821054693, 1780677831, 1639305832, 1104961002, 1790314797, 1780178541, 1578738191, 1891226031, 1871170258, 1255999223, 1508933565, 1063876894, 1659511038]}]}]}, {"tin": {"type": "ein", "value": "274185968"}, "billing_class": "professional", "service_codes": ["52", "51", "21"], "payments": [{"allowed_amount": 128.05, "providers": [{"billed_charge": 418.0, "npi": [1356051676, 1467844340]}, {"billed_charge": 439.0, "npi": [1336592328]}]}]}, {"tin": {"type": "ein", "value": "331159776"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 158.48, "providers": [{"billed_charge": 175.0, "npi": [1538252622]}]}]}, {"tin": {"type": "ein", "value": "332787291"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 147.64, "providers": [{"billed_charge": 364.0, "npi": [1720516776]}]}]}, {"tin": {"type": "ein", "value": "363966745"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 143.95, "providers": [{"billed_charge": 200.0, "npi": [1336777184]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 139.44, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 396.0, "npi": [1134772106, 1619553526]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 396.0, "npi": [1558968834, 1780236380, 1205892239, 1851028369, 1740668144, 1336240696, 1356804124]}, {"billed_charge": 399.0, "npi": [1609045152, 1104961002, 1467005108, 1497066799]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 152.87, "providers": [{"billed_charge": 235.0, "npi": [1457884355, 1053674515, 1356834774]}]}, {"allowed_amount": 158.22, "providers": [{"billed_charge": 235.0, "npi": [1295397313, 1639374507, 1376830646]}]}]}, {"tin": {"type": "ein", "value": "431600770"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 193.14, "providers": [{"billed_charge": 413.0, "npi": [1336324979]}]}]}, {"tin": {"type": "ein", "value": "460899960"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 461.16, "providers": [{"billed_charge": 1081.67, "npi": [1982055760, 1518119510]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 103.17, "providers": [{"billed_charge": 230.99, "npi": [1265450217]}]}, {"allowed_amount": 106.14, "providers": [{"billed_charge": 230.99, "npi": [1568549269]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 230.99, "npi": [1154855617, 1023159522, 1457976839, 1689291049, 1255366902, 1932696119, 1619069176, 1992327449, 1689776890, 1144970203, 1598929945]}]}, {"allowed_amount": 188.88, "providers": [{"billed_charge": 230.99, "npi": [1811968035]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 133.63, "providers": [{"billed_charge": 305.73, "npi": [1063707438]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 400.0, "npi": [1891130936, 1447710546, 1710117296]}]}]}, {"tin": {"type": "ein", "value": "465027835"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 154.92, "providers": [{"billed_charge": 1054.09, "npi": [1356465793, 1285252973]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 111.99, "providers": [{"billed_charge": 297.75, "npi": [1326076548]}]}, {"allowed_amount": 139.44, "providers": [{"billed_charge": 297.75, "npi": [1427270750]}]}]}, {"tin": {"type": "ein", "value": "472209130"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 143.95, "providers": [{"billed_charge": 240.0, "npi": [1699878504, 1952417644, 1982642476, 1356457006]}]}]}, {"tin": {"type": "ein", "value": "472538324"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.83, "providers": [{"billed_charge": 400.0, "npi": [1790071074]}]}]}, {"tin": {"type": "ein", "value": "480767137"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 108.2, "providers": [{"billed_charge": 325.0, "npi": [1154391654]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 325.0, "npi": [1588191977, 1760879639]}]}]}, {"tin": {"type": "ein", "value": "480778482"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 193.14, "providers": [{"billed_charge": 987.0, "npi": [1568806842, 1174262026, 1073672499]}]}]}, {"tin": {"type": "ein", "value": "481163756"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 138.91, "providers": [{"billed_charge": 312.0, "npi": [1790278364]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 128.05, "providers": [{"billed_charge": 449.0, "npi": [1063962421]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 139.44, "providers": [{"billed_charge": 188.31, "npi": [1184744609, 1740801059, 1417239013, 1376033894, 1578735056, 1134409105, 1801280086, 1801114202, 1659877470, 1598170367]}]}, {"allowed_amount": 141.42, "providers": [{"billed_charge": 188.31, "npi": [1982868097, 1396051595]}]}, {"allowed_amount": 142.35, "providers": [{"billed_charge": 188.31, "npi": [1972165793, 1366860058]}]}, {"allowed_amount": 143.95, "providers": [{"billed_charge": 188.31, "npi": [1710691886, 1982334322, 