{"reporting_entity_name":"Regence BlueCross BlueShield of Utah","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-07-21","version":"1.0.0","out_of_network":[{"billing_code":"0753T","allowed_amounts":[{"tin":[{"type":"ein","value":"880577143 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"11.25","providers":[{"billed_charge":"25.00","npi":"1013168830"},{"billed_charge":"25.00","npi":"1841261286"}]},{"allowed_amount":"12.50","providers":[{"billed_charge":"50.00","npi":"1013168830"},{"billed_charge":"50.00","npi":"1447743976"}]},{"allowed_amount":"22.50","providers":[{"billed_charge":"50.00","npi":"1013168830"}]},{"allowed_amount":"6.25","providers":[{"billed_charge":"25.00","npi":"1013168830"},{"billed_charge":"25.00","npi":"1356456347"},{"billed_charge":"25.00","npi":"1578848842"},{"billed_charge":"25.00","npi":"1841261286"}]}]}]},{"name":"Behavioral Health Accommodations - Residential treatment - psychiatric","billing_code_type":"RC","billing_code_type_version":"2022","billing_code":"1001","description":"Behavioral Health Accommodations - Residential treatment - psychiatric","allowed_amounts":[{"tin":[{"type":"ein","value":"205110801 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"1200.00","providers":[{"billed_charge":"5880.00","npi":"1023865656"}]},{"allowed_amount":"275.50","providers":[{"billed_charge":"4880.00","npi":"1861249492"}]},{"allowed_amount":"495.90","providers":[{"billed_charge":"5880.00","npi":"1023865656"}]}]}]},{"name":"Insertion of needle into vein for collection of blood sample","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"36415","description":"Insertion of needle into vein for collection of blood sample","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"14.33","providers":[{"billed_charge":"72.88","npi":"1801591391"}]},{"allowed_amount":"3.88","providers":[{"billed_charge":"72.88","npi":"1346945839"}]},{"allowed_amount":"4.05","providers":[{"billed_charge":"72.88","npi":"1043915523"},{"billed_charge":"72.88","npi":"1801591391"}]},{"allowed_amount":"5.94","providers":[{"billed_charge":"72.88","npi":"1043915523"},{"billed_charge":"72.88","npi":"1346945839"},{"billed_charge":"72.88","npi":"1801591391"}]}]}]},{"name":"Insertion of needle into vein for collection of blood sample","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"36415","description":"Insertion of needle into vein for collection of blood sample","allowed_amounts":[{"tin":[{"type":"ein","value":"876000525 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"11.21","providers":[{"billed_charge":"29.30","npi":"1588656870"}]},{"allowed_amount":"14.33","providers":[{"billed_charge":"38.09","npi":"1588656870"}]},{"allowed_amount":"4.05","providers":[{"billed_charge":"29.30","npi":"1588656870"}]},{"allowed_amount":"5.94","providers":[{"billed_charge":"29.30","npi":"1588656870"}]}]}]},{"name":"Insertion of needle into vein for collection of blood sample","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"36415","description":"Insertion of needle into vein for collection of blood sample","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"4.05","providers":[{"billed_charge":"27.62","npi":"1366452880"},{"billed_charge":"27.62","npi":"1831108497"},{"billed_charge":"32.49","npi":"1043220650"},{"billed_charge":"32.49","npi":"1114025491"},{"billed_charge":"32.49","npi":"1154551919"},{"billed_charge":"32.49","npi":"1194749580"},{"billed_charge":"32.49","npi":"1528078581"},{"billed_charge":"32.49","npi":"1801903240"},{"billed_charge":"32.49","npi":"1912014358"},{"billed_charge":"32.49","npi":"1962412486"}]},{"allowed_amount":"5.94","providers":[{"billed_charge":"27.62","npi":"1366452880"},{"billed_charge":"27.62","npi":"1831108497"},{"billed_charge":"32.49","npi":"1043220650"},{"billed_charge":"32.49","npi":"1154551919"},{"billed_charge":"32.49","npi":"1194749580"},{"billed_charge":"32.49","npi":"1528078581"},{"billed_charge":"32.49","npi":"1912014358"},{"billed_charge":"32.49","npi":"1962412486"},{"billed_charge":"64.98","npi":"1962412486"}]},{"allowed_amount":"6.06","providers":[{"billed_charge":"27.62","npi":"1316055205"},{"billed_charge":"27.62","npi":"1538178801"},{"billed_charge":"27.62","npi":"1851530984"},{"billed_charge":"55.24","npi":"1538178801"}]},{"allowed_amount":"8.94","providers":[{"billed_charge":"27.62","npi":"1336256775"}]}]}]},{"name":"Insertion of needle into vein for collection of blood sample","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"36415","description":"Insertion of needle into vein for collection of blood sample","allowed_amounts":[{"tin":[{"type":"ein","value":"992885130 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"3.38","providers":[{"billed_charge":"9.00","npi":"1538635628"}]},{"allowed_amount":"3.97","providers":[{"billed_charge":"9.00","npi":"1295113025"}]},{"allowed_amount":"6.08","providers":[{"billed_charge":"9.00","npi":"1538635628"}]},{"allowed_amount":"7.15","providers":[{"billed_charge":"9.00","npi":"1295113025"}]}]}]},{"name":"CT scan head or brain","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"70450","description":"CT scan head or brain","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"87.07","providers":[{"billed_charge":"139.27","npi":"1033371760"},{"billed_charge":"139.27","npi":"1184626756"},{"billed_charge":"139.27","npi":"1235183781"},{"billed_charge":"139.27","npi":"1245264399"},{"billed_charge":"139.27","npi":"1245785492"},{"billed_charge":"139.27","npi":"1316108152"},{"billed_charge":"139.27","npi":"1366883324"},{"billed_charge":"139.27","npi":"1376540955"},{"billed_charge":"139.27","npi":"1477593556"},{"billed_charge":"139.27","npi":"1518910108"},{"billed_charge":"139.27","npi":"1629029319"},{"billed_charge":"139.27","npi":"1629266317"},{"billed_charge":"139.27","npi":"1730421918"},{"billed_charge":"139.27","npi":"1760420996"},{"billed_charge":"139.27","npi":"1861955049"},{"billed_charge":"139.27","npi":"1952644239"},{"billed_charge":"139.27","npi":"1982651717"}]}]}]},{"name":"X-ray of chest, 1 view","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"71045","description":"X-ray of chest, 1 view","allowed_amounts":[{"tin":[{"type":"ein","value":"751286819 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"11.15","providers":[{"billed_charge":"36.00","npi":"1023079050"},{"billed_charge":"36.00","npi":"1558576348"}]},{"allowed_amount":"17.33","providers":[{"billed_charge":"36.00","npi":"1336262153"},{"billed_charge":"36.00","npi":"1700812815"},{"billed_charge":"36.00","npi":"1942326699"}]},{"allowed_amount":"18.51","providers":[{"billed_charge":"107.00","npi":"1104141399"}]},{"allowed_amount":"8.33","providers":[{"billed_charge":"36.00","npi":"1114289741"},{"billed_charge":"36.00","npi":"1164405734"},{"billed_charge":"36.00","npi":"1336262153"},{"billed_charge":"36.00","npi":"1467847574"},{"billed_charge":"36.00","npi":"1578514246"},{"billed_charge":"36.00","npi":"1639130644"},{"billed_charge":"36.00","npi":"1679849822"},{"billed_charge":"36.00","npi":"1790019347"}]},{"allowed_amount":"9.49","providers":[{"billed_charge":"36.00","npi":"1114289741"},{"billed_charge":"36.00","npi":"1124059738"},{"billed_charge":"36.00","npi":"1245420348"},{"billed_charge":"36.00","npi":"1255759437"},{"billed_charge":"36.00","npi":"1396011771"},{"billed_charge":"36.00","npi":"1467744573"},{"billed_charge":"36.00","npi":"1467847574"},{"billed_charge":"36.00","npi":"1497118665"},{"billed_charge":"36.00","npi":"1528234127"},{"billed_charge":"36.00","npi":"1629151584"},{"billed_charge":"36.00","npi":"1649265612"},{"billed_charge":"36.00","npi":"1679891980"},{"billed_charge":"36.00","npi":"1821314667"},{"billed_charge":"36.00","npi":"1841468360"},{"billed_charge":"36.00","npi":"1841585304"},{"billed_charge":"36.00","npi":"1982724720"}]}]}]},{"name":"X-ray of chest, 1 view","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"71045","description":"X-ray of chest, 1 view","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"18.55","providers":[{"billed_charge":"28.14","npi":"1023265840"},{"billed_charge":"28.14","npi":"1043833569"},{"billed_charge":"28.14","npi":"1063541993"},{"billed_charge":"28.14","npi":"1104868850"},{"billed_charge":"28.14","npi":"1114119484"},{"billed_charge":"28.14","npi":"1144289521"},{"billed_charge":"28.14","npi":"1164516878"},{"billed_charge":"28.14","npi":"1184121675"},{"billed_charge":"28.14","npi":"1316108152"},{"billed_charge":"28.14","npi":"1336192970"},{"billed_charge":"28.14","npi":"1356309512"},{"billed_charge":"28.14","npi":"1376540955"},{"billed_charge":"28.14","npi":"1386067478"},{"billed_charge":"28.14","npi":"1386900595"},{"billed_charge":"28.14","npi":"1427092469"},{"billed_charge":"28.14","npi":"1447204672"},{"billed_charge":"28.14","npi":"1457336729"},{"billed_charge":"28.14","npi":"1477593556"},{"billed_charge":"28.14","npi":"1508427469"},{"billed_charge":"28.14","npi":"1508905514"},{"billed_charge":"28.14","npi":"1518306240"},{"billed_charge":"28.14","npi":"1518910108"},{"billed_charge":"28.14","npi":"1588608582"},{"billed_charge":"28.14","npi":"1629266317"},{"billed_charge":"28.14","npi":"1659390086"},{"billed_charge":"28.14","npi":"1720037641"},{"billed_charge":"28.14","npi":"1780815027"},{"billed_charge":"28.14","npi":"1841449030"},{"billed_charge":"28.14","npi":"1861955049"},{"billed_charge":"28.14","npi":"1912947995"}]}]}]},{"name":"X-ray of chest, 2 views","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"71046","description":"X-ray of chest, 2 views","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["20","23"],"billing_class":"professional","payments":[{"allowed_amount":"15.36","providers":[{"billed_charge":"31.50","npi":"1114962180"},{"billed_charge":"31.50","npi":"1588608582"},{"billed_charge":"31.50","npi":"1952644239"}]},{"allowed_amount":"19.28","providers":[{"billed_charge":"57.00","npi":"1235626698"},{"billed_charge":"57.00","npi":"1245374313"},{"billed_charge":"57.00","npi":"1265562326"},{"billed_charge":"57.00","npi":"1346486206"},{"billed_charge":"57.00","npi":"1396982203"},{"billed_charge":"57.00","npi":"1407982358"},{"billed_charge":"57.00","npi":"1477683357"},{"billed_charge":"57.00","npi":"1578687323"},{"billed_charge":"57.00","npi":"1720114648"},{"billed_charge":"57.00","npi":"1861757478"},{"billed_charge":"57.00","npi":"1881166361"}]},{"allowed_amount":"34.70","providers":[{"billed_charge":"57.00","npi":"1396982203"},{"billed_charge":"57.00","npi":"1407291974"},{"billed_charge":"57.00","npi":"1730217233"}]},{"allowed_amount":"8.54","providers":[{"billed_charge":"31.50","npi":"1114962180"},{"billed_charge":"31.50","npi":"1265562326"},{"billed_charge":"31.50","npi":"1346486206"},{"billed_charge":"31.50","npi":"1376540955"},{"billed_charge":"31.50","npi":"1407982358"},{"billed_charge":"31.50","npi":"1487004529"},{"billed_charge":"31.50","npi":"1578687323"},{"billed_charge":"31.50","npi":"1588608582"},{"billed_charge":"31.50","npi":"1629266317"},{"billed_charge":"31.50","npi":"1730421918"},{"billed_charge":"31.50","npi":"1881166361"}]}]}]},{"name":"X-ray of chest, 2 views","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"71046","description":"X-ray of chest, 2 views","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["20","23"],"billing_class":"professional","payments":[{"allowed_amount":"22.13","providers":[{"billed_charge":"31.50","npi":"1063541993"},{"billed_charge":"31.50","npi":"1104868850"},{"billed_charge":"31.50","npi":"1144289521"},{"billed_charge":"31.50","npi":"1215974266"},{"billed_charge":"31.50","npi":"1255630745"},{"billed_charge":"31.50","npi":"1316473887"},{"billed_charge":"31.50","npi":"1336192970"},{"billed_charge":"31.50","npi":"1356309512"},{"billed_charge":"31.50","npi":"1366883324"},{"billed_charge":"31.50","npi":"1376540955"},{"billed_charge":"31.50","npi":"1386067478"},{"billed_charge":"31.50","npi":"1386902120"},{"billed_charge":"31.50","npi":"1477593556"},{"billed_charge":"31.50","npi":"1487625869"},{"billed_charge":"31.50","npi":"1518128552"},{"billed_charge":"31.50","npi":"1588608582"},{"billed_charge":"31.50","npi":"1689625097"},{"billed_charge":"31.50","npi":"1932661154"},{"billed_charge":"31.50","npi":"1952644239"},{"billed_charge":"31.50","npi":"1982651717"}]}]}]},{"name":"CT scan of abdomen and pelvis with contrast","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"74177","description":"CT scan of abdomen and pelvis with contrast","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"185.49","providers":[{"billed_charge":"297.28","npi":"1023265840"},{"billed_charge":"297.28","npi":"1033371760"},{"billed_charge":"297.28","npi":"1083654065"},{"billed_charge":"297.28","npi":"1104868850"},{"billed_charge":"297.28","npi":"1114119484"},{"billed_charge":"297.28","npi":"1144289521"},{"billed_charge":"297.28","npi":"1164516878"},{"billed_charge":"297.28","npi":"1184039059"},{"billed_charge":"297.28","npi":"1215974266"},{"billed_charge":"297.28","npi":"1225172661"},{"billed_charge":"297.28","npi":"1235183781"},{"billed_charge":"297.28","npi":"1255345823"},{"billed_charge":"297.28","npi":"1306042957"},{"billed_charge":"297.28","npi":"1336192970"},{"billed_charge":"297.28","npi":"1356309512"},{"billed_charge":"297.28","npi":"1366883324"},{"billed_charge":"297.28","npi":"1376540955"},{"billed_charge":"297.28","npi":"1386902120"},{"billed_charge":"297.28","npi":"1427092469"},{"billed_charge":"297.28","npi":"1427231091"},{"billed_charge":"297.28","npi":"1447204672"},{"billed_charge":"297.28","npi":"1477593556"},{"billed_charge":"297.28","npi":"1497953384"},{"billed_charge":"297.28","npi":"1518306240"},{"billed_charge":"297.28","npi":"1518910108"},{"billed_charge":"297.28","npi":"1528280385"},{"billed_charge":"297.28","npi":"1588608582"},{"billed_charge":"297.28","npi":"1598296667"},{"billed_charge":"297.28","npi":"1619311792"},{"billed_charge":"297.28","npi":"1629029319"},{"billed_charge":"297.28","npi":"1649383027"},{"billed_charge":"297.28","npi":"1700092319"},{"billed_charge":"297.28","npi":"1770018301"},{"billed_charge":"297.28","npi":"1780815027"},{"billed_charge":"297.28","npi":"1821032863"},{"billed_charge":"297.28","npi":"1831298900"},{"billed_charge":"297.28","npi":"1891737094"},{"billed_charge":"297.28","npi":"1891796249"},{"billed_charge":"297.28","npi":"1902094667"},{"billed_charge":"297.28","npi":"1912947995"},{"billed_charge":"297.28","npi":"1942526801"},{"billed_charge":"297.28","npi":"1952644239"},{"billed_charge":"297.28","npi":"1982651717"}]}]}]},{"name":"Screening digital tomography of both breasts","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"77063","description":"Screening digital tomography of both breasts","allowed_amounts":[{"tin":[{"type":"ein","value":"870687771 "}],"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":"60.62","providers":[{"billed_charge":"74.90","npi":"1912074352"}]}]}]},{"name":"Screening digital tomography of both breasts","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"77063","description":"Screening digital tomography of both