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oral evaluation                                                                            ","billing_code_type":"CDT","billing_code_type_version":"2022","billing_code":"D0120","description":"periodic oral evaluation                                                                            ","allowed_amounts":[{"tin":[{"value":"202091219 "}],"service_code":["OV"],"billing_class":"professional","payments":[{"allowed_amount":"34.00","providers":[{"billed_charge":"62.00","npi":"1104845817"}]}]}]},{"name":"periodic oral evaluation                                                                            ","billing_code_type":"CDT","billing_code_type_version":"2022","billing_code":"D0120","description":"periodic oral evaluation                                                                            ","allowed_amounts":[{"tin":[{"value":"262999138 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oral evaluation                                                                       ","billing_code_type":"CDT","billing_code_type_version":"2022","billing_code":"D0150","description":"comprehensive oral evaluation                                                                       ","allowed_amounts":[{"tin":[{"value":"          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