1568878130, 1841770773, 1982717757]}]}, {"allowed_amount": 158.48, "providers": [{"billed_charge": 188.31, "npi": [1215589874, 1972910651, 1467831693, 1366412751]}]}]}, {"tin": {"type": "ein", "value": "743083325"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 106.14, "providers": [{"billed_charge": 250.0, "npi": [1578660585, 1235236258]}]}]}, {"tin": {"type": "ein", "value": "821368185"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.83, "providers": [{"billed_charge": 210.0, "npi": [1659959989]}, {"billed_charge": 320.0, "npi": [1659959989, 1386873743]}]}]}, {"tin": {"type": "ein", "value": "830528240"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 103.17, "providers": [{"billed_charge": 234.0, "npi": [1790712750]}]}]}, {"tin": {"type": "ein", "value": "863429621"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 158.48, "providers": [{"billed_charge": 240.0, "npi": [1295825685]}]}]}, {"tin": {"type": "ein", "value": "871286179"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 130.31, "providers": [{"billed_charge": 296.0, "npi": [1053796417]}]}]}, {"tin": {"type": "ein", "value": "882355153"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 150.52, "providers": [{"billed_charge": 492.8, "npi": [1598938193]}]}]}, {"tin": {"type": "ein", "value": "883543992"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 140.83, "providers": [{"billed_charge": 250.0, "npi": [1366786451]}]}]}, {"tin": {"type": "ein", "value": "922116659"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 134.0, "providers": [{"billed_charge": 572.0, "npi": [1184640864]}]}]}, {"tin": {"type": "ein", "value": "942854057"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 117.9, "providers": [{"billed_charge": 285.0, "npi": [1649731001]}]}]}, {"tin": {"type": "ein", "value": "993151146"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 177.83, "providers": [{"billed_charge": 727.0, "npi": [1891996039]}]}]}]}, {"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": "202738286"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 108.78, "providers": [{"billed_charge": 140.0, "npi": [1285603704]}]}]}, {"tin": {"type": "ein", "value": "271371893"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 13.51, "providers": [{"billed_charge": 500.0, "npi": [1982840336]}]}, {"allowed_amount": 85.56, "providers": [{"billed_charge": 500.0, "npi": [1912469586, 1518673367]}]}, {"allowed_amount": 100.8, "providers": [{"billed_charge": 500.0, "npi": [1356964076, 1063866374]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 500.0, "npi": [1821054693, 1689733701, 1780677831, 1104961002, 1669035531, 1780178541, 1790314797, 1578738191, 1497066799, 1588862353, 1871170258, 1255999223, 1508933565, 1659511038, 1063876894]}]}]}, {"tin": {"type": "ein", "value": "271672159"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 92.36, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 254.0, "npi": [1548658842]}]}]}, {"tin": {"type": "ein", "value": "274185968"}, "billing_class": "professional", "service_codes": ["61", "21"], "payments": [{"allowed_amount": 85.56, "providers": [{"billed_charge": 307.0, "npi": [1336592328, 1376810598]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 307.0, "npi": [1902899834, 1932194925]}]}]}, {"tin": {"type": "ein", "value": "320391082"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 108.69, "providers": [{"billed_charge": 108.69, "npi": [1346473360, 1154017408, 1275027278]}]}]}, {"tin": {"type": "ein", "value": "331159776"}, "billing_class": "professional", "service_codes": ["61"], "payments": [{"allowed_amount": 85.56, "providers": [{"billed_charge": 110.0, "npi": [1710454855]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 110.0, "npi": [1538252622]}]}]}, {"tin": {"type": "ein", "value": "332787291"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 96.9, "providers": [{"billed_charge": 244.0, "npi": [1720516776]}]}]}, {"tin": {"type": "ein", "value": "384058466"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 75.06, "providers": [{"billed_charge": 278.0, "npi": [1982840336, 1215420369, 1063876894]}]}, {"allowed_amount": 95.67, "providers": [{"billed_charge": 276.0, "npi": [1811375058, 1104433762]}]}, {"allowed_amount": 100.8, "providers": [{"billed_charge": 276.0, "npi": [1134772106, 1619553526]}, {"billed_charge": 277.0, "npi": [1457766974]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 276.0, "npi": [1558968834, 1205892239, 1740668144, 1982264305, 1851028369, 1780236380, 1700881174, 1336240696, 1144970203, 1356804124]}, {"billed_charge": 277.0, "npi": [1609045152, 1104961002, 1467005108, 1497066799]}]}, {"allowed_amount": 131.55, "providers": [{"billed_charge": 