breasts","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"231.70","providers":[{"billed_charge":"231.70","npi":"1043220650"}]},{"allowed_amount":"34.38","providers":[{"billed_charge":"115.85","npi":"1194749580"},{"billed_charge":"115.85","npi":"1912014358"},{"billed_charge":"185.36","npi":"1679582944"},{"billed_charge":"231.70","npi":"1043220650"},{"billed_charge":"231.70","npi":"1154551919"},{"billed_charge":"231.70","npi":"1194749580"}]},{"allowed_amount":"50.43","providers":[{"billed_charge":"115.85","npi":"1043220650"},{"billed_charge":"115.85","npi":"1154551919"},{"billed_charge":"115.85","npi":"1194749580"},{"billed_charge":"231.70","npi":"1043220650"},{"billed_charge":"231.70","npi":"1114025491"},{"billed_charge":"231.70","npi":"1124661384"},{"billed_charge":"231.70","npi":"1194749580"},{"billed_charge":"231.70","npi":"1528078581"},{"billed_charge":"231.70","npi":"1801903240"},{"billed_charge":"231.70","npi":"1962412486"}]},{"allowed_amount":"51.45","providers":[{"billed_charge":"185.36","npi":"1851530984"},{"billed_charge":"92.68","npi":"1851530984"}]}]}]},{"name":"Screening mammography of both breasts","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"77067","description":"Screening mammography of both breasts","allowed_amounts":[{"tin":[{"type":"ein","value":"870687771 "}],"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":"75.09","providers":[{"billed_charge":"95.38","npi":"1912074352"}]}]}]},{"name":"Screening mammography of both breasts","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"77067","description":"Screening mammography of both breasts","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"130.48","providers":[{"billed_charge":"1229.89","npi":"1679582944"},{"billed_charge":"1446.93","npi":"1043220650"},{"billed_charge":"1446.93","npi":"1154551919"},{"billed_charge":"1446.93","npi":"1194749580"},{"billed_charge":"723.47","npi":"1194749580"},{"billed_charge":"723.47","npi":"1912014358"}]},{"allowed_amount":"1446.93","providers":[{"billed_charge":"1446.93","npi":"1043220650"}]},{"allowed_amount":"191.37","providers":[{"billed_charge":"1446.93","npi":"1043220650"},{"billed_charge":"1446.93","npi":"1114025491"},{"billed_charge":"1446.93","npi":"1124661384"},{"billed_charge":"1446.93","npi":"1194749580"},{"billed_charge":"1446.93","npi":"1528078581"},{"billed_charge":"1446.93","npi":"1801903240"},{"billed_charge":"1446.93","npi":"1962412486"},{"billed_charge":"723.47","npi":"1043220650"},{"billed_charge":"723.47","npi":"1154551919"},{"billed_charge":"723.47","npi":"1194749580"}]},{"allowed_amount":"195.23","providers":[{"billed_charge":"1229.89","npi":"1851530984"},{"billed_charge":"614.95","npi":"1851530984"}]}]}]},{"name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80050","description":"General health panel","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"24.14","providers":[{"billed_charge":"150.00","npi":"1740715333"}]},{"allowed_amount":"43.45","providers":[{"billed_charge":"150.00","npi":"1740715333"}]}]}]},{"name":"Blood test, comprehensive group of blood chemicals","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80053","description":"Blood test, comprehensive group of blood chemicals","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"10.56","providers":[{"billed_charge":"362.63","npi":"1043915523"},{"billed_charge":"362.63","npi":"1801591391"}]},{"allowed_amount":"109.12","providers":[{"billed_charge":"362.63","npi":"1801591391"}]},{"allowed_amount":"14.26","providers":[{"billed_charge":"362.63","npi":"1801591391"}]},{"allowed_amount":"18.61","providers":[{"billed_charge":"362.63","npi":"1346945839"}]},{"allowed_amount":"20.91","providers":[{"billed_charge":"362.63","npi":"1043915523"},{"billed_charge":"362.63","npi":"1801591391"}]},{"allowed_amount":"68.63","providers":[{"billed_charge":"362.63","npi":"1043915523"},{"billed_charge":"362.63","npi":"1801591391"}]}]}]},{"name":"Blood test, comprehensive group of blood chemicals","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80053","description":"Blood test, comprehensive group of blood chemicals","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"14.26","providers":[{"billed_charge":"81.45","npi":"1366452880"},{"billed_charge":"81.45","npi":"1831108497"},{"billed_charge":"95.82","npi":"1043220650"},{"billed_charge":"95.82","npi":"1154551919"},{"billed_charge":"95.82","npi":"1194749580"},{"billed_charge":"95.82","npi":"1528078581"},{"billed_charge":"95.82","npi":"1962412486"}]},{"allowed_amount":"20.91","providers":[{"billed_charge":"81.45","npi":"1831108497"},{"billed_charge":"95.82","npi":"1043220650"},{"billed_charge":"95.82","npi":"1114025491"},{"billed_charge":"95.82","npi":"1124661384"},{"billed_charge":"95.82","npi":"1154551919"},{"billed_charge":"95.82","npi":"1194749580"},{"billed_charge":"95.82","npi":"1528078581"},{"billed_charge":"95.82","npi":"1912014358"}]},{"allowed_amount":"21.33","providers":[{"billed_charge":"81.45","npi":"1316055205"},{"billed_charge":"81.45","npi":"1851530984"}]},{"allowed_amount":"31.47","providers":[{"billed_charge":"81.45","npi":"1336256775"}]}]}]},{"name":"Blood test, lipids (cholesterol and triglycerides)","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80061","description":"Blood test, lipids (cholesterol and triglycerides)","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"10.24","providers":[{"billed_charge":"33.48","npi":"1740715333"}]},{"allowed_amount":"5.69","providers":[{"billed_charge":"33.48","npi":"1740715333"}]}]}]},{"name":"Blood test, lipids (cholesterol and triglycerides)","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80061","description":"Blood test, lipids (cholesterol and triglycerides)","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"18.08","providers":[{"billed_charge":"80.38","npi":"1366452880"},{"billed_charge":"94.57","npi":"1154551919"},{"billed_charge":"94.57","npi":"1194749580"},{"billed_charge":"94.57","npi":"1962412486"}]},{"allowed_amount":"20.09","providers":[{"billed_charge":"94.57","npi":"1194749580"}]},{"allowed_amount":"26.51","providers":[{"billed_charge":"80.38","npi":"1831108497"},{"billed_charge":"94.57","npi":"1114025491"},{"billed_charge":"94.57","npi":"1194749580"},{"billed_charge":"94.57","npi":"1528078581"}]},{"allowed_amount":"27.05","providers":[{"billed_charge":"80.38","npi":"1851530984"}]},{"allowed_amount":"39.90","providers":[{"billed_charge":"80.38","npi":"1336256775"}]}]}]},{"name":"Testing for presence of drug, by chemistry analyzers","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80307","description":"Testing for presence of drug, by chemistry analyzers","allowed_amounts":[{"tin":[{"type":"ein","value":"474815114 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"26.41","providers":[{"billed_charge":"99.42","npi":"1215302245"}]},{"allowed_amount":"47.54","providers":[{"billed_charge":"99.42","npi":"1215302245"}]}]}]},{"name":"Testing for presence of drug, by chemistry analyzers","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80307","description":"Testing for presence of drug, by chemistry analyzers","allowed_amounts":[{"tin":[{"type":"ein","value":"824323767 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"74.57","providers":[{"billed_charge":"3795.00","npi":"1194201558"}]}]}]},{"name":"Testing for presence of drug, by chemistry analyzers","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"80307","description":"Testing for presence of drug, by chemistry analyzers","allowed_amounts":[{"tin":[{"type":"ein","value":"843172409 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"70.10","providers":[{"billed_charge":"4198.40","npi":"1003437500"}]},{"allowed_amount":"74.57","providers":[{"billed_charge":"4198.40","npi":"1003437500"}]}]}]},{"name":"Automated urinalysis test","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"81003","description":"Automated urinalysis test","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"12.22","providers":[{"billed_charge":"72.52","npi":"1043915523"},{"billed_charge":"72.52","npi":"1801591391"}]},{"allowed_amount":"18.07","providers":[{"billed_charge":"72.52","npi":"1801591391"}]},{"allowed_amount":"2.25","providers":[{"billed_charge":"72.52","npi":"1801591391"}]},{"allowed_amount":"3.85","providers":[{"billed_charge":"72.52","npi":"1346945839"}]}]}]},{"name":"Automated urinalysis test","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"81003","description":"Automated urinalysis test","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"0.81","providers":[{"billed_charge":"6.00","npi":"1407322779"},{"billed_charge":"6.00","npi":"1689141442"}]},{"allowed_amount":"0.96","providers":[{"billed_charge":"6.00","npi":"1114944790"},{"billed_charge":"6.00","npi":"1598294696"},{"billed_charge":"6.00","npi":"1932156247"}]},{"allowed_amount":"1.46","providers":[{"billed_charge":"6.00","npi":"1083676647"},{"billed_charge":"6.00","npi":"1205590791"},{"billed_charge":"6.00","npi":"1245743640"},{"billed_charge":"6.00","npi":"1508481706"},{"billed_charge":"6.00","npi":"1528840378"},{"billed_charge":"6.00","npi":"1598503716"}]},{"allowed_amount":"1.72","providers":[{"billed_charge":"6.00","npi":"1033556204"},{"billed_charge":"6.00","npi":"1124588488"},{"billed_charge":"6.00","npi":"1215170311"},{"billed_charge":"6.00","npi":"1598869026"},{"billed_charge":"6.00","npi":"1639288715"},{"billed_charge":"6.00","npi":"1659782969"},{"billed_charge":"6.00","npi":"1669821559"},{"billed_charge":"6.00","npi":"1679589881"},{"billed_charge":"6.00","npi":"1699354639"},{"billed_charge":"6.00","npi":"1831106681"}]}]}]},{"name":"Automated urinalysis test","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"81003","description":"Automated urinalysis test","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"0.96","providers":[{"billed_charge":"6.00","npi":"1194084996"},{"billed_charge":"6.00","npi":"1245374313"},{"billed_charge":"6.00","npi":"1265562326"},{"billed_charge":"6.00","npi":"1346486206"},{"billed_charge":"6.00","npi":"1396982203"},{"billed_charge":"6.00","npi":"1407291974"},{"billed_charge":"6.00","npi":"1467878256"},{"billed_charge":"6.00","npi":"1477680221"},{"billed_charge":"6.00","npi":"1578687323"},{"billed_charge":"6.00","npi":"1578693750"},{"billed_charge":"6.00","npi":"1689709875"},{"billed_charge":"6.00","npi":"1720114648"},{"billed_charge":"6.00","npi":"1730215518"},{"billed_charge":"6.00","npi":"1861757478"},{"billed_charge":"6.00","npi":"1881166361"},{"billed_charge":"6.00","npi":"1912250549"}]},{"allowed_amount":"1.72","providers":[{"billed_charge":"6.00","npi":"1245374313"},{"billed_charge":"6.00","npi":"1396982203"},{"billed_charge":"6.00","npi":"1407982358"},{"billed_charge":"6.00","npi":"1437289808"},{"billed_charge":"6.00","npi":"1568818003"}]}]}]},{"name":"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"81420","description":"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel","allowed_amounts":[{"tin":[{"type":"ein","value":"010894487 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"3400.00","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"394.71","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"425.00","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"455.43","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"493.38","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"500.00","providers":[{"billed_charge":"2900.00","npi":"1558672279"},{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"531.34","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"759.05","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]},{"allowed_amount":"910.86","providers":[{"billed_charge":"3400.00","npi":"1558672279"}]}]}]},{"name":"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"81420","description":"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel","allowed_amounts":[{"tin":[{"type":"ein","value":"811082020 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"1138.58","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"322.60","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"425.00","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"451.63","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"500.00","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"580.67","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]},{"allowed_amount":"910.86","providers":[{"billed_charge":"3036.20","npi":"1598314437"}]}]}]},{"name":"Cortisol (hormone) measurement, total","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"82533","description":"Cortisol (hormone) measurement, total","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"12.47","providers":[{"billed_charge":"40.75","npi":"1740715333"}]},{"allowed_amount":"6.93","providers":[{"billed_charge":"40.75","npi":"1740715333"}]}]}]},{"name":"Cyanocobalamin (vitamin B-12) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"82607","description":"Cyanocobalamin (vitamin B-12) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"11.54","providers":[{"billed_charge":"37.70","npi":"1740715333"}]},{"allowed_amount":"6.41","providers":[{"billed_charge":"37.70","npi":"1740715333"}]}]}]},{"name":"Dehydroepiandrosterone (DHEA-S) hormone level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"82627","description":"Dehydroepiandrosterone (DHEA-S) hormone level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"17.01","providers":[{"billed_charge":"55.58","npi":"1740715333"}]},{"allowed_amount":"9.45","providers":[{"billed_charge":"55.58","npi":"1740715333"}]}]}]},{"name":"Estradiol; total                                                                                    ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"82670","description":"Estradiol; total                                                                                    ","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"11.88","providers":[{"billed_charge":"69.85","npi":"1740715333"}]},{"allowed_amount":"21.38","providers":[{"billed_charge":"69.85","npi":"1740715333"}]}]}]},{"name":"Gonadotropin, follicle stimulating (reproductive hormone) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83001","description":"Gonadotropin, follicle stimulating (reproductive hormone) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"14.21","providers":[{"billed_charge":"46.45","npi":"1740715333"}]},{"allowed_amount":"7.90","providers":[{"billed_charge":"46.45","npi":"1740715333"}]}]}]},{"name":"Gonadotropin, luteinizing (reproductive hormone) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83002","description":"Gonadotropin, luteinizing (reproductive hormone) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"14.17","providers":[{"billed_charge":"46.30","npi":"1740715333"}]},{"allowed_amount":"7.87","providers":[{"billed_charge":"46.30","npi":"1740715333"}]}]}]},{"name":"Human growth hormone level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83003","description":"Human growth hormone level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"12.75","providers":[{"billed_charge":"41.68","npi":"1740715333"}]},{"allowed_amount":"7.09","providers":[{"billed_charge":"41.68","npi":"1740715333"}]}]}]},{"name":"Hemoglobin A1C level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83036","description":"Hemoglobin A1C level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"4.13","providers":[{"billed_charge":"24.28","npi":"1740715333"}]},{"allowed_amount":"7.43","providers":[{"billed_charge":"24.28","npi":"1740715333"}]}]}]},{"name":"Hemoglobin A1C level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83036","description":"Hemoglobin A1C level","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"13.11","providers":[{"billed_charge":"67.01","npi":"1831108497"},{"billed_charge":"78.83","npi":"1154551919"},{"billed_charge":"78.83","npi":"1194749580"},{"billed_charge":"78.83","npi":"1528078581"},{"billed_charge":"78.83","npi":"1962412486"}]},{"allowed_amount":"14.57","providers":[{"billed_charge":"78.83","npi":"1194749580"}]},{"allowed_amount":"19.23","providers":[{"billed_charge":"67.01","npi":"1831108497"},{"billed_charge":"78.83","npi":"1114025491"},{"billed_charge":"78.83","npi":"1154551919"},{"billed_charge":"78.83","npi":"1194749580"},{"billed_charge":"78.83","npi":"1528078581"}]},{"allowed_amount":"19.61","providers":[{"billed_charge":"67.01","npi":"1538178801"},{"billed_charge":"67.01","npi":"1851530984"}]}]}]},{"name":"Insulin measurement, total","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83525","description":"Insulin measurement, total","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"4.86","providers":[{"billed_charge":"28.58","npi":"1740715333"}]},{"allowed_amount":"8.75","providers":[{"billed_charge":"28.58","npi":"1740715333"}]}]}]},{"name":"Iron level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83540","description":"Iron level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"2.75","providers":[{"billed_charge":"16.18","npi":"1740715333"}]},{"allowed_amount":"4.95","providers":[{"billed_charge":"16.18","npi":"1740715333"}]}]}]},{"name":"Lipase (fat enzyme) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83690","description":"Lipase (fat enzyme) level","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"12.56","providers":[{"billed_charge":"228.72","npi":"1346945839"}]},{"allowed_amount":"44.72","providers":[{"billed_charge":"228.72","npi":"1801591391"}]},{"allowed_amount":"6.89","providers":[{"billed_charge":"228.72","npi":"1801591391"}]},{"allowed_amount":"70.07","providers":[{"billed_charge":"228.72","npi":"1801591391"}]}]}]},{"name":"Magnesium level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"83735","description":"Magnesium level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"2.85","providers":[{"billed_charge":"16.75","npi":"1740715333"}]},{"allowed_amount":"5.13","providers":[{"billed_charge":"16.75","npi":"1740715333"}]}]}]},{"name":"Progesterone (reproductive hormone) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84144","description":"Progesterone (reproductive hormone) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"15.96","providers":[{"billed_charge":"52.15","npi":"1740715333"}]},{"allowed_amount":"8.87","providers":[{"billed_charge":"52.15","npi":"1740715333"}]}]}]},{"name":"Prolactin (milk producing hormone) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84146","description":"Prolactin (milk producing hormone) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"14.82","providers":[{"billed_charge":"48.45","npi":"1740715333"}]},{"allowed_amount":"8.24","providers":[{"billed_charge":"48.45","npi":"1740715333"}]}]}]},{"name":"Sex hormone binding globulin (protein) level","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84270","description":"Sex hormone binding globulin (protein) level","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"16.62","providers":[{"billed_charge":"54.33","npi":"1740715333"}]},{"allowed_amount":"9.24","providers":[{"billed_charge":"54.33","npi":"1740715333"}]}]}]},{"name":"Testosterone (hormone) level, total","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84403","description":"Testosterone (hormone) level, total","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"10.97","providers":[{"billed_charge":"64.53","npi":"1740715333"}]},{"allowed_amount":"19.75","providers":[{"billed_charge":"64.53","npi":"1740715333"}]}]}]},{"name":"Thyroxine (thyroid chemical), free","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84439","description":"Thyroxine (thyroid chemical), free","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"3.84","providers":[{"billed_charge":"22.55","npi":"1740715333"}]},{"allowed_amount":"6.90","providers":[{"billed_charge":"22.55","npi":"1740715333"}]}]}]},{"name":"Blood test, thyroid stimulating hormone (TSH)","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84443","description":"Blood test, thyroid stimulating hormone (TSH)","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"22.68","providers":[{"billed_charge":"117.52","npi":"1154551919"},{"billed_charge":"117.52","npi":"1194749580"},{"billed_charge":"117.52","npi":"1528078581"},{"billed_charge":"117.52","npi":"1962412486"},{"billed_charge":"99.89","npi":"1831108497"}]},{"allowed_amount":"33.26","providers":[{"billed_charge":"117.52","npi":"1043220650"},{"billed_charge":"117.52","npi":"1154551919"},{"billed_charge":"117.52","npi":"1194749580"},{"billed_charge":"117.52","npi":"1528078581"},{"billed_charge":"117.52","npi":"1912014358"},{"billed_charge":"117.52","npi":"1962412486"},{"billed_charge":"99.89","npi":"1831108497"}]},{"allowed_amount":"50.06","providers":[{"billed_charge":"99.89","npi":"1336256775"}]}]}]},{"name":"Thyroid hormone, T3 measurement, free","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84481","description":"Thyroid hormone, T3 measurement, free","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"12.96","providers":[{"billed_charge":"42.35","npi":"1740715333"}]},{"allowed_amount":"7.20","providers":[{"billed_charge":"42.35","npi":"1740715333"}]}]}]},{"name":"Troponin (protein) analysis, quantitative","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84484","description":"Troponin (protein) analysis, quantitative","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"11.92","providers":[{"billed_charge":"281.00","npi":"1346945839"}]},{"allowed_amount":"12.47","providers":[{"billed_charge":"281.00","npi":"1043915523"}]},{"allowed_amount":"141.60","providers":[{"billed_charge":"562.00","npi":"1801591391"}]},{"allowed_amount":"24.94","providers":[{"billed_charge":"562.00","npi":"1043915523"},{"billed_charge":"562.00","npi":"1801591391"}]},{"allowed_amount":"42.88","providers":[{"billed_charge":"281.00","npi":"1043915523"},{"billed_charge":"281.00","npi":"1801591391"}]},{"allowed_amount":"47.69","providers":[{"billed_charge":"1124.00","npi":"1346945839"}]},{"allowed_amount":"70.80","providers":[{"billed_charge":"281.00","npi":"1801591391"}]},{"allowed_amount":"85.77","providers":[{"billed_charge":"562.00","npi":"1043915523"},{"billed_charge":"562.00","npi":"1801591391"}]}]}]},{"name":"Gonadotropin (reproductive hormone) analysis","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"84703","description":"Gonadotropin (reproductive hormone) analysis","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"13.34","providers":[{"billed_charge":"176.15","npi":"1346945839"}]},{"allowed_amount":"33.78","providers":[{"billed_charge":"176.15","npi":"1801591391"}]},{"allowed_amount":"35.71","providers":[{"billed_charge":"176.15","npi":"1801591391"}]},{"allowed_amount":"7.52","providers":[{"billed_charge":"176.15","npi":"1801591391"}]}]}]},{"name":"Blood count, hemoglobin","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"85018","description":"Blood count, hemoglobin","allowed_amounts":[{"tin":[{"type":"ein","value":"710897031 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"2.50","providers":[{"billed_charge":"8.85","npi":"1366479099"}]}]}]},{"name":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated dif","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"85025","description":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated dif","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"11.77","providers":[{"billed_charge":"326.71","npi":"1346945839"}]},{"allowed_amount":"15.38","providers":[{"billed_charge":"326.71","npi":"1801591391"}]},{"allowed_amount":"34.61","providers":[{"billed_charge":"326.71","npi":"1043915523"},{"billed_charge":"326.71","npi":"1801591391"}]},{"allowed_amount":"7.77","providers":[{"billed_charge":"326.71","npi":"1043915523"},{"billed_charge":"326.71","npi":"1801591391"}]},{"allowed_amount":"72.62","providers":[{"billed_charge":"326.71","npi":"1801591391"}]}]}]},{"name":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated dif","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"85025","description":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated dif","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"10.49","providers":[{"billed_charge":"77.73","npi":"1366452880"},{"billed_charge":"77.73","npi":"1831108497"},{"billed_charge":"91.45","npi":"1043220650"},{"billed_charge":"91.45","npi":"1124661384"},{"billed_charge":"91.45","npi":"1194749580"},{"billed_charge":"91.45","npi":"1528078581"},{"billed_charge":"91.45","npi":"1962412486"}]},{"allowed_amount":"15.38","providers":[{"billed_charge":"77.73","npi":"1831108497"},{"billed_charge":"91.45","npi":"1043220650"},{"billed_charge":"91.45","npi":"1114025491"},{"billed_charge":"91.45","npi":"1124661384"},{"billed_charge":"91.45","npi":"1154551919"},{"billed_charge":"91.45","npi":"1194749580"},{"billed_charge":"91.45","npi":"1528078581"},{"billed_charge":"91.45","npi":"1912014358"},{"billed_charge":"91.45","npi":"1962412486"}]},{"allowed_amount":"15.70","providers":[{"billed_charge":"77.73","npi":"1538178801"}]},{"allowed_amount":"23.15","providers":[{"billed_charge":"77.73","npi":"1336256775"}]}]}]},{"name":"Complete blood cell count (red cells, white blood cell, platelets), automated test","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"85027","description":"Complete blood cell count (red cells, white blood cell, platelets), automated test","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"12.81","providers":[{"billed_charge":"58.37","npi":"1831108497"},{"billed_charge":"68.67","npi":"1154551919"},{"billed_charge":"68.67","npi":"1194749580"},{"billed_charge":"68.67","npi":"1528078581"},{"billed_charge":"68.67","npi":"1962412486"}]},{"allowed_amount":"13.07","providers":[{"billed_charge":"58.37","npi":"1316055205"},{"billed_charge":"58.37","npi":"1851530984"}]},{"allowed_amount":"8.73","providers":[{"billed_charge":"68.67","npi":"1114025491"},{"billed_charge":"68.67","npi":"1124661384"},{"billed_charge":"68.67","npi":"1154551919"},{"billed_charge":"68.67","npi":"1528078581"},{"billed_charge":"68.67","npi":"1962412486"}]}]}]},{"name":"Microsomal antibodies (autoantibody) measurement","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"86376","description":"Microsomal antibodies (autoantibody) measurement","allowed_amounts":[{"tin":[{"type":"ein","value":"814697090 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"11.13","providers":[{"billed_charge":"36.38","npi":"1740715333"}]},{"allowed_amount":"6.19","providers":[{"billed_charge":"36.38","npi":"1740715333"}]}]}]},{"name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavir","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"87637","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavir","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":"109.12","providers":[{"billed_charge":"357.00","npi":"1407291974"},{"billed_charge":"357.00","npi":"1477680221"},{"billed_charge":"357.00","npi":"1881166361"}]},{"allowed_amount":"60.62","providers":[{"billed_charge":"357.00","npi":"1033240460"},{"billed_charge":"357.00","npi":"1164911962"},{"billed_charge":"357.00","npi":"1235626698"},{"billed_charge":"357.00","npi":"1245374313"},{"billed_charge":"357.00","npi":"1265562326"},{"billed_charge":"357.00","npi":"1396982203"},{"billed_charge":"357.00","npi":"1477680221"},{"billed_charge":"357.00","npi":"1578693750"},{"billed_charge":"357.00","npi":"1730217233"},{"billed_charge":"357.00","npi":"1861757478"}]},{"allowed_amount":"84.87","providers":[{"billed_charge":"357.00","npi":"1477680221"}]}]}]},{"name":"Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, gr","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"87880","description":"Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, gr","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":"12.65","providers":[{"billed_charge":"41.00","npi":"1033240460"},{"billed_charge":"41.00","npi":"1477680221"},{"billed_charge":"41.00","npi":"1578687323"},{"billed_charge":"41.00","npi":"1730217233"},{"billed_charge":"41.00","npi":"1881166361"},{"billed_charge":"41.00","npi":"1902936008"}]},{"allowed_amount":"7.03","providers":[{"billed_charge":"41.00","npi":"1033240460"},{"billed_charge":"41.00","npi":"1164911962"},{"billed_charge":"41.00","npi":"1245374313"},{"billed_charge":"41.00","npi":"1346486206"},{"billed_charge":"41.00","npi":"1396982203"},{"billed_charge":"41.00","npi":"1407982358"},{"billed_charge":"41.00","npi":"1477680221"},{"billed_charge":"41.00","npi":"1477683357"},{"billed_charge":"41.00","npi":"1568818003"},{"billed_charge":"41.00","npi":"1578687323"},{"billed_charge":"41.00","npi":"1578693750"},{"billed_charge":"41.00","npi":"1689709875"},{"billed_charge":"41.00","npi":"1720114648"},{"billed_charge":"41.00","npi":"1730217233"},{"billed_charge":"41.00","npi":"1861757478"},{"billed_charge":"41.00","npi":"1881166361"},{"billed_charge":"41.00","npi":"1912250549"}]},{"allowed_amount":"9.84","providers":[{"billed_charge":"41.00","npi":"1477680221"}]}]}]},{"name":"Pathology examination of tissue using a microscope, intermediate complexity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"88305","description":"Pathology examination of tissue using a microscope, intermediate complexity","allowed_amounts":[{"tin":[{"type":"ein","value":"841433257 "}],"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":"112.04","providers":[{"billed_charge":"407.00","npi":"1225349525"},{"billed_charge":"407.00","npi":"1497795728"},{"billed_charge":"407.00","npi":"1598082398"}]},{"allowed_amount":"168.07","providers":[{"billed_charge":"610.50","npi":"1225349525"},{"billed_charge":"610.50","npi":"1497795728"}]},{"allowed_amount":"224.09","providers":[{"billed_charge":"814.00","npi":"1225349525"},{"billed_charge":"814.00","npi":"1497795728"}]},{"allowed_amount":"280.11","providers":[{"billed_charge":"1017.50","npi":"1497795728"}]},{"allowed_amount":"56.02","providers":[{"billed_charge":"203.50","npi":"1225349525"},{"billed_charge":"203.50","npi":"1497795728"},{"billed_charge":"203.50","npi":"1598082398"},{"billed_charge":"203.50","npi":"1700265436"}]},{"allowed_amount":"560.22","providers":[{"billed_charge":"2035.00","npi":"1497795728"}]},{"allowed_amount":"672.26","providers":[{"billed_charge":"2442.00","npi":"1598082398"}]}]}]},{"name":"Pathology examination