278.0, "npi": [1457766974]}]}]}, {"tin": {"type": "ein", "value": "416011702"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 107.78, "providers": [{"billed_charge": 303.0, "npi": [1306343207]}]}]}, {"tin": {"type": "ein", "value": "431454831"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 71.76, "providers": [{"billed_charge": 113.0, "npi": [1043405731, 1750370615]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 88.7, "providers": [{"billed_charge": 217.0, "npi": [1558785220]}]}, {"allowed_amount": 100.82, "providers": [{"billed_charge": 217.0, "npi": [1265059406, 1609869775]}]}, {"allowed_amount": 104.36, "providers": [{"billed_charge": 217.0, "npi": [1295397313, 1730123548, 1144266248, 1376830646, 1760864730, 1689603771, 1831332444]}]}]}, {"tin": {"type": "ein", "value": "431600770"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 100.8, "providers": [{"billed_charge": 288.0, "npi": [1922071729]}]}]}, {"tin": {"type": "ein", "value": "461796402"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 108.78, "providers": [{"billed_charge": 153.54, "npi": [1023159522, 1144970203, 1033643572, 1033736772]}]}]}, {"tin": {"type": "ein", "value": "462414983"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 84.71, "providers": [{"billed_charge": 201.63, "npi": [1427007764]}]}, {"allowed_amount": 85.56, "providers": [{"billed_charge": 201.63, "npi": [1740603935]}]}, {"allowed_amount": 96.02, "providers": [{"billed_charge": 201.63, "npi": [1003252453]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 201.63, "npi": [1013973288, 1720245442]}]}]}, {"tin": {"type": "ein", "value": "471216616"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 77.72, "providers": [{"billed_charge": 217.25, "npi": [1104137496, 1871756882]}]}, {"allowed_amount": 100.8, "providers": [{"billed_charge": 217.25, "npi": [1235577511]}]}]}, {"tin": {"type": "ein", "value": "472209130"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 95.67, "providers": [{"billed_charge": 169.0, "npi": [1699878504, 1952417644, 1982642476, 1356457006]}]}]}, {"tin": {"type": "ein", "value": "472661514"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 102.48, "providers": [{"billed_charge": 160.0, "npi": [1730264169]}]}]}, {"tin": {"type": "ein", "value": "475317446"}, "billing_class": "professional", "service_codes": ["51"], "payments": [{"allowed_amount": 159.12, "providers": [{"billed_charge": 214.89, "npi": [1538533443]}]}, {"allowed_amount": 180.34, "providers": [{"billed_charge": 214.89, "npi": [1689219768]}]}, {"allowed_amount": 212.16, "providers": [{"billed_charge": 214.89, "npi": [1962591313, 1437213998]}]}]}, {"tin": {"type": "ein", "value": "480767137"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 75.1, "providers": [{"billed_charge": 250.0, "npi": [1154391654]}]}, {"allowed_amount": 84.71, "providers": [{"billed_charge": 250.0, "npi": [1003263419, 1205923109]}]}, {"allowed_amount": 116.27, "providers": [{"billed_charge": 250.0, "npi": [1922489244]}]}]}, {"tin": {"type": "ein", "value": "481020227"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 96.02, "providers": [{"billed_charge": 189.0, "npi": [1972544583]}]}]}, {"tin": {"type": "ein", "value": "481156958"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 96.02, "providers": [{"billed_charge": 126.0, "npi": [1740802685]}]}]}, {"tin": {"type": "ein", "value": "481163756"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 92.36, "providers": [{"billed_charge": 207.0, "npi": [1497109524, 1700071479]}]}]}, {"tin": {"type": "ein", "value": "481216340"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 92.66, "providers": [{"billed_charge": 141.0, "npi": [1295501872]}]}]}, {"tin": {"type": "ein", "value": "486341644"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 71.76, "providers": [{"billed_charge": 130.2, "npi": [1790877660, 1831127455]}]}, {"allowed_amount": 95.67, "providers": [{"billed_charge": 130.2, "npi": [1780735936, 1780002378, 1336186329, 1780959536, 1124568977, 1821727124, 1841770773, 1184322422, 1598193401]}]}, {"allowed_amount": 96.02, "providers": [{"billed_charge": 130.2, "npi": [1396051595]}]}, {"allowed_amount": 96.9, "providers": [{"billed_charge": 130.2, "npi": [1982922936]}]}, {"allowed_amount": 97.15, "providers": [{"billed_charge": 130.2, "npi": [1366860058]}]}, {"allowed_amount": 100.8, "providers": [{"billed_charge": 130.2, "npi": [1578735056, 1184744609, 1699169540, 1417239013]}]}, {"allowed_amount": 108.78, "providers": [{"billed_charge": 130.2, "npi": [1902865769, 1134726466, 1972910651, 1366412751]}]}, {"allowed_amount": 126.11, "providers": [{"billed_charge": 130.2, "npi": [1346463825]}]}, {"allowed_amount": 130.2, "providers": [{"billed_charge": 130.2, "npi": [1124522024, 