of tissue using a microscope, intermediate complexity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"88305","description":"Pathology examination of tissue using a microscope, intermediate complexity","allowed_amounts":[{"tin":[{"type":"ein","value":"880577143 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"154.42","providers":[{"billed_charge":"590.00","npi":"1013168830"}]},{"allowed_amount":"42.90","providers":[{"billed_charge":"295.00","npi":"1013168830"},{"billed_charge":"295.00","npi":"1356456347"},{"billed_charge":"295.00","npi":"1578848842"},{"billed_charge":"295.00","npi":"1841261286"}]},{"allowed_amount":"77.21","providers":[{"billed_charge":"295.00","npi":"1013168830"},{"billed_charge":"295.00","npi":"1578848842"},{"billed_charge":"295.00","npi":"1760828560"},{"billed_charge":"295.00","npi":"1841261286"}]},{"allowed_amount":"85.79","providers":[{"billed_charge":"590.00","npi":"1013168830"},{"billed_charge":"590.00","npi":"1447743976"}]}]}]},{"name":"Administration of 1 vaccine","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"90471","description":"Administration of 1 vaccine","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"11.20","providers":[{"billed_charge":"50.00","npi":"1134744014"},{"billed_charge":"50.00","npi":"1336760537"},{"billed_charge":"50.00","npi":"1730571126"},{"billed_charge":"50.00","npi":"1730655994"}]},{"allowed_amount":"13.18","providers":[{"billed_charge":"50.00","npi":"1083051478"},{"billed_charge":"50.00","npi":"1154600922"},{"billed_charge":"50.00","npi":"1316920770"},{"billed_charge":"50.00","npi":"1497259675"},{"billed_charge":"50.00","npi":"1538497524"},{"billed_charge":"50.00","npi":"1538629647"},{"billed_charge":"50.00","npi":"1578852174"},{"billed_charge":"50.00","npi":"1619928140"},{"billed_charge":"50.00","npi":"1730765504"},{"billed_charge":"50.00","npi":"1740232750"},{"billed_charge":"50.00","npi":"1821188442"},{"billed_charge":"50.00","npi":"1831106681"},{"billed_charge":"50.00","npi":"1932153145"},{"billed_charge":"50.00","npi":"1982885471"}]},{"allowed_amount":"20.16","providers":[{"billed_charge":"50.00","npi":"1275223067"},{"billed_charge":"50.00","npi":"1366094617"},{"billed_charge":"50.00","npi":"1376553834"},{"billed_charge":"50.00","npi":"1417945023"},{"billed_charge":"50.00","npi":"1528193802"},{"billed_charge":"50.00","npi":"1770118457"},{"billed_charge":"50.00","npi":"1902592652"}]},{"allowed_amount":"23.72","providers":[{"billed_charge":"50.00","npi":"1023150851"},{"billed_charge":"50.00","npi":"1144724857"},{"billed_charge":"50.00","npi":"1255744652"},{"billed_charge":"50.00","npi":"1457000838"},{"billed_charge":"50.00","npi":"1538497524"},{"billed_charge":"50.00","npi":"1770642480"},{"billed_charge":"50.00","npi":"1992047286"}]},{"allowed_amount":"31.73","providers":[{"billed_charge":"50.00","npi":"1497259675"}]}]}]},{"name":"Psychotherapy performed with evaluation and management visit, 30 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"90833","description":"Psychotherapy performed with evaluation and management visit, 30 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"100.16","providers":[{"billed_charge":"161.00","npi":"1225327927"},{"billed_charge":"161.00","npi":"1457883134"},{"billed_charge":"161.00","npi":"1639469398"},{"billed_charge":"161.00","npi":"1750516472"},{"billed_charge":"161.00","npi":"1770712283"}]},{"allowed_amount":"36.77","providers":[{"billed_charge":"161.00","npi":"1457883134"},{"billed_charge":"161.00","npi":"1740508340"}]},{"allowed_amount":"66.19","providers":[{"billed_charge":"161.00","npi":"1053844258"},{"billed_charge":"161.00","npi":"1336465962"},{"billed_charge":"161.00","npi":"1346520434"},{"billed_charge":"161.00","npi":"1477087138"},{"billed_charge":"161.00","npi":"1770712283"},{"billed_charge":"161.00","npi":"1922029495"}]}]}]},{"name":"Psychotherapy, 60 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"90837","description":"Psychotherapy, 60 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"864006611 "}],"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":"175.00","providers":[{"billed_charge":"175.00","npi":"1124695788"}]}]}]},{"name":"Psychotherapy, 60 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"90837","description":"Psychotherapy, 60 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"934291264 "}],"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":"210.00","providers":[{"billed_charge":"210.00","npi":"1063231827"}]}]}]},{"name":"Inpatient or outpatient dialysis services","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"90999","description":"Inpatient or outpatient dialysis services","allowed_amounts":[{"tin":[{"type":"ein","value":"953372911 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"207.22","providers":[{"billed_charge":"3287.25","npi":"1750046686"}]},{"allowed_amount":"377.67","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"377.78","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"378.45","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"379.00","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"380.40","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"381.61","providers":[{"billed_charge":"6144.00","npi":"1295498608"}]},{"allowed_amount":"459.00","providers":[{"billed_charge":"6144.00","npi":"1184387516"}]},{"allowed_amount":"576.24","providers":[{"billed_charge":"6768.00","npi":"1750046686"}]},{"allowed_amount":"579.45","providers":[{"billed_charge":"6768.00","npi":"1750046686"}]},{"allowed_amount":"825.00","providers":[{"billed_charge":"10108.00","npi":"1619630571"},{"billed_charge":"6144.00","npi":"1750046686"},{"billed_charge":"6768.00","npi":"1750046686"}]}]}]},{"name":"Treatment of speech, language, voice, communication, and\/or hearing processing disorder","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"92507","description":"Treatment of speech, language, voice, communication, and\/or hearing processing disorder","allowed_amounts":[{"tin":[{"type":"ein","value":"853869910 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"93.18","providers":[{"billed_charge":"340.00","npi":"1750014809"},{"billed_charge":"340.00","npi":"1780317230"}]}]}]},{"name":"Routine electrocardiogram (EKG) with tracing using at least 12 leads","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"93005","description":"Routine electrocardiogram (EKG) with tracing using at least 12 leads","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"110.80","providers":[{"billed_charge":"524.75","npi":"1043915523"},{"billed_charge":"524.75","npi":"1801591391"}]},{"allowed_amount":"133.59","providers":[{"billed_charge":"524.75","npi":"1801591391"}]},{"allowed_amount":"141.18","providers":[{"billed_charge":"524.75","npi":"1346945839"}]},{"allowed_amount":"145.90","providers":[{"billed_charge":"524.75","npi":"1043915523"},{"billed_charge":"524.75","npi":"1801591391"}]},{"allowed_amount":"423.53","providers":[{"billed_charge":"1574.25","npi":"1346945839"}]}]}]},{"name":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"93010","description":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","allowed_amounts":[{"tin":[{"type":"ein","value":"870301301 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"16.42","providers":[{"billed_charge":"63.00","npi":"1184398679"}]},{"allowed_amount":"17.54","providers":[{"billed_charge":"63.00","npi":"1205691649"},{"billed_charge":"63.00","npi":"1851916993"}]},{"allowed_amount":"20.64","providers":[{"billed_charge":"63.00","npi":"1043381437"},{"billed_charge":"63.00","npi":"1053586651"},{"billed_charge":"63.00","npi":"1053873174"},{"billed_charge":"63.00","npi":"1073747887"},{"billed_charge":"63.00","npi":"1114136132"},{"billed_charge":"63.00","npi":"1114582392"},{"billed_charge":"63.00","npi":"1124274139"},{"billed_charge":"63.00","npi":"1124563432"},{"billed_charge":"63.00","npi":"1144513623"},{"billed_charge":"63.00","npi":"1205586195"},{"billed_charge":"63.00","npi":"1326542242"},{"billed_charge":"63.00","npi":"1336679430"},{"billed_charge":"63.00","npi":"1346680808"},{"billed_charge":"63.00","npi":"1407296247"},{"billed_charge":"63.00","npi":"1417375387"},{"billed_charge":"63.00","npi":"1548288806"},{"billed_charge":"63.00","npi":"1548792187"},{"billed_charge":"63.00","npi":"1578799342"},{"billed_charge":"63.00","npi":"1619193026"},{"billed_charge":"63.00","npi":"1619506870"},{"billed_charge":"63.00","npi":"1639308745"},{"billed_charge":"63.00","npi":"1639531478"},{"billed_charge":"63.00","npi":"1649660846"},{"billed_charge":"63.00","npi":"1659723914"},{"billed_charge":"63.00","npi":"1679136758"},{"billed_charge":"63.00","npi":"1710565718"},{"billed_charge":"63.00","npi":"1730522277"},{"billed_charge":"63.00","npi":"1770769895"},{"billed_charge":"63.00","npi":"1821618810"},{"billed_charge":"63.00","npi":"1831432723"},{"billed_charge":"63.00","npi":"1841213691"},{"billed_charge":"63.00","npi":"1851911663"},{"billed_charge":"63.00","npi":"1932510724"},{"billed_charge":"63.00","npi":"1942837703"},{"billed_charge":"63.00","npi":"1962580654"},{"billed_charge":"63.00","npi":"1982017232"},{"billed_charge":"63.00","npi":"1992384960"}]},{"allowed_amount":"63.00","providers":[{"billed_charge":"63.00","npi":"1942837703"}]}]}]},{"name":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"93010","description":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","allowed_amounts":[{"tin":[{"type":"ein","value":"870492357 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"17.54","providers":[{"billed_charge":"54.00","npi":"1063467819"},{"billed_charge":"54.00","npi":"1184623217"},{"billed_charge":"54.00","npi":"1497200539"},{"billed_charge":"54.00","npi":"1770814238"}]},{"allowed_amount":"20.64","providers":[{"billed_charge":"54.00","npi":"1003863770"},{"billed_charge":"54.00","npi":"1013177328"},{"billed_charge":"54.00","npi":"1104117019"},{"billed_charge":"54.00","npi":"1114967163"},{"billed_charge":"54.00","npi":"1124293139"},{"billed_charge":"54.00","npi":"1144894668"},{"billed_charge":"54.00","npi":"1154364891"},{"billed_charge":"54.00","npi":"1164950176"},{"billed_charge":"54.00","npi":"1225201148"},{"billed_charge":"54.00","npi":"1285048363"},{"billed_charge":"54.00","npi":"1376766220"},{"billed_charge":"54.00","npi":"1417319799"},{"billed_charge":"54.00","npi":"1417374737"},{"billed_charge":"54.00","npi":"1427478577"},{"billed_charge":"54.00","npi":"1528402526"},{"billed_charge":"54.00","npi":"1528640430"},{"billed_charge":"54.00","npi":"1538216742"},{"billed_charge":"54.00","npi":"1598847568"},{"billed_charge":"54.00","npi":"1659991321"},{"billed_charge":"54.00","npi":"1679520456"},{"billed_charge":"54.00","npi":"1699712836"},{"billed_charge":"54.00","npi":"1700266285"},{"billed_charge":"54.00","npi":"1710220876"},{"billed_charge":"54.00","npi":"1710399944"},{"billed_charge":"54.00","npi":"1770016925"},{"billed_charge":"54.00","npi":"1811932700"},{"billed_charge":"54.00","npi":"1851853477"},{"billed_charge":"54.00","npi":"1932544798"},{"billed_charge":"54.00","npi":"1952713299"},{"billed_charge":"54.00","npi":"1982165833"},{"billed_charge":"54.00","npi":"1992191324"}]},{"allowed_amount":"54.00","providers":[{"billed_charge":"54.00","npi":"1003863770"},{"billed_charge":"54.00","npi":"1124293139"},{"billed_charge":"54.00","npi":"1417374737"},{"billed_charge":"54.00","npi":"1811932700"}]}]}]},{"name":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"93010","description":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","allowed_amounts":[{"tin":[{"type":"ein","value":"870636000 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"20.64","providers":[{"billed_charge":"54.00","npi":"1124558119"},{"billed_charge":"54.00","npi":"1235636952"},{"billed_charge":"54.00","npi":"1245268390"},{"billed_charge":"54.00","npi":"1295994549"},{"billed_charge":"54.00","npi":"1386872828"},{"billed_charge":"54.00","npi":"1477507200"},{"billed_charge":"54.00","npi":"1487278966"},{"billed_charge":"54.00","npi":"1588604532"},{"billed_charge":"54.00","npi":"1588691190"},{"billed_charge":"54.00","npi":"1669425146"},{"billed_charge":"54.00","npi":"1770539744"},{"billed_charge":"54.00","npi":"1780819771"},{"billed_charge":"54.00","npi":"1801457528"},{"billed_charge":"54.00","npi":"1851597090"},{"billed_charge":"54.00","npi":"1902192164"}]},{"allowed_amount":"54.00","providers":[{"billed_charge":"54.00","npi":"1386872828"},{"billed_charge":"54.00","npi":"1477507200"},{"billed_charge":"54.00","npi":"1487278966"},{"billed_charge":"54.00","npi":"1588604532"},{"billed_charge":"54.00","npi":"1770539744"}]}]}]},{"name":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"93010","description":"Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"15.27","providers":[{"billed_charge":"19.00","npi":"1255308813"},{"billed_charge":"19.00","npi":"1497742829"}]},{"allowed_amount":"19.00","providers":[{"billed_charge":"19.00","npi":"1013293620"},{"billed_charge":"19.00","npi":"1043288368"},{"billed_charge":"19.00","npi":"1225023088"},{"billed_charge":"19.00","npi":"1255308813"},{"billed_charge":"19.00","npi":"1396937363"},{"billed_charge":"19.00","npi":"1417959206"},{"billed_charge":"19.00","npi":"1447387386"},{"billed_charge":"19.00","npi":"1518303569"},{"billed_charge":"19.00","npi":"1629422159"},{"billed_charge":"19.00","npi":"1649491440"},{"billed_charge":"19.00","npi":"1669440269"},{"billed_charge":"19.00","npi":"1689838542"},{"billed_charge":"19.00","npi":"1902988546"}]},{"allowed_amount":"8.49","providers":[{"billed_charge":"19.00","npi":"1255308813"}]}]}]},{"name":"Hydration infusion into a vein","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"96361","description":"Hydration infusion into a vein","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"101.58","providers":[{"billed_charge":"467.47","npi":"1346945839"}]},{"allowed_amount":"172.61","providers":[{"billed_charge":"934.94","npi":"1801591391"}]},{"allowed_amount":"184.29","providers":[{"billed_charge":"934.94","npi":"1801591391"}]},{"allowed_amount":"258.92","providers":[{"billed_charge":"1402.41","npi":"1801591391"}]},{"allowed_amount":"276.43","providers":[{"billed_charge":"1402.41","npi":"1801591391"}]},{"allowed_amount":"86.05","providers":[{"billed_charge":"467.47","npi":"1346945839"},{"billed_charge":"467.47","npi":"1801591391"}]},{"allowed_amount":"86.31","providers":[{"billed_charge":"467.47","npi":"1043915523"},{"billed_charge":"467.47","npi":"1801591391"}]},{"allowed_amount":"92.14","providers":[{"billed_charge":"467.47","npi":"1801591391"}]}]}]},{"name":"Therapeutic, prophylactic, or diagnostic injection                                                  ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"96372","description":"Therapeutic, prophylactic, or diagnostic injection                                                  ","allowed_amounts":[{"tin":[{"type":"ein","value":"275505337 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"13.99","providers":[{"billed_charge":"25.00","npi":"1790582591"}]},{"allowed_amount":"7.77","providers":[{"billed_charge":"25.00","npi":"1598556805"},{"billed_charge":"25.00","npi":"1790582591"},{"billed_charge":"25.00","npi":"1871259184"}]}]}]},{"name":"Injection