1902880164]}]}]}, {"tin": {"type": "ein", "value": "743083325"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 75.1, "providers": [{"billed_charge": 200.0, "npi": [1578660585]}]}]}, {"tin": {"type": "ein", "value": "812951254"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 96.02, "providers": [{"billed_charge": 151.0, "npi": [1619075355, 1548674989]}]}]}, {"tin": {"type": "ein", "value": "822402237"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 96.9, "billing_code_modifier": ["25"], "providers": [{"billed_charge": 125.0, "npi": [1558474486]}]}]}, {"tin": {"type": "ein", "value": "830528240"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 71.76, "providers": [{"billed_charge": 142.0, "npi": [1790712750]}]}]}, {"tin": {"type": "ein", "value": "863429621"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 108.78, "providers": [{"billed_charge": 169.0, "npi": [1295825685]}]}]}, {"tin": {"type": "ein", "value": "872020101"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 92.36, "providers": [{"billed_charge": 108.0, "npi": [1295839439]}]}]}, {"tin": {"type": "ein", "value": "882355153"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 91.99, "providers": [{"billed_charge": 330.4, "npi": [1033423553]}]}]}, {"tin": {"type": "ein", "value": "942854057"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 92.0, "providers": [{"billed_charge": 191.0, "npi": [1649731001, 1851895551]}]}]}]}, {"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": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 43.45, "providers": [{"billed_charge": 180.23, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 101.07, "providers": [{"billed_charge": 226.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 273.0, "providers": [{"billed_charge": 455.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 114.84, "providers": [{"billed_charge": 165.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 98.57, "providers": [{"billed_charge": 348.7, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 98.57, "providers": [{"billed_charge": 285.32, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 98.57, "providers": [{"billed_charge": 277.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 35.52, "providers": [{"billed_charge": 59.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 98.57, "providers": [{"billed_charge": 315.5, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 108.92, "providers": [{"billed_charge": 403.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 72.36, "providers": [{"billed_charge": 524.06, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 69.17, "providers": [{"billed_charge": 423.55, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 120.05, "providers": [{"billed_charge": 343.0, "npi": [1447299649]}]}, {"allowed_amount": 126.0, "providers": [{"billed_charge": 360.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 126.0, "providers": [{"billed_charge": 126.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 98.57, "providers": [{"billed_charge": 307.61, "npi": [1750921029]}]}]}]}, {"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": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 92.78, "providers": [{"billed_charge": 705.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 57.85, "providers": [{"billed_charge": 368.03, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "430652680"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 81.33, "providers": [{"billed_charge": 282.0, "npi": [1346251543]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 191.22, "providers": [{"billed_charge": 226.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 192.93, "providers": [{"billed_charge": 275.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 232.38, "providers": [{"billed_charge": 740.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 119.66, "providers": [{"billed_charge": 1219.18, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 119.66, "providers": [{"billed_charge": 348.14, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 119.66, "providers": [{"billed_charge": 336.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 57.85, "providers": [{"billed_charge": 311.98, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 119.66, "providers": [{"billed_charge": 435.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 374.0, "providers": [{"billed_charge": 374.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 271.69, "providers": [{"billed_charge": 425.8, "npi": [1164590386]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 222.6, "providers": [{"billed_charge": 636.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 210.0, "providers": [{"billed_charge": 210.