of drug or substance into a vein for therapy, diagnosis, or prevention","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"96374","description":"Injection of drug or substance into a vein for therapy, diagnosis, or prevention","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"258.17","providers":[{"billed_charge":"886.56","npi":"1346945839"}]},{"allowed_amount":"263.35","providers":[{"billed_charge":"886.56","npi":"1043915523"},{"billed_charge":"886.56","npi":"1801591391"}]},{"allowed_amount":"271.48","providers":[{"billed_charge":"886.56","npi":"1801591391"}]},{"allowed_amount":"388.26","providers":[{"billed_charge":"886.56","npi":"1043915523"},{"billed_charge":"886.56","npi":"1346945839"},{"billed_charge":"886.56","npi":"1801591391"}]}]}]},{"name":"Injection of different drug or substance into a vein for therapy, diagnosis, or prevention","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"96375","description":"Injection of different drug or substance into a vein for therapy, diagnosis, or prevention","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"110.15","providers":[{"billed_charge":"221.64","npi":"1346945839"}]},{"allowed_amount":"118.09","providers":[{"billed_charge":"221.64","npi":"1801591391"}]},{"allowed_amount":"122.33","providers":[{"billed_charge":"221.64","npi":"1043915523"},{"billed_charge":"221.64","npi":"1801591391"}]},{"allowed_amount":"172.10","providers":[{"billed_charge":"443.28","npi":"1346945839"},{"billed_charge":"443.28","npi":"1801591391"}]},{"allowed_amount":"220.30","providers":[{"billed_charge":"443.28","npi":"1346945839"}]},{"allowed_amount":"236.18","providers":[{"billed_charge":"443.28","npi":"1801591391"}]},{"allowed_amount":"244.65","providers":[{"billed_charge":"443.28","npi":"1801591391"}]},{"allowed_amount":"330.45","providers":[{"billed_charge":"664.92","npi":"1346945839"}]},{"allowed_amount":"354.26","providers":[{"billed_charge":"664.92","npi":"1801591391"}]},{"allowed_amount":"366.98","providers":[{"billed_charge":"664.92","npi":"1043915523"},{"billed_charge":"664.92","npi":"1801591391"}]},{"allowed_amount":"472.35","providers":[{"billed_charge":"886.56","npi":"1801591391"}]},{"allowed_amount":"489.30","providers":[{"billed_charge":"886.56","npi":"1801591391"}]},{"allowed_amount":"86.05","providers":[{"billed_charge":"221.64","npi":"1801591391"}]}]}]},{"name":"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minut","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"97110","description":"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minut","allowed_amounts":[{"tin":[{"type":"ein","value":"844236556 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"112.50","providers":[{"billed_charge":"296.00","npi":"1306354881"}]},{"allowed_amount":"62.13","providers":[{"billed_charge":"148.00","npi":"1306354881"}]},{"allowed_amount":"74.66","providers":[{"billed_charge":"296.00","npi":"1306354881"}]},{"allowed_amount":"88.56","providers":[{"billed_charge":"222.00","npi":"1306354881"}]},{"allowed_amount":"93.54","providers":[{"billed_charge":"296.00","npi":"1306354881"}]}]}]},{"name":"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minut","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"97110","description":"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minut","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"17.05","providers":[{"billed_charge":"73.00","npi":"1063568533"},{"billed_charge":"73.00","npi":"1063601730"},{"billed_charge":"73.00","npi":"1508597279"},{"billed_charge":"73.00","npi":"1629350582"},{"billed_charge":"73.00","npi":"1689148454"},{"billed_charge":"73.00","npi":"1780365239"},{"billed_charge":"73.00","npi":"1962177170"}]},{"allowed_amount":"30.69","providers":[{"billed_charge":"73.00","npi":"1205993961"},{"billed_charge":"73.00","npi":"1841640752"}]},{"allowed_amount":"34.10","providers":[{"billed_charge":"146.00","npi":"1063568533"},{"billed_charge":"146.00","npi":"1508597279"},{"billed_charge":"146.00","npi":"1962177170"}]},{"allowed_amount":"51.15","providers":[{"billed_charge":"219.00","npi":"1508597279"}]},{"allowed_amount":"61.38","providers":[{"billed_charge":"146.00","npi":"1205993961"}]},{"allowed_amount":"68.20","providers":[{"billed_charge":"292.00","npi":"1508597279"}]}]}]},{"name":"Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"97112","description":"Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"19.57","providers":[{"billed_charge":"83.00","npi":"1689148454"},{"billed_charge":"83.00","npi":"1780365239"}]},{"allowed_amount":"35.23","providers":[{"billed_charge":"83.00","npi":"1205993961"}]},{"allowed_amount":"39.14","providers":[{"billed_charge":"166.00","npi":"1700254620"},{"billed_charge":"166.00","npi":"1750093431"},{"billed_charge":"166.00","npi":"1780365239"}]},{"allowed_amount":"58.71","providers":[{"billed_charge":"249.00","npi":"1780365239"}]},{"allowed_amount":"70.45","providers":[{"billed_charge":"166.00","npi":"1205993961"},{"billed_charge":"166.00","npi":"1356060875"}]}]}]},{"name":"Adaptive behavior treatment by protocol, administered by technician under direction of qualified hea","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"97153","description":"Adaptive behavior treatment by protocol, administered by technician under direction of qualified hea","allowed_amounts":[{"tin":[{"type":"ein","value":"932687817 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"153.45","providers":[{"billed_charge":"1237.50","npi":"1215587050"},{"billed_charge":"1237.50","npi":"1639612088"}]},{"allowed_amount":"167.40","providers":[{"billed_charge":"1350.00","npi":"1215587050"},{"billed_charge":"1350.00","npi":"1639612088"}]},{"allowed_amount":"27.90","providers":[{"billed_charge":"225.00","npi":"1215587050"}]},{"allowed_amount":"97.65","providers":[{"billed_charge":"787.50","npi":"1215587050"}]}]}]},{"name":"Therapeutic activities to improve function, with one-on-one contact between patient and provider, ea","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"97530","description":"Therapeutic activities to improve function, with one-on-one contact between patient and provider, ea","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"21.32","providers":[{"billed_charge":"85.00","npi":"1629350582"},{"billed_charge":"85.00","npi":"1962177170"}]},{"allowed_amount":"38.37","providers":[{"billed_charge":"85.00","npi":"1205993961"}]},{"allowed_amount":"42.63","providers":[{"billed_charge":"170.00","npi":"1063568533"},{"billed_charge":"170.00","npi":"1063601730"},{"billed_charge":"170.00","npi":"1215710256"},{"billed_charge":"170.00","npi":"1225551567"},{"billed_charge":"170.00","npi":"1508597279"}]},{"allowed_amount":"76.73","providers":[{"billed_charge":"170.00","npi":"1205993961"},{"billed_charge":"170.00","npi":"1841640752"}]}]}]},{"name":"Chiropractic manipulative treatment, 3 to 4 spinal regions","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"98941","description":"Chiropractic manipulative treatment, 3 to 4 spinal regions","allowed_amounts":[{"tin":[{"type":"ein","value":"845043988 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"16.50","providers":[{"billed_charge":"90.00","npi":"1023643129"}]}]}]},{"name":"Chiropractic manipulative treatment, 3 to 4 spinal regions","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"98941","description":"Chiropractic manipulative treatment, 3 to 4 spinal regions","allowed_amounts":[{"tin":[{"type":"ein","value":"870570021 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"19.17","providers":[{"billed_charge":"75.00","npi":"1831186634"}]},{"allowed_amount":"24.64","providers":[{"billed_charge":"75.00","npi":"1831186634"}]},{"allowed_amount":"56.22","providers":[{"billed_charge":"75.00","npi":"1831186634"}]}]}]},{"name":"Remote therapeutic monitoring; initial set","billing_code_type":"CPT","billing_code_type_version":"0","billing_code":"98975","description":"Remote therapeutic monitoring; initial set","allowed_amounts":[{"tin":[{"type":"ein","value":"371849452 "}],"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":"144.37","providers":[{"billed_charge":"144.37","npi":"1568921278"}]},{"allowed_amount":"144.38","providers":[{"billed_charge":"144.38","npi":"1568921278"}]},{"allowed_amount":"151.59","providers":[{"billed_charge":"151.59","npi":"1568921278"}]},{"allowed_amount":"151.60","providers":[{"billed_charge":"151.60","npi":"1568921278"}]},{"allowed_amount":"288.75","providers":[{"billed_charge":"288.75","npi":"1568921278"}]},{"allowed_amount":"303.19","providers":[{"billed_charge":"303.19","npi":"1568921278"}]},{"allowed_amount":"498.75","providers":[{"billed_charge":"498.75","npi":"1568921278"}]},{"allowed_amount":"523.69","providers":[{"billed_charge":"523.69","npi":"1568921278"}]}]}]},{"name":"Remote therapeutic monitoring treatment ma","billing_code_type":"CPT","billing_code_type_version":"0","billing_code":"98980","description":"Remote therapeutic monitoring treatment ma","allowed_amounts":[{"tin":[{"type":"ein","value":"371849452 "}],"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":"249.37","providers":[{"billed_charge":"249.37","npi":"1568921278"}]},{"allowed_amount":"261.84","providers":[{"billed_charge":"261.84","npi":"1568921278"}]}]}]},{"name":"Management and supervision of oxygen chamber therapy per session","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99183","description":"Management and supervision of oxygen chamber therapy per session","allowed_amounts":[{"tin":[{"type":"ein","value":"873975257 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"120.11","providers":[{"billed_charge":"208.00","npi":"1366705097"},{"billed_charge":"208.00","npi":"1669838405"},{"billed_charge":"700.00","npi":"1366705097"},{"billed_charge":"700.00","npi":"1669838405"}]},{"allowed_amount":"56.72","providers":[{"billed_charge":"208.00","npi":"1669838405"},{"billed_charge":"700.00","npi":"1669838405"}]},{"allowed_amount":"66.73","providers":[{"billed_charge":"208.00","npi":"1366705097"},{"billed_charge":"700.00","npi":"1366705097"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99203","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"115.57","providers":[{"billed_charge":"273.00","npi":"1053060939"},{"billed_charge":"273.00","npi":"1053441238"},{"billed_charge":"273.00","npi":"1093949620"},{"billed_charge":"273.00","npi":"1144236225"},{"billed_charge":"273.00","npi":"1205148541"},{"billed_charge":"273.00","npi":"1245766393"},{"billed_charge":"273.00","npi":"1265069462"},{"billed_charge":"273.00","npi":"1275747529"},{"billed_charge":"273.00","npi":"1346465119"},{"billed_charge":"273.00","npi":"1366651671"},{"billed_charge":"273.00","npi":"1538500731"},{"billed_charge":"273.00","npi":"1629187638"},{"billed_charge":"273.00","npi":"1639144934"},{"billed_charge":"273.00","npi":"1710991344"},{"billed_charge":"273.00","npi":"1801247630"},{"billed_charge":"273.00","npi":"1831848175"},{"billed_charge":"273.00","npi":"1841618972"},{"billed_charge":"273.00","npi":"1962467324"}]},{"allowed_amount":"145.44","providers":[{"billed_charge":"273.00","npi":"1982272480"}]},{"allowed_amount":"54.58","providers":[{"billed_charge":"273.00","npi":"1225652548"},{"billed_charge":"273.00","npi":"1447341193"},{"billed_charge":"273.00","npi":"1477834067"},{"billed_charge":"273.00","npi":"1598013625"},{"billed_charge":"273.00","npi":"1598503716"},{"billed_charge":"273.00","npi":"1942962998"}]},{"allowed_amount":"64.21","providers":[{"billed_charge":"273.00","npi":"1043486384"},{"billed_charge":"273.00","npi":"1053441238"},{"billed_charge":"273.00","npi":"1134575384"},{"billed_charge":"273.00","npi":"1205963949"},{"billed_charge":"273.00","npi":"1356830533"},{"billed_charge":"273.00","npi":"1427553973"},{"billed_charge":"273.00","npi":"1487116109"},{"billed_charge":"273.00","npi":"1497953384"},{"billed_charge":"273.00","npi":"1609845775"},{"billed_charge":"273.00","npi":"1639463714"},{"billed_charge":"273.00","npi":"1700959525"},{"billed_charge":"273.00","npi":"1740784735"},{"billed_charge":"273.00","npi":"1750416947"},{"billed_charge":"273.00","npi":"1780644054"},{"billed_charge":"273.00","npi":"1790816973"},{"billed_charge":"273.00","npi":"1821336496"},{"billed_charge":"273.00","npi":"1851706691"},{"billed_charge":"273.00","npi":"1871112268"}]},{"allowed_amount":"98.24","providers":[{"billed_charge":"273.00","npi":"1134504608"},{"billed_charge":"273.00","npi":"1225652548"},{"billed_charge":"273.00","npi":"1275224016"},{"billed_charge":"273.00","npi":"1437702172"},{"billed_charge":"273.00","npi":"1457969834"},{"billed_charge":"273.00","npi":"1598013625"},{"billed_charge":"273.00","npi":"1639752405"},{"billed_charge":"273.00","npi":"1790061919"},{"billed_charge":"273.00","npi":"1881299048"},{"billed_charge":"273.00","npi":"1891341574"},{"billed_charge":"273.00","npi":"1912339078"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99203","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"115.57","providers":[{"billed_charge":"273.00","npi":"1245374313"},{"billed_charge":"273.00","npi":"1265562326"},{"billed_charge":"273.00","npi":"1396982203"},{"billed_charge":"273.00","npi":"1407982358"},{"billed_charge":"273.00","npi":"1477680221"},{"billed_charge":"273.00","npi":"1578687323"},{"billed_charge":"273.00","npi":"1881166361"},{"billed_charge":"273.00","npi":"1902936008"}]},{"allowed_amount":"64.21","providers":[{"billed_charge":"273.00","npi":"1033240460"},{"billed_charge":"273.00","npi":"1245374313"},{"billed_charge":"273.00","npi":"1245441971"},{"billed_charge":"273.00","npi":"1265562326"},{"billed_charge":"273.00","npi":"1346486206"},{"billed_charge":"273.00","npi":"1396982203"},{"billed_charge":"273.00","npi":"1407291974"},{"billed_charge":"273.00","npi":"1437289808"},{"billed_charge":"273.00","npi":"1477680221"},{"billed_charge":"273.00","npi":"1477683357"},{"billed_charge":"273.00","npi":"1568818003"},{"billed_charge":"273.00","npi":"1578687323"},{"billed_charge":"273.00","npi":"1578693750"},{"billed_charge":"273.00","npi":"1689709875"},{"billed_charge":"273.00","npi":"1700921343"},{"billed_charge":"273.00","npi":"1720114648"},{"billed_charge":"273.00","npi":"1730215518"},{"billed_charge":"273.00","npi":"1730217233"},{"billed_charge":"273.00","npi":"1861757478"},{"billed_charge":"273.00","npi":"1881166361"},{"billed_charge":"273.00","npi":"1902936008"},{"billed_charge":"273.00","npi":"1912250549"}]},{"allowed_amount":"89.89","providers":[{"billed_charge":"273.00","npi":"1477680221"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99204","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"134.69","providers":[{"billed_charge":"408.00","npi":"1972912657"}]},{"allowed_amount":"147.20","providers":[{"billed_charge":"408.00","npi":"1205267432"},{"billed_charge":"408.00","npi":"1386106698"},{"billed_charge":"408.00","npi":"1407571011"},{"billed_charge":"408.00","npi":"1477834067"},{"billed_charge":"408.00","npi":"1568552172"},{"billed_charge":"408.00","npi":"1801303003"}]},{"allowed_amount":"173.18","providers":[{"billed_charge":"408.00","npi":"1013283449"},{"billed_charge":"408.00","npi":"1013293620"},{"billed_charge":"408.00","npi":"1013370725"},{"billed_charge":"408.00","npi":"1043741911"},{"billed_charge":"408.00","npi":"1093949620"},{"billed_charge":"408.00","npi":"1124400569"},{"billed_charge":"408.00","npi":"1205148541"},{"billed_charge":"408.00","npi":"1376527556"},{"billed_charge":"408.00","npi":"1376854067"},{"billed_charge":"408.00","npi":"1407055833"},{"billed_charge":"408.00","npi":"1437545043"},{"billed_charge":"408.00","npi":"1457000838"},{"billed_charge":"408.00","npi":"1508392242"},{"billed_charge":"408.00","npi":"1518456771"},{"billed_charge":"408.00","npi":"1538435979"},{"billed_charge":"408.00","npi":"1548350176"},{"billed_charge":"408.00","npi":"1609211507"},{"billed_charge":"408.00","npi":"1609854132"},{"billed_charge":"408.00","npi":"1629696794"},{"billed_charge":"408.00","npi":"1669821559"},{"billed_charge":"408.00","npi":"1689089666"},{"billed_charge":"408.00","npi":"1689765372"},{"billed_charge":"408.00","npi":"1750416947"},{"billed_charge":"408.00","npi":"1760404974"},{"billed_charge":"408.00","npi":"1851854897"},{"billed_charge":"408.00","npi":"1861650731"},{"billed_charge":"408.00","npi":"1871112268"},{"billed_charge":"408.00","npi":"1891354080"},{"billed_charge":"408.00","npi":"1992786115"}]},{"allowed_amount":"257.39","providers":[{"billed_charge":"408.00","npi":"1093128142"},{"billed_charge":"408.00","npi":"1831848175"}]},{"allowed_amount":"258.68","providers":[{"billed_charge":"408.00","npi":"1225482276"}]},{"allowed_amount":"73.60","providers":[{"billed_charge":"408.00","npi":"1275224016"}]},{"allowed_amount":"81.78","providers":[{"billed_charge":"408.00","npi":"1407571011"},{"billed_charge":"408.00","npi":"1487310967"},{"billed_charge":"408.00","npi":"1528840378"},{"billed_charge":"408.00","npi":"1538713920"},{"billed_charge":"408.00","npi":"1598503716"},{"billed_charge":"408.00","npi":"1720747355"}]},{"allowed_amount":"96.21","providers":[{"billed_charge":"408.00","npi":"1013160548"},{"billed_charge":"408.00","npi":"1093128142"},{"billed_charge":"408.00","npi":"1336192566"},{"billed_charge":"408.00","npi":"1346602307"},{"billed_charge":"408.00","npi":"1598294696"},{"billed_charge":"408.00","npi":"1699353532"},{"billed_charge":"408.00","npi":"1730617341"},{"billed_charge":"408.00","npi":"1780639500"},{"billed_charge":"408.00","npi":"1811927965"},{"billed_charge":"408.00","npi":"1871112268"},{"billed_charge":"408.00","npi":"1912224957"},{"billed_charge":"408.00","npi":"1962416727"},{"billed_charge":"408.00","npi":"1992110787"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99204","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11","20"],"billing_class":"professional","payments":[{"allowed_amount":"173.18","providers":[{"billed_charge":"408.00","npi":"1033240460"},{"billed_charge":"408.00","npi":"1245374313"},{"billed_charge":"408.00","npi":"1346486206"},{"billed_charge":"408.00","npi":"1396982203"},{"billed_charge":"408.00","npi":"1407291974"},{"billed_charge":"408.00","npi":"1407982358"},{"billed_charge":"408.00","npi":"1437289808"},{"billed_charge":"408.00","npi":"1477680221"},{"billed_charge":"408.00","npi":"1689709875"},{"billed_charge":"408.00","npi":"1720114648"},{"billed_charge":"408.00","npi":"1730217233"},{"billed_charge":"408.00","npi":"1881166361"}]},{"allowed_amount":"81.78","providers":[{"billed_charge":"408.00","npi":"1902273311"}]},{"allowed_amount":"96.21","providers":[{"billed_charge":"408.00","npi":"1033240460"},{"billed_charge":"408.00","npi":"1164911962"},{"billed_charge":"408.00","npi":"1235626698"},{"billed_charge":"408.00","npi":"1245374313"},{"billed_charge":"408.00","npi":"1265562326"},{"billed_charge":"408.00","npi":"1346486206"},{"billed_charge":"408.00","npi":"1396982203"},{"billed_charge":"408.00","npi":"1407291974"},{"billed_charge":"408.00","npi":"1467878256"},{"billed_charge":"408.00","npi":"1477680221"},{"billed_charge":"408.00","npi":"1477683357"},{"billed_charge":"408.00","npi":"1578687323"},{"billed_charge":"408.00","npi":"1689709875"},{"billed_charge":"408.00","npi":"1700921343"},{"billed_charge":"408.00","npi":"1720114648"},{"billed_charge":"408.00","npi":"1730215518"},{"billed_charge":"408.00","npi":"1730217233"},{"billed_charge":"408.00","npi":"1881166361"},{"billed_charge":"408.00","npi":"1902936008"},{"billed_charge":"408.00","npi":"1912250549"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99212","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"16.29","providers":[{"billed_charge":"137.00","npi":"1619928140"},{"billed_charge":"137.00","npi":"1740232750"},{"billed_charge":"137.00","npi":"1932153145"}]},{"allowed_amount":"24.93","providers":[{"billed_charge":"137.00","npi":"1275224016"}]},{"allowed_amount":"27.70","providers":[{"billed_charge":"137.00","npi":"1134897135"},{"billed_charge":"137.00","npi":"1275842783"},{"billed_charge":"137.00","npi":"1598002602"}]},{"allowed_amount":"29.32","providers":[{"billed_charge":"137.00","npi":"1124400692"},{"billed_charge":"137.00","npi":"1538497524"}]},{"allowed_amount":"32.58","providers":[{"billed_charge":"137.00","npi":"1467778548"},{"billed_charge":"137.00","npi":"1629187638"}]},{"allowed_amount":"49.85","providers":[{"billed_charge":"137.00","npi":"1275224016"},{"billed_charge":"137.00","npi":"1427609403"},{"billed_charge":"137.00","npi":"1457969834"},{"billed_charge":"137.00","npi":"1497262380"}]},{"allowed_amount":"58.64","providers":[{"billed_charge":"137.00","npi":"1396782207"},{"billed_charge":"137.00","npi":"1538106414"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"260103977 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"20.00","providers":[{"billed_charge":"20.00","npi":"1033773544"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"272210284 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"20.00","providers":[{"billed_charge":"20.00","npi":"1629931886"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"44.47","providers":[{"billed_charge":"261.00","npi":"1033998315"},{"billed_charge":"261.00","npi":"1205195088"},{"billed_charge":"261.00","npi":"1881178655"},{"billed_charge":"261.00","npi":"1972377307"}]},{"allowed_amount":"47.09","providers":[{"billed_charge":"261.00","npi":"1962735670"}]},{"allowed_amount":"52.32","providers":[{"billed_charge":"261.00","npi":"1053494393"},{"billed_charge":"261.00","npi":"1063442523"},{"billed_charge":"261.00","npi":"1275114753"},{"billed_charge":"261.00","npi":"1427443449"},{"billed_charge":"261.00","npi":"1477547164"},{"billed_charge":"261.00","npi":"1528409513"},{"billed_charge":"261.00","npi":"1639336795"},{"billed_charge":"261.00","npi":"1932161668"},{"billed_charge":"261.00","npi":"1962735670"}]},{"allowed_amount":"62.26","providers":[{"billed_charge":"261.00","npi":"1912427584"}]},{"allowed_amount":"94.18","providers":[{"billed_charge":"261.00","npi":"1629050067"},{"billed_charge":"261.00","npi":"1639336795"},{"billed_charge":"261.00","npi":"1841495066"},{"billed_charge":"261.00","npi":"1992190680"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"128.70","providers":[{"billed_charge":"222.00","npi":"1093128142"}]},{"allowed_amount":"138.63","providers":[{"billed_charge":"222.00","npi":"1932553773"}]},{"allowed_amount":"44.47","providers":[{"billed_charge":"222.00","npi":"1033354717"},{"billed_charge":"222.00","npi":"1356366181"},{"billed_charge":"222.00","npi":"1558110395"},{"billed_charge":"222.00","npi":"1609253962"},{"billed_charge":"222.00","npi":"1730571126"},{"billed_charge":"222.00","npi":"1740583863"}]},{"allowed_amount":"52.32","providers":[{"billed_charge":"160.00","npi":"1700259207"},{"billed_charge":"222.00","npi":"1053653436"},{"billed_charge":"222.00","npi":"1104830884"},{"billed_charge":"222.00","npi":"1144236225"},{"billed_charge":"222.00","npi":"1174918163"},{"billed_charge":"222.00","npi":"1609984798"},{"billed_charge":"222.00","npi":"1619047743"},{"billed_charge":"222.00","npi":"1679101992"},{"billed_charge":"222.00","npi":"1831625995"},{"billed_charge":"222.00","npi":"1932553773"}]},{"allowed_amount":"73.25","providers":[{"billed_charge":"160.00","npi":"1700259207"}]},{"allowed_amount":"80.05","providers":[{"billed_charge":"222.00","npi":"1437903648"},{"billed_charge":"222.00","npi":"1588147789"},{"billed_charge":"222.00","npi":"1902573553"}]},{"allowed_amount":"94.18","providers":[{"billed_charge":"160.00","npi":"1700259207"},{"billed_charge":"222.00","npi":"1013092360"},{"billed_charge":"222.00","npi":"1124400692"},{"billed_charge":"222.00","npi":"1154342764"},{"billed_charge":"222.00","npi":"1225270895"},{"billed_charge":"222.00","npi":"1326135807"},{"billed_charge":"222.00","npi":"1518233352"},{"billed_charge":"222.00","npi":"1770504045"},{"billed_charge":"222.00","npi":"1770642480"},{"billed_charge":"222.00","npi":"1922029495"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"22.24","providers":[{"billed_charge":"222.00","npi":"1134744014"}]},{"allowed_amount":"26.16","providers":[{"billed_charge":"222.00","npi":"1326061920"},{"billed_charge":"222.00","npi":"1538497524"},{"billed_charge":"222.00","npi":"1538629647"}]},{"allowed_amount":"40.03","providers":[{"billed_charge":"222.00","npi":"1992109946"}]},{"allowed_amount":"44.47","providers":[{"billed_charge":"222.00","npi":"1003567785"},{"billed_charge":"222.00","npi":"1023253754"},{"billed_charge":"222.00","npi":"1285854612"},{"billed_charge":"222.00","npi":"1295318251"},{"billed_charge":"222.00","npi":"1316957863"},{"billed_charge":"222.00","npi":"1417312604"},{"billed_charge":"222.00","npi":"1477834067"},{"billed_charge":"222.00","npi":"1487216735"},{"billed_charge":"222.00","npi":"1609253962"},{"billed_charge":"222.00","npi":"1710937826"},{"billed_charge":"222.00","npi":"1770118457"},{"billed_charge":"222.00","npi":"1851802888"},{"billed_charge":"222.00","npi":"1962051938"}]},{"allowed_amount":"47.09","providers":[{"billed_charge":"222.00","npi":"1407275787"},{"billed_charge":"222.00","npi":"1811945769"}]},{"allowed_amount":"52.32","providers":[{"billed_charge":"222.00","npi":"1023150851"},{"billed_charge":"222.00","npi":"1033614458"},{"billed_charge":"222.00","npi":"1053346734"},{"billed_charge":"222.00","npi":"1053441238"},{"billed_charge":"222.00","npi":"1093767196"},{"billed_charge":"222.00","npi":"1205169497"},{"billed_charge":"222.00","npi":"1205963949"},{"billed_charge":"222.00","npi":"1215073127"},{"billed_charge":"222.00","npi":"1316920770"},{"billed_charge":"222.00","npi":"1346256690"},{"billed_charge":"222.00","npi":"1396782207"},{"billed_charge":"222.00","npi":"1467561613"},{"billed_charge":"222.00","npi":"1508485764"},{"billed_charge":"222.00","npi":"1548645195"},{"billed_charge":"222.00","npi":"1568478832"},{"billed_charge":"222.00","npi":"1578902896"},{"billed_charge":"222.00","npi":"1588673800"},{"billed_charge":"222.00","npi":"1588863880"},{"billed_charge":"222.00","npi":"1639463714"},{"billed_charge":"222.00","npi":"1639490386"},{"billed_charge":"222.00","npi":"1730290636"},{"billed_charge":"222.00","npi":"1770670242"},{"billed_charge":"222.00","npi":"1790006237"},{"billed_charge":"222.00","npi":"1790816973"},{"billed_charge":"222.00","npi":"1861699324"},{"billed_charge":"222.00","npi":"1891157210"},{"billed_charge":"222.00","npi":"1902366446"},{"billed_charge":"222.00","npi":"1952798589"},{"billed_charge":"222.00","npi":"1982885471"},{"billed_charge":"273.00","npi":"1205148541"}]},{"allowed_amount":"73.25","providers":[{"billed_charge":"222.00","npi":"1245766393"}]},{"allowed_amount":"80.05","providers":[{"billed_charge":"222.00","npi":"1033354717"},{"billed_charge":"222.00","npi":"1154796498"},{"billed_charge":"222.00","npi":"1245754878"},{"billed_charge":"222.00","npi":"1275224016"},{"billed_charge":"222.00","npi":"1376553834"},{"billed_charge":"222.00","npi":"1427514454"},{"billed_charge":"222.00","npi":"1437903648"},{"billed_charge":"222.00","npi":"1457969834"},{"billed_charge":"222.00","npi":"1477113256"},{"billed_charge":"222.00","npi":"1508481706"},{"billed_charge":"222.00","npi":"1528840378"},{"billed_charge":"222.00","npi":"1598013625"},{"billed_charge":"222.00","npi":"1598503716"},{"billed_charge":"222.00","npi":"1629685177"},{"billed_charge":"222.00","npi":"1639539521"},{"billed_charge":"222.00","npi":"1689141442"},{"billed_charge":"222.00","npi":"1730655994"},{"billed_charge":"222.00","npi":"1770863862"},{"billed_charge":"222.00","npi":"1801033360"},{"billed_charge":"222.00","npi":"1801303003"},{"billed_charge":"222.00","npi":"1811230352"},{"billed_charge":"222.00","npi":"1912029778"},{"billed_charge":"222.00","npi":"1932897600"}]},{"allowed_amount":"94.18","providers":[{"billed_charge":"222.00","npi":"1023150851"},{"billed_charge":"222.00","npi":"1053346734"},{"billed_charge":"222.00","npi":"1083094197"},{"billed_charge":"222.00","npi":"1093949620"},{"billed_charge":"222.00","npi":"1114453925"},{"billed_charge":"222.00","npi":"1124007836"},{"billed_charge":"222.00","npi":"1134373582"},{"billed_charge":"222.00","npi":"1134575384"},{"billed_charge":"222.00","npi":"1144236225"},{"billed_charge":"222.00","npi":"1144717802"},{"billed_charge":"222.00","npi":"1205034113"},{"billed_charge":"222.00","npi":"1205916111"},{"billed_charge":"222.00","npi":"1205963949"},{"billed_charge":"222.00","npi":"1215170311"},{"billed_charge":"222.00","npi":"1215978234"},{"billed_charge":"222.00","npi":"1235349192"},{"billed_charge":"222.00","npi":"1265446751"},{"billed_charge":"222.00","npi":"1265744882"},{"billed_charge":"222.00","npi":"1376527556"},{"billed_charge":"222.00","npi":"1437178076"},{"billed_charge":"222.00","npi":"1487116109"},{"billed_charge":"222.00","npi":"1528015542"},{"billed_charge":"222.00","npi":"1538193933"},{"billed_charge":"222.00","npi":"1558948307"},{"billed_charge":"222.00","npi":"1699354639"},{"billed_charge":"222.00","npi":"1770015018"},{"billed_charge":"222.00","npi":"1770670242"},{"billed_charge":"222.00","npi":"1790129831"},{"billed_charge":"222.00","npi":"1831155746"},{"billed_charge":"222.00","npi":"1831625995"},{"billed_charge":"222.00","npi":"1831848175"},{"billed_charge":"222.00","npi":"1841558780"},{"billed_charge":"222.00","npi":"1841618972"},{"billed_charge":"222.00","npi":"1861650731"},{"billed_charge":"222.00","npi":"1861789356"},{"billed_charge":"222.00","npi":"1922120468"},{"billed_charge":"222.00","npi":"1922232867"},{"billed_charge":"222.00","npi":"1962467324"},{"billed_charge":"222.00","npi":"1962637538"},{"billed_charge":"222.00","npi":"1972828812"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99213","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"52.32","providers":[{"billed_charge":"222.00","npi":"1033240460"},{"billed_charge":"222.00","npi":"1164911962"},{"billed_charge":"222.00","npi":"1194084996"},{"billed_charge":"222.00","npi":"1235626698"},{"billed_charge":"222.00","npi":"1245374313"},{"billed_charge":"222.00","npi":"1265562326"},{"billed_charge":"222.00","npi":"1346486206"},{"billed_charge":"222.00","npi":"1396982203"},{"billed_charge":"222.00","npi":"1407291974"},{"billed_charge":"222.00","npi":"1407982358"},{"billed_charge":"222.00","npi":"1437289808"},{"billed_charge":"222.00","npi":"1467878256"},{"billed_charge":"222.00","npi":"1477680221"},{"billed_charge":"222.00","npi":"1477683357"},{"billed_charge":"222.00","npi":"1578687323"},{"billed_charge":"222.00","npi":"1578693750"},{"billed_charge":"222.00","npi":"1720114648"},{"billed_charge":"222.00","npi":"1730217233"},{"billed_charge":"222.00","npi":"1861757478"},{"billed_charge":"222.00","npi":"1881166361"},{"billed_charge":"222.00","npi":"1902936008"},{"billed_charge":"222.00","npi":"1912250549"},{"billed_charge":"273.00","npi":"1245374313"},{"billed_charge":"273.00","npi":"1396982203"},{"billed_charge":"273.00","npi":"1578687323"},{"billed_charge":"273.00","npi":"1689709875"},{"billed_charge":"273.00","npi":"1720114648"},{"billed_charge":"273.00","npi":"1730215518"}]},{"allowed_amount":"73.25","providers":[{"billed_charge":"222.00","npi":"1265562326"},{"billed_charge":"222.00","npi":"1477680221"}]},{"allowed_amount":"94.18","providers":[{"billed_charge":"222.00","npi":"1245374313"},{"billed_charge":"222.00","npi":"1245441971"},{"billed_charge":"222.00","npi":"1346486206"},{"billed_charge":"222.00","npi":"1477680221"},{"billed_charge":"222.00","npi":"1730217233"},{"billed_charge":"273.00","npi":"1730217233"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"454027438 