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 119.66, "providers": [{"billed_charge": 454.35, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 210.0, "providers": [{"billed_charge": 210.0, "npi": [1639185457]}]}]}]}, {"name": "Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular", "billing_code_type": "CPT", "billing_code": "96372", "billing_code_type_version": "2022", "description": "THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM", "allowed_amounts": [{"tin": {"type": "ein", "value": "141973790"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.44, "providers": [{"billed_charge": 67.0, "npi": [1548682941]}]}]}, {"tin": {"type": "ein", "value": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 59.0, "providers": [{"billed_charge": 310.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "262583411"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 60.09, "providers": [{"billed_charge": 491.73, "npi": [1659538858]}]}]}, {"tin": {"type": "ein", "value": "314394942"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 33.55, "providers": [{"billed_charge": 281.0, "npi": [1972535052]}]}]}, {"tin": {"type": "ein", "value": "440577118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 91.01, "providers": [{"billed_charge": 200.23, "npi": [1093740128]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.83, "providers": [{"billed_charge": 389.21, "npi": [1528301900]}]}, {"allowed_amount": 311.37, "providers": [{"billed_charge": 389.21, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.83, "providers": [{"billed_charge": 279.37, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "480860883"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 55.95, "providers": [{"billed_charge": 107.0, "npi": [1376548370]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 55.95, "providers": [{"billed_charge": 94.55, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.83, "providers": [{"billed_charge": 266.75, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 96.95, "providers": [{"billed_charge": 277.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "742849611"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 97.0, "providers": [{"billed_charge": 97.0, "npi": [1316911878]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 78.83, "providers": [{"billed_charge": 328.1, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "834333066"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 14.15, "providers": [{"billed_charge": 93.0, "npi": [1922402452]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 97.0, "providers": [{"billed_charge": 97.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "850732004"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 16.92, "providers": [{"billed_charge": 44.0, "npi": [1508595869]}]}]}, {"tin": {"type": "ein", "value": "946003822"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 201.0, "providers": [{"billed_charge": 201.0, "npi": [1184662652]}]}]}]}, {"name": "Troponin, quantitative", "billing_code_type": "CPT", "billing_code": "84484", "billing_code_type_version": "2022", "description": "ASSAY OF TROPONIN QUANTITATIVE", "allowed_amounts": [{"tin": {"type": "ein", "value": "262525968"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 60.37, "providers": [{"billed_charge": 225.0, "npi": [1124272547]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 81.08, "providers": [{"billed_charge": 291.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "430980256"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 82.93, "providers": [{"billed_charge": 141.0, "npi": [1568481984]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 180.49, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 328.27, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481186704"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 133.0, "npi": [1760482517]}]}]}, {"tin": {"type": "ein", "value": "481236156"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 81.08, "providers": [{"billed_charge": 90.0, "npi": [1306875745]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 334.0, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "562070036"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 72.07, "providers": [{"billed_charge": 241.0, "npi": [1992703540]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.23, "providers": [{"billed_charge": 430.59, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "621762545"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 17.5, "providers": [{"billed_charge": 50.0, "npi": [1447299649]}]}]}, {"tin": {"type": "ein", "value": "721526400"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 224.0, "npi": [1588657928]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.6, "providers": [{"billed_charge": 397.79, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 200.0, "providers": [{"billed_charge": 200.0, "npi": [1639185457]}]}]}]}, {"name": "Ultrasound, abdominal, real time with image documentation; complete", "billing_code_type": "CPT", "billing_code": "76700", "billing_code_type_version": "2022", "description": "US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 37.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1528448479]}]}, {"allowed_amount": 63.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1215166681, 1306340195, 1598883787]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1026.6, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1711.0, "npi": [1366515488]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 72.0, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1679503528]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 63.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 146.0, "npi": [1164537346, 1083729222, 1417972944, 1780028563, 1679598197, 1497779961]}]}, {"allowed_amount": 72.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 146.0, "npi": [1770515249, 1952862054]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22", "21"], "payments": [{"allowed_amount": 37.75, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1447697321]}]}, {"allowed_amount": 63.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1679718209, 1790912897, 1629365010, 1073774923]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 72.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 185.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 63.82, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 140.0, "npi": [1396793923]}]}]}]}, {"name": "Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)", "billing_code_type": "CPT", "billing_code": "76705", "billing_code_type_version": "2022", "description": "US ABDOMINAL REAL TIME W/IMAGE LIMITED", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 39.33, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1952347270]}]}, {"allowed_amount": 40.41, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 75.0, "npi": [1982125407]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 27.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 115.0, "npi": [1326201617, 1528448479]}]}, {"allowed_amount": 48.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 115.0, "npi": [1497784896, 1306340195, 1518177252, 1598883787, 1174662894, 1538303383, 1215166681]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 781.8, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1303.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 52.2, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 87.0, "npi": [1346496528, 1790764124]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 191.11, "providers": [{"billed_charge": 1948.5, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 191.11, "providers": [{"billed_charge": 1073.16, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 48.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 106.0, "npi": [1497779961, 1679598197, 1376694901]}]}, {"allowed_amount": 52.59, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 106.0, "npi": [1124113972, 1245296805]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 27.12, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.0, "npi": [1447697321, 1194840918]}]}, {"allowed_amount": 48.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 60.0, "npi": [1790912897, 1891799557, 1497728422, 1316942667, 1104319664, 1316942576, 1629365010, 1306161237, 1538507256, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["11"], "payments": [{"allowed_amount": 52.59, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 150.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 39.54, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 119.0, "npi": [1487897369]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["21"], "payments": [{"allowed_amount": 39.54, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 104.0, "npi": [1306003579]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 48.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 100.0, "npi": [1841516226, 1437513322, 1548688567]}]}]}]}, {"name": "Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited", "billing_code_type": "CPT", "billing_code": "76642", "billing_code_type_version": "2022", "description": "US BREAST UNI REAL TIME WITH IMAGE LIMITED", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 51.