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"112.89","providers":[{"billed_charge":"180.00","npi":"1063039196"},{"billed_charge":"180.00","npi":"1740679430"},{"billed_charge":"180.00","npi":"1992990311"}]},{"allowed_amount":"31.36","providers":[{"billed_charge":"180.00","npi":"1992990311"}]},{"allowed_amount":"62.72","providers":[{"billed_charge":"180.00","npi":"1063039196"},{"billed_charge":"180.00","npi":"1740679430"},{"billed_charge":"180.00","npi":"1992990311"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"471484631 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"112.89","providers":[{"billed_charge":"275.10","npi":"1144404757"},{"billed_charge":"275.10","npi":"1194142620"},{"billed_charge":"275.10","npi":"1205070091"},{"billed_charge":"275.10","npi":"1336130889"},{"billed_charge":"275.10","npi":"1356446215"},{"billed_charge":"275.10","npi":"1710360078"},{"billed_charge":"275.10","npi":"1760859300"},{"billed_charge":"275.10","npi":"1912215476"}]},{"allowed_amount":"123.36","providers":[{"billed_charge":"275.10","npi":"1053512665"}]},{"allowed_amount":"132.81","providers":[{"billed_charge":"275.10","npi":"1255368148"},{"billed_charge":"275.10","npi":"1366486805"},{"billed_charge":"275.10","npi":"1962829374"}]},{"allowed_amount":"134.38","providers":[{"billed_charge":"275.10","npi":"1417384637"}]},{"allowed_amount":"62.72","providers":[{"billed_charge":"275.10","npi":"1144777418"},{"billed_charge":"275.10","npi":"1164049268"},{"billed_charge":"275.10","npi":"1184310708"},{"billed_charge":"275.10","npi":"1215360581"},{"billed_charge":"275.10","npi":"1255881397"},{"billed_charge":"275.10","npi":"1295825800"},{"billed_charge":"275.10","npi":"1316426059"},{"billed_charge":"275.10","npi":"1356852719"},{"billed_charge":"275.10","npi":"1376052910"},{"billed_charge":"275.10","npi":"1457809477"},{"billed_charge":"275.10","npi":"1528589579"},{"billed_charge":"275.10","npi":"1659925915"},{"billed_charge":"275.10","npi":"1730637661"},{"billed_charge":"275.10","npi":"1851725121"},{"billed_charge":"275.10","npi":"1912215476"}]},{"allowed_amount":"73.79","providers":[{"billed_charge":"275.10","npi":"1245867555"},{"billed_charge":"275.10","npi":"1346695327"},{"billed_charge":"275.10","npi":"1487232914"},{"billed_charge":"275.10","npi":"1730779984"},{"billed_charge":"275.10","npi":"1790313716"},{"billed_charge":"275.10","npi":"1811124514"},{"billed_charge":"275.10","npi":"1841451473"},{"billed_charge":"275.10","npi":"1992895585"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"112.89","providers":[{"billed_charge":"370.00","npi":"1043561517"},{"billed_charge":"370.00","npi":"1467035634"},{"billed_charge":"370.00","npi":"1912427584"}]},{"allowed_amount":"132.81","providers":[{"billed_charge":"370.00","npi":"1255341806"},{"billed_charge":"370.00","npi":"1588617542"},{"billed_charge":"370.00","npi":"1639336795"},{"billed_charge":"370.00","npi":"1841495066"},{"billed_charge":"370.00","npi":"1962735670"}]},{"allowed_amount":"62.72","providers":[{"billed_charge":"370.00","npi":"1043561517"},{"billed_charge":"370.00","npi":"1427851575"},{"billed_charge":"370.00","npi":"1972377307"},{"billed_charge":"483.00","npi":"1043561517"}]},{"allowed_amount":"73.79","providers":[{"billed_charge":"370.00","npi":"1104212877"},{"billed_charge":"370.00","npi":"1316329329"},{"billed_charge":"370.00","npi":"1427443449"},{"billed_charge":"370.00","npi":"1447373576"},{"billed_charge":"370.00","npi":"1932161668"},{"billed_charge":"370.00","npi":"1932693512"},{"billed_charge":"370.00","npi":"1962735670"},{"billed_charge":"370.00","npi":"1962765222"},{"billed_charge":"370.00","npi":"1972000222"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"103.30","providers":[{"billed_charge":"313.00","npi":"1073190922"},{"billed_charge":"313.00","npi":"1669093860"}]},{"allowed_amount":"112.89","providers":[{"billed_charge":"313.00","npi":"1053390344"},{"billed_charge":"313.00","npi":"1114403698"},{"billed_charge":"313.00","npi":"1154796498"},{"billed_charge":"313.00","npi":"1326608647"},{"billed_charge":"313.00","npi":"1417603994"},{"billed_charge":"313.00","npi":"1619402732"},{"billed_charge":"313.00","npi":"1700911906"},{"billed_charge":"313.00","npi":"1760788160"},{"billed_charge":"313.00","npi":"1821698077"},{"billed_charge":"313.00","npi":"1902239478"},{"billed_charge":"313.00","npi":"1932674413"},{"billed_charge":"313.00","npi":"1942437918"},{"billed_charge":"313.00","npi":"1952811515"}]},{"allowed_amount":"123.36","providers":[{"billed_charge":"313.00","npi":"1538585823"}]},{"allowed_amount":"132.81","providers":[{"billed_charge":"313.00","npi":"1043779036"},{"billed_charge":"313.00","npi":"1124400692"},{"billed_charge":"313.00","npi":"1134575384"},{"billed_charge":"313.00","npi":"1154341634"},{"billed_charge":"313.00","npi":"1205148541"},{"billed_charge":"313.00","npi":"1336151786"},{"billed_charge":"313.00","npi":"1346483849"},{"billed_charge":"313.00","npi":"1346530524"},{"billed_charge":"313.00","npi":"1346558517"},{"billed_charge":"313.00","npi":"1366449241"},{"billed_charge":"313.00","npi":"1396270344"},{"billed_charge":"313.00","npi":"1518233352"},{"billed_charge":"313.00","npi":"1538185749"},{"billed_charge":"313.00","npi":"1538505409"},{"billed_charge":"313.00","npi":"1578598298"},{"billed_charge":"313.00","npi":"1649424409"},{"billed_charge":"313.00","npi":"1841728011"},{"billed_charge":"313.00","npi":"1871780676"},{"billed_charge":"313.00","npi":"1962964742"}]},{"allowed_amount":"197.67","providers":[{"billed_charge":"313.00","npi":"1932122520"}]},{"allowed_amount":"62.72","providers":[{"billed_charge":"313.00","npi":"1033354717"},{"billed_charge":"313.00","npi":"1326608647"},{"billed_charge":"313.00","npi":"1386216539"},{"billed_charge":"313.00","npi":"1417603994"},{"billed_charge":"313.00","npi":"1558110395"},{"billed_charge":"313.00","npi":"1598786303"},{"billed_charge":"313.00","npi":"1619005659"},{"billed_charge":"313.00","npi":"1730571126"},{"billed_charge":"313.00","npi":"1740221738"},{"billed_charge":"313.00","npi":"1770118457"},{"billed_charge":"313.00","npi":"1821698077"},{"billed_charge":"313.00","npi":"1902239478"}]},{"allowed_amount":"73.79","providers":[{"billed_charge":"235.00","npi":"1518194455"},{"billed_charge":"313.00","npi":"1003347923"},{"billed_charge":"313.00","npi":"1073190922"},{"billed_charge":"313.00","npi":"1235719774"},{"billed_charge":"313.00","npi":"1265464960"},{"billed_charge":"313.00","npi":"1306805577"},{"billed_charge":"313.00","npi":"1346483849"},{"billed_charge":"313.00","npi":"1417214958"},{"billed_charge":"313.00","npi":"1437343316"},{"billed_charge":"313.00","npi":"1578820445"},{"billed_charge":"313.00","npi":"1629606637"},{"billed_charge":"313.00","npi":"1649424409"},{"billed_charge":"313.00","npi":"1740669118"},{"billed_charge":"313.00","npi":"1760503072"},{"billed_charge":"313.00","npi":"1952677874"},{"billed_charge":"313.00","npi":"1952798589"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"112.89","providers":[{"billed_charge":"313.00","npi":"1033354717"},{"billed_charge":"313.00","npi":"1033803481"},{"billed_charge":"313.00","npi":"1043925522"},{"billed_charge":"313.00","npi":"1073365482"},{"billed_charge":"313.00","npi":"1164951737"},{"billed_charge":"313.00","npi":"1174589105"},{"billed_charge":"313.00","npi":"1194208454"},{"billed_charge":"313.00","npi":"1205590791"},{"billed_charge":"313.00","npi":"1215238530"},{"billed_charge":"313.00","npi":"1245743640"},{"billed_charge":"313.00","npi":"1285854612"},{"billed_charge":"313.00","npi":"1326077934"},{"billed_charge":"313.00","npi":"1346011152"},{"billed_charge":"313.00","npi":"1356993661"},{"billed_charge":"313.00","npi":"1386106698"},{"billed_charge":"313.00","npi":"1386216539"},{"billed_charge":"313.00","npi":"1417603994"},{"billed_charge":"313.00","npi":"1427782713"},{"billed_charge":"313.00","npi":"1497485049"},{"billed_charge":"313.00","npi":"1528193802"},{"billed_charge":"313.00","npi":"1548752827"},{"billed_charge":"313.00","npi":"1689141442"},{"billed_charge":"313.00","npi":"1699785105"},{"billed_charge":"313.00","npi":"1710746797"},{"billed_charge":"313.00","npi":"1720747355"},{"billed_charge":"313.00","npi":"1740514892"},{"billed_charge":"313.00","npi":"1750891552"},{"billed_charge":"313.00","npi":"1780110742"},{"billed_charge":"313.00","npi":"1790061919"},{"billed_charge":"313.00","npi":"1801033360"},{"billed_charge":"313.00","npi":"1861490609"},{"billed_charge":"313.00","npi":"1891280343"},{"billed_charge":"313.00","npi":"1902405228"},{"billed_charge":"313.00","npi":"1902573553"},{"billed_charge":"313.00","npi":"1922976059"},{"billed_charge":"313.00","npi":"1932671211"},{"billed_charge":"313.00","npi":"1952332223"}]},{"allowed_amount":"132.81","providers":[{"billed_charge":"313.00","npi":"1013028901"},{"billed_charge":"313.00","npi":"1033452271"},{"billed_charge":"313.00","npi":"1033556204"},{"billed_charge":"313.00","npi":"1053060939"},{"billed_charge":"313.00","npi":"1053346734"},{"billed_charge":"313.00","npi":"1053842914"},{"billed_charge":"313.00","npi":"1063611986"},{"billed_charge":"313.00","npi":"1063787315"},{"billed_charge":"313.00","npi":"1083094197"},{"billed_charge":"313.00","npi":"1093128142"},{"billed_charge":"313.00","npi":"1104897800"},{"billed_charge":"313.00","npi":"1124400692"},{"billed_charge":"313.00","npi":"1124588488"},{"billed_charge":"313.00","npi":"1144724857"},{"billed_charge":"313.00","npi":"1174020168"},{"billed_charge":"313.00","npi":"1184073785"},{"billed_charge":"313.00","npi":"1194135350"},{"billed_charge":"313.00","npi":"1205148541"},{"billed_charge":"313.00","npi":"1245766393"},{"billed_charge":"313.00","npi":"1255793824"},{"billed_charge":"313.00","npi":"1275747529"},{"billed_charge":"313.00","npi":"1275848038"},{"billed_charge":"313.00","npi":"1295707677"},{"billed_charge":"313.00","npi":"1295865517"},{"billed_charge":"313.00","npi":"1326135807"},{"billed_charge":"313.00","npi":"1346256690"},{"billed_charge":"313.00","npi":"1346558517"},{"billed_charge":"313.00","npi":"1366449241"},{"billed_charge":"313.00","npi":"1366462913"},{"billed_charge":"313.00","npi":"1366977225"},{"billed_charge":"313.00","npi":"1376651448"},{"billed_charge":"313.00","npi":"1376939827"},{"billed_charge":"313.00","npi":"1386088532"},{"billed_charge":"313.00","npi":"1396068342"},{"billed_charge":"313.00","npi":"1417214958"},{"billed_charge":"313.00","npi":"1427388032"},{"billed_charge":"313.00","npi":"1437389301"},{"billed_charge":"313.00","npi":"1508215757"},{"billed_charge":"313.00","npi":"1538428370"},{"billed_charge":"313.00","npi":"1538629647"},{"billed_charge":"313.00","npi":"1558658237"},{"billed_charge":"313.00","npi":"1588892954"},{"billed_charge":"313.00","npi":"1598107187"},{"billed_charge":"313.00","npi":"1598294696"},{"billed_charge":"313.00","npi":"1598869026"},{"billed_charge":"313.00","npi":"1598992570"},{"billed_charge":"313.00","npi":"1609854132"},{"billed_charge":"313.00","npi":"1619154135"},{"billed_charge":"313.00","npi":"1629206149"},{"billed_charge":"313.00","npi":"1629422159"},{"billed_charge":"313.00","npi":"1639288715"},{"billed_charge":"313.00","npi":"1659782969"},{"billed_charge":"313.00","npi":"1679589881"},{"billed_charge":"313.00","npi":"1699354639"},{"billed_charge":"313.00","npi":"1699769471"},{"billed_charge":"313.00","npi":"1770872319"},{"billed_charge":"313.00","npi":"1790129831"},{"billed_charge":"313.00","npi":"1790962587"},{"billed_charge":"313.00","npi":"1801247630"},{"billed_charge":"313.00","npi":"1811490642"},{"billed_charge":"313.00","npi":"1831106681"},{"billed_charge":"313.00","npi":"1831848175"},{"billed_charge":"313.00","npi":"1841728011"},{"billed_charge":"313.00","npi":"1841788031"},{"billed_charge":"313.00","npi":"1871696898"},{"billed_charge":"313.00","npi":"1881009157"},{"billed_charge":"313.00","npi":"1902366446"},{"billed_charge":"313.00","npi":"1922341015"},{"billed_charge":"313.00","npi":"1932553773"},{"billed_charge":"313.00","npi":"1942799002"},{"billed_charge":"313.00","npi":"1952677874"},{"billed_charge":"313.00","npi":"1952863797"},{"billed_charge":"313.00","npi":"1992047286"},{"billed_charge":"313.00","npi":"1992110787"},{"billed_charge":"408.00","npi":"1962467324"}]},{"allowed_amount":"145.13","providers":[{"billed_charge":"313.00","npi":"1700185162"}]},{"allowed_amount":"158.14","providers":[{"billed_charge":"313.00","npi":"1225526460"},{"billed_charge":"313.00","npi":"1336151786"}]},{"allowed_amount":"36.90","providers":[{"billed_charge":"313.00","npi":"1881343036"}]},{"allowed_amount":"62.72","providers":[{"billed_charge":"313.00","npi":"1033354717"},{"billed_charge":"313.00","npi":"1093289522"},{"billed_charge":"313.00","npi":"1174589105"},{"billed_charge":"313.00","npi":"1215246731"},{"billed_charge":"313.00","npi":"1245754878"},{"billed_charge":"313.00","npi":"1265907497"},{"billed_charge":"313.00","npi":"1285854612"},{"billed_charge":"313.00","npi":"1326608647"},{"billed_charge":"313.00","npi":"1407322779"},{"billed_charge":"313.00","npi":"1417945023"},{"billed_charge":"313.00","npi":"1558110395"},{"billed_charge":"313.00","npi":"1588617229"},{"billed_charge":"313.00","npi":"1598786303"},{"billed_charge":"313.00","npi":"1669002150"},{"billed_charge":"313.00","npi":"1689141442"},{"billed_charge":"313.00","npi":"1740583863"},{"billed_charge":"313.00","npi":"1760788160"},{"billed_charge":"313.00","npi":"1770863862"},{"billed_charge":"313.00","npi":"1790188829"},{"billed_charge":"313.00","npi":"1871229625"},{"billed_charge":"313.00","npi":"1962051938"},{"billed_charge":"313.00","npi":"1962072736"}]},{"allowed_amount":"66.41","providers":[{"billed_charge":"313.00","npi":"1144724857"},{"billed