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1497784896, 1518177252, 1336597582, 1174662894, 1215166681]}, {"billed_charge": 260.0, "npi": [1497784896]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 51.95, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 124.0, "npi": [1871750729, 1083135180, 1063507853, 1124113972, 1851564892]}]}, {"allowed_amount": 61.19, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 124.0, "npi": [1083135180]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 54.51, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 168.0, "npi": [1326027657, 1841619871]}]}]}, {"tin": {"type": "ein", "value": "824944510"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 45.23, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1184153769, 1831517770]}]}]}]}, {"name": "Ultrasound, pelvic (nonobstetric), real time with image documentation; complete", "billing_code_type": "CPT", "billing_code": "76856", "billing_code_type_version": "2022", "description": "US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE", "allowed_amounts": [{"tin": {"type": "ein", "value": "412007905"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 61.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1730211046]}]}]}, {"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 46.35, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 85.0, "npi": [1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 135.0, "npi": [1306340195, 1518177252, 1841280005, 1598883787, 1174662894, 1538303383, 1215166681, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 124.0, "npi": [1912096868, 1043266117, 1083729222, 1871750729, 1417972944, 1770515249, 1780028563, 1053346452, 1679598197, 1942867411]}]}, {"allowed_amount": 61.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 124.0, "npi": [1699062232, 1164537346, 1124113972, 1679598197]}]}]}, {"tin": {"type": "ein", "value": "481203262"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 250.0, "providers": [{"billed_charge": 1893.0, "npi": [1154303337]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 65.0, "npi": [1790912897, 1497728422, 1871936518, 1285297549, 1316942576, 1306161237, 1538507256, 1588693949]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 61.67, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 175.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 139.7, "providers": [{"billed_charge": 2418.0, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1477751584, 1841516226, 1255780029]}]}]}]}, {"name": "Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation", "billing_code_type": "CPT", "billing_code": "76536", "billing_code_type_version": "2022", "description": "US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM", "allowed_amounts": [{"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 94.0, "npi": [1215166681, 1306340195, 1518177252, 1174662894]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 1096.2, "billing_code_modifier": ["TC"], "providers": [{"billed_charge": 1827.0, "npi": [1154400232, 1366515488]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 50.4, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 84.0, "npi": [1346496528, 1679503528]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 38.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 102.0, "npi": [1508205345]}]}, {"allowed_amount": 43.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 102.0, "npi": [1417972944, 1770515249, 1649659459]}]}, {"allowed_amount": 50.6, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 102.0, "npi": [1417972944]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 55.0, "npi": [1891799557, 1497728422, 1316942576, 1104319664, 1629365010, 1558579763, 1306161237]}]}]}, {"tin": {"type": "ein", "value": "710924732"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 38.1, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 128.0, "npi": [1346341583]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 43.77, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 95.0, "npi": [1841516226]}]}]}]}, {"name": "Ultrasound, transvaginal", "billing_code_type": "CPT", "billing_code": "76830", "billing_code_type_version": "2022", "description": "US TRANSVAGINAL", "allowed_amounts": [{"tin": {"type": "ein", "value": "431598353"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 46.35, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 85.0, "npi": [1831194901]}]}]}, {"tin": {"type": "ein", "value": "431793813"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 130.0, "npi": [1306340195, 1518177252, 1841280005, 1861602088, 1598883787, 1336597582, 1508229808, 1538303383, 1215166681, 1821009531]}]}]}, {"tin": {"type": "ein", "value": "461485841"}, "billing_class": "professional", "service_codes": ["23"], "payments": [{"allowed_amount": 54.88, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 133.0, "npi": [1619955671]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 103.72, "providers": [{"billed_charge": 970.19, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "481200790"}, "billing_class": "professional", "service_codes": ["23", "22", "21"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1912096868, 1043266117, 1083729222, 1871750729, 1417972944, 1770515249, 1780028563, 1194741652, 1679598197, 1053346452, 1124113972, 1942867411]}]}, {"allowed_amount": 62.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 125.0, "npi": [1164537346, 1164546479, 1124113972, 1679598197, 1699062232]}]}]}, {"tin": {"type": "ein", "value": "481220873"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 65.0, "npi": [1790912897, 1497728422, 1871936518, 1316942576, 1538507256]}]}]}, {"tin": {"type": "ein", "value": "481235274"}, "billing_class": "professional", "service_codes": ["22"], "payments": [{"allowed_amount": 62.28, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 110.0, "npi": [1578657623]}]}]}, {"tin": {"type": "ein", "value": "842772374"}, "billing_class": "professional", "service_codes": ["23", "22"], "payments": [{"allowed_amount": 53.16, "billing_code_modifier": ["26"], "providers": [{"billed_charge": 120.0, "npi": [1477751584, 1255780029]}]}]}]}, {"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": "262583411"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 45.3, "providers": [{"billed_charge": 311.66, "npi": [1659538858]}]}]}, {"tin": {"type": "ein", "value": "331234289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 42.57, "providers": [{"billed_charge": 151.0, "npi": [1245058916]}]}]}, {"tin": {"type": "ein", "value": "420680452"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 17.75, "providers": [{"billed_charge": 32.14, "npi": [1598905762]}]}]}, {"tin": {"type": "ein", "value": "440545289"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 72.6, "providers": [{"billed_charge": 90.0, "npi": [1437259694]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 23.4, "providers": [{"billed_charge": 39.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "446000696"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 26.0, "providers": [{"billed_charge": 26.0, "npi": [1942283866]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.26, "providers": [{"billed_charge": 58.94, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.26, "providers": [{"billed_charge": 141.75, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "486033703"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 9.26, "providers": [{"billed_charge": 210.25, "npi": [1508883422]}]}]}, {"tin": {"type": "ein", "value": "580566213"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.39, "providers": [{"billed_charge": 210.9, "npi": [1962461681]}]}]}, {"tin": {"type": "ein", "value": "620475842"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 22.9, "providers": [{"billed_charge": 22.9, "npi": [1164590386]}]}]}]}, {"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": "440545297"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 108.4, "providers": [{"billed_charge": 271.0, "npi": [1063494177]}]}]}, {"tin": {"type": "ein", "value": "440605373"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 16.8, "providers": [{"billed_charge": 28.0, "npi": [1154400232]}]}]}, {"tin": {"type": "ein", "value": "462162669"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.22, "providers": [{"billed_charge": 49.11, "npi": [1528301900]}]}]}, {"tin": {"type": "ein", "value": "480543789"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.22, "providers": [{"billed_charge": 103.22, "npi": [1194782409]}]}]}, {"tin": {"type": "ein", "value": "591113901"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 20.49, "providers": [{"billed_charge": 250.02, "npi": [1053321919]}]}]}, {"tin": {"type": "ein", "value": "731687745"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 21.35, "providers": [{"billed_charge": 40.0, "npi": [1528041704]}]}]}, {"tin": {"type": "ein", "value": "832312217"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 32.22, "providers": [{"billed_charge": 194.47, "npi": [1750921029]}]}]}, {"tin": {"type": "ein", "value": "843362602"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 53.0, "providers": [{"billed_charge": 53.0, "npi": [1639185457]}]}]}, {"tin": {"type": "ein", "value": "850732004"}, "billing_class": "professional", "service_codes": ["20"], "payments": [{"allowed_amount": 2.5, "providers": [{"billed_charge": 7.0, "npi": [1710370697, 1932730579, 1396412516]}]}]}, {"tin": {"type": "ein", "value": "900065118"}, "billing_class": "institutional", "service_codes": [null], "payments": [{"allowed_amount": 19.47, "providers": [{"billed_charge": 74.0, "npi": [1275566200]}]}]}]}]}