_charge":"313.00","npi":"1326135807"},{"billed_charge":"313.00","npi":"1932153145"}]},{"allowed_amount":"73.79","providers":[{"billed_charge":"313.00","npi":"1003436122"},{"billed_charge":"313.00","npi":"1013150218"},{"billed_charge":"313.00","npi":"1013160548"},{"billed_charge":"313.00","npi":"1053060939"},{"billed_charge":"313.00","npi":"1063421451"},{"billed_charge":"313.00","npi":"1063851871"},{"billed_charge":"313.00","npi":"1083051478"},{"billed_charge":"313.00","npi":"1093155988"},{"billed_charge":"313.00","npi":"1114944790"},{"billed_charge":"313.00","npi":"1144236225"},{"billed_charge":"313.00","npi":"1164533071"},{"billed_charge":"313.00","npi":"1205028784"},{"billed_charge":"313.00","npi":"1235620303"},{"billed_charge":"313.00","npi":"1265639223"},{"billed_charge":"313.00","npi":"1275747529"},{"billed_charge":"313.00","npi":"1295865517"},{"billed_charge":"313.00","npi":"1306595947"},{"billed_charge":"313.00","npi":"1346558517"},{"billed_charge":"313.00","npi":"1366449241"},{"billed_charge":"313.00","npi":"1427410059"},{"billed_charge":"313.00","npi":"1548414097"},{"billed_charge":"313.00","npi":"1578786851"},{"billed_charge":"313.00","npi":"1598107187"},{"billed_charge":"313.00","npi":"1609854132"},{"billed_charge":"313.00","npi":"1619086493"},{"billed_charge":"313.00","npi":"1629606637"},{"billed_charge":"313.00","npi":"1629709860"},{"billed_charge":"313.00","npi":"1699353532"},{"billed_charge":"313.00","npi":"1699354639"},{"billed_charge":"313.00","npi":"1699719559"},{"billed_charge":"313.00","npi":"1700959525"},{"billed_charge":"313.00","npi":"1730290636"},{"billed_charge":"313.00","npi":"1740644574"},{"billed_charge":"313.00","npi":"1740784735"},{"billed_charge":"313.00","npi":"1780644054"},{"billed_charge":"313.00","npi":"1790123321"},{"billed_charge":"313.00","npi":"1811490642"},{"billed_charge":"313.00","npi":"1831477256"},{"billed_charge":"313.00","npi":"1841728011"},{"billed_charge":"313.00","npi":"1851534374"},{"billed_charge":"313.00","npi":"1861781742"},{"billed_charge":"313.00","npi":"1891113304"},{"billed_charge":"313.00","npi":"1922426782"},{"billed_charge":"313.00","npi":"1932122520"},{"billed_charge":"313.00","npi":"1932156247"},{"billed_charge":"313.00","npi":"1942799002"},{"billed_charge":"313.00","npi":"1942862156"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99214","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["10","11","20"],"billing_class":"professional","payments":[{"allowed_amount":"103.30","providers":[{"billed_charge":"313.00","npi":"1033240460"}]},{"allowed_amount":"132.81","providers":[{"billed_charge":"313.00","npi":"1033240460"},{"billed_charge":"313.00","npi":"1396982203"},{"billed_charge":"313.00","npi":"1407982358"},{"billed_charge":"313.00","npi":"1437289808"},{"billed_charge":"313.00","npi":"1477680221"},{"billed_charge":"313.00","npi":"1568818003"},{"billed_charge":"313.00","npi":"1578687323"},{"billed_charge":"313.00","npi":"1730217233"},{"billed_charge":"313.00","npi":"1881166361"},{"billed_charge":"313.00","npi":"1912250549"},{"billed_charge":"408.00","npi":"1407982358"},{"billed_charge":"408.00","npi":"1720114648"},{"billed_charge":"408.00","npi":"1881166361"}]},{"allowed_amount":"73.79","providers":[{"billed_charge":"313.00","npi":"1033240460"},{"billed_charge":"313.00","npi":"1164911962"},{"billed_charge":"313.00","npi":"1225168610"},{"billed_charge":"313.00","npi":"1245374313"},{"billed_charge":"313.00","npi":"1265562326"},{"billed_charge":"313.00","npi":"1346486206"},{"billed_charge":"313.00","npi":"1396982203"},{"billed_charge":"313.00","npi":"1407291974"},{"billed_charge":"313.00","npi":"1407982358"},{"billed_charge":"313.00","npi":"1467878256"},{"billed_charge":"313.00","npi":"1477680221"},{"billed_charge":"313.00","npi":"1568818003"},{"billed_charge":"313.00","npi":"1578687323"},{"billed_charge":"313.00","npi":"1578693750"},{"billed_charge":"313.00","npi":"1689709875"},{"billed_charge":"313.00","npi":"1720114648"},{"billed_charge":"313.00","npi":"1730215518"},{"billed_charge":"313.00","npi":"1730217233"},{"billed_charge":"313.00","npi":"1861757478"},{"billed_charge":"313.00","npi":"1881166361"},{"billed_charge":"313.00","npi":"1902936008"},{"billed_charge":"313.00","npi":"1912250549"},{"billed_charge":"408.00","npi":"1033240460"},{"billed_charge":"408.00","npi":"1346486206"},{"billed_charge":"408.00","npi":"1407982358"},{"billed_charge":"408.00","npi":"1881166361"}]}]}]},{"name":"Office or other outpatient visit for the evaluation and management of an established patient, which ","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99215","description":"Office or other outpatient visit for the evaluation and management of an established patient, which ","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"103.88","providers":[{"billed_charge":"439.00","npi":"1134355001"},{"billed_charge":"439.00","npi":"1174727739"},{"billed_charge":"439.00","npi":"1780644054"},{"billed_charge":"439.00","npi":"1790723195"}]},{"allowed_amount":"158.93","providers":[{"billed_charge":"439.00","npi":"1275223067"},{"billed_charge":"439.00","npi":"1366431918"},{"billed_charge":"439.00","npi":"1528840378"},{"billed_charge":"439.00","npi":"1548884851"},{"billed_charge":"439.00","npi":"1639989601"},{"billed_charge":"439.00","npi":"1700911906"},{"billed_charge":"439.00","npi":"1811695901"}]},{"allowed_amount":"186.98","providers":[{"billed_charge":"439.00","npi":"1174020168"},{"billed_charge":"439.00","npi":"1215464391"},{"billed_charge":"439.00","npi":"1518108117"},{"billed_charge":"439.00","npi":"1538505409"},{"billed_charge":"439.00","npi":"1538622188"},{"billed_charge":"439.00","npi":"1548521941"},{"billed_charge":"439.00","npi":"1598107187"},{"billed_charge":"439.00","npi":"1780644054"},{"billed_charge":"439.00","npi":"1790723195"},{"billed_charge":"439.00","npi":"1790962587"},{"billed_charge":"439.00","npi":"1831364249"},{"billed_charge":"439.00","npi":"1841417896"},{"billed_charge":"439.00","npi":"1912923541"},{"billed_charge":"439.00","npi":"1922636448"}]},{"allowed_amount":"88.30","providers":[{"billed_charge":"439.00","npi":"1073365482"}]}]}]},{"name":"Initial hospital inpatient care, typically 50 minutes per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99222","description":"Initial hospital inpatient care, typically 50 minutes per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"113.77","providers":[{"billed_charge":"314.00","npi":"1215339957"},{"billed_charge":"314.00","npi":"1740567767"},{"billed_charge":"314.00","npi":"1932740651"}]},{"allowed_amount":"133.85","providers":[{"billed_charge":"314.00","npi":"1588059950"},{"billed_charge":"314.00","npi":"1740296730"},{"billed_charge":"314.00","npi":"1962654681"}]},{"allowed_amount":"184.75","providers":[{"billed_charge":"314.00","npi":"1205481801"},{"billed_charge":"314.00","npi":"1225221807"},{"billed_charge":"314.00","npi":"1558102541"},{"billed_charge":"314.00","npi":"1578763389"},{"billed_charge":"314.00","npi":"1629685177"},{"billed_charge":"314.00","npi":"1790594265"},{"billed_charge":"314.00","npi":"1801326137"}]},{"allowed_amount":"217.35","providers":[{"billed_charge":"314.00","npi":"1033370291"},{"billed_charge":"314.00","npi":"1134708712"},{"billed_charge":"314.00","npi":"1164402897"},{"billed_charge":"314.00","npi":"1225131287"},{"billed_charge":"314.00","npi":"1619292745"},{"billed_charge":"314.00","npi":"1740419274"},{"billed_charge":"314.00","npi":"1881678399"},{"billed_charge":"314.00","npi":"1922472604"},{"billed_charge":"314.00","npi":"1962654681"},{"billed_charge":"314.00","npi":"1972002574"},{"billed_charge":"314.00","npi":"1992000582"}]},{"allowed_amount":"63.21","providers":[{"billed_charge":"314.00","npi":"1528460326"}]},{"allowed_amount":"74.36","providers":[{"billed_charge":"314.00","npi":"1376040790"},{"billed_charge":"314.00","npi":"1710546528"},{"billed_charge":"314.00","npi":"1740296730"}]}]}]},{"name":"Initial hospital inpatient care, typically 70 minutes per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99223","description":"Initial hospital inpatient care, typically 70 minutes per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"177.32","providers":[{"billed_charge":"418.00","npi":"1104244714"},{"billed_charge":"418.00","npi":"1134563307"},{"billed_charge":"418.00","npi":"1174273700"},{"billed_charge":"418.00","npi":"1265633937"},{"billed_charge":"418.00","npi":"1336465962"},{"billed_charge":"418.00","npi":"1346520434"},{"billed_charge":"418.00","npi":"1477087138"},{"billed_charge":"418.00","npi":"1609080720"},{"billed_charge":"418.00","npi":"1700464740"},{"billed_charge":"418.00","npi":"1760649560"},{"billed_charge":"418.00","npi":"1760877443"},{"billed_charge":"418.00","npi":"1891323069"}]},{"allowed_amount":"245.37","providers":[{"billed_charge":"418.00","npi":"1972244929"}]},{"allowed_amount":"273.04","providers":[{"billed_charge":"418.00","npi":"1184979783"},{"billed_charge":"418.00","npi":"1396557310"},{"billed_charge":"418.00","npi":"1578763389"}]},{"allowed_amount":"321.23","providers":[{"billed_charge":"418.00","npi":"1043626112"},{"billed_charge":"418.00","npi":"1063040319"},{"billed_charge":"418.00","npi":"1114484490"},{"billed_charge":"418.00","npi":"1174273700"},{"billed_charge":"418.00","npi":"1235666918"},{"billed_charge":"418.00","npi":"1417675828"},{"billed_charge":"418.00","npi":"1457883134"},{"billed_charge":"418.00","npi":"1487142196"},{"billed_charge":"418.00","npi":"1528453503"},{"billed_charge":"418.00","npi":"1609219229"},{"billed_charge":"418.00","npi":"1750812244"},{"billed_charge":"418.00","npi":"1770712283"},{"billed_charge":"418.00","npi":"1780038638"},{"billed_charge":"418.00","npi":"1780832915"},{"billed_charge":"418.00","npi":"1972244929"}]},{"allowed_amount":"98.51","providers":[{"billed_charge":"418.00","npi":"1114484490"},{"billed_charge":"418.00","npi":"1235666918"},{"billed_charge":"418.00","npi":"1457883134"},{"billed_charge":"418.00","npi":"1467870931"},{"billed_charge":"418.00","npi":"1760649560"},{"billed_charge":"418.00","npi":"1942720586"}]}]}]},{"name":"Subsequent hospital inpatient care, typically 15 minutes per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99231","description":"Subsequent hospital inpatient care, typically 15 minutes per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"43.11","providers":[{"billed_charge":"118.00","npi":"1134568850"},{"billed_charge":"118.00","npi":"1174633408"},{"billed_charge":"118.00","npi":"1316726987"},{"billed_charge":"118.00","npi":"1376675231"},{"billed_charge":"118.00","npi":"1548884851"},{"billed_charge":"118.00","npi":"1700911906"}]},{"allowed_amount":"50.72","providers":[{"billed_charge":"118.00","npi":"1164402897"},{"billed_charge":"118.00","npi":"1740296730"}]},{"allowed_amount":"53.15","providers":[{"billed_charge":"118.00","npi":"1508462151"},{"billed_charge":"118.00","npi":"1548884851"},{"billed_charge":"118.00","npi":"1700911906"}]},{"allowed_amount":"62.54","providers":[{"billed_charge":"118.00","npi":"1154611986"},{"billed_charge":"118.00","npi":"1184016081"},{"billed_charge":"118.00","npi":"1194246736"},{"billed_charge":"118.00","npi":"1225327927"},{"billed_charge":"118.00","npi":"1447459151"},{"billed_charge":"118.00","npi":"1568478832"},{"billed_charge":"118.00","npi":"1629606637"},{"billed_charge":"118.00","npi":"1710187133"},{"billed_charge":"118.00","npi":"1992094759"}]}]}]},{"name":"Subsequent hospital inpatient care, typically 25 minutes per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99232","description":"Subsequent hospital inpatient care, typically 25 minutes per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"111.99","providers":[{"billed_charge":"191.00","npi":"1598347221"}]},{"allowed_amount":"114.09","providers":[{"billed_charge":"191.00","npi":"1033370291"},{"billed_charge":"191.00","npi":"1053730242"},{"billed_charge":"191.00","npi":"1063040319"},{"billed_charge":"191.00","npi":"1073716064"},{"billed_charge":"191.00","npi":"1083101091"},{"billed_charge":"191.00","npi":"1104828987"},{"billed_charge":"191.00","npi":"1124681374"},{"billed_charge":"191.00","npi":"1134708712"},{"billed_charge":"191.00","npi":"1174987374"},{"billed_charge":"191.00","npi":"1194246736"},{"billed_charge":"191.00","npi":"1205068749"},{"billed_charge":"191.00","npi":"1225294853"},{"billed_charge":"191.00","npi":"1225327927"},{"billed_charge":"191.00","npi":"1285864413"},{"billed_charge":"191.00","npi":"1346520434"},{"billed_charge":"191.00","npi":"1356667273"},{"billed_charge":"191.00","npi":"1356870620"},{"billed_charge":"191.00","npi":"1386641249"},{"billed_charge":"191.00","npi":"1386746659"},{"billed_charge":"191.00","npi":"1396937363"},{"billed_charge":"191.00","npi":"1417135096"},{"billed_charge":"191.00","npi":"1447410444"},{"billed_charge":"191.00","npi":"1457883134"},{"billed_charge":"191.00","npi":"1477087138"},{"billed_charge":"191.00","npi":"1487188363"},{"billed_charge":"191.00","npi":"1528379831"},{"billed_charge":"191.00","npi":"1538500731"},{"billed_charge":"191.00","npi":"1568478832"},{"billed_charge":"191.00","npi":"1578083887"},{"billed_charge":"191.00","npi":"1609167063"},{"billed_charge":"191.00","npi":"1619292745"},{"billed_charge":"191.00","npi":"1629606637"},{"billed_charge":"191.00","npi":"1659909240"},{"billed_charge":"191.00","npi":"1720605892"},{"billed_charge":"191.00","npi":"1730281478"},{"billed_charge":"191.00","npi":"1750516472"},{"billed_charge":"191.00","npi":"1770712283"},{"billed_charge":"191.00","npi":"1811254253"},{"billed_charge":"191.00","npi":"1821520966"},{"billed_charge":"191.00","npi":"1881678399"},{"billed_charge":"191.00","npi":"1902347198"},{"billed_charge":"191.00","npi":"1962654681"},{"billed_charge":"191.00","npi":"1962936385"}]},{"allowed_amount":"38.12","providers":[{"billed_charge":"191.00","npi":"1801432265"}]},{"allowed_amount":"44.85","providers":[{"billed_charge":"191.00","npi":"1053730242"},{"billed_charge":"191.00","npi":"1174961361"},{"billed_charge":"191.00","npi":"1205931037"},{"billed_charge":"191.00","npi":"1235666918"},{"billed_charge":"191.00","npi":"1417135096"},{"billed_charge":"191.00","npi":"1457883134"},{"billed_charge":"191.00","npi":"1578083887"},{"billed_charge":"191.00","npi":"1659909240"},{"billed_charge":"191.00","npi":"1730281478"},{"billed_charge":"191.00","npi":"1740296730"},{"billed_charge":"191.00","npi":"1740508340"},{"billed_charge":"191.00","npi":"1811254253"},{"billed_charge":"191.00","npi":"1881678399"},{"billed_charge":"191.00","npi":"1972965127"}]},{"allowed_amount":"68.62","providers":[{"billed_charge":"191.00","npi":"1215339957"},{"billed_charge":"191.00","npi":"1396181202"},{"billed_charge":"191.00","npi":"1407398746"},{"billed_charge":"191.00","npi":"1548922248"},{"billed_charge":"191.00","npi":"1619201951"},{"billed_charge":"191.00","npi":"1629685177"}]},{"allowed_amount":"80.72","providers":[{"billed_charge":"191.00","npi":"1073002994"},{"billed_charge":"191.00","npi":"1083101091"},{"billed_charge":"191.00","npi":"1225294853"},{"billed_charge":"191.00","npi":"1255996492"},{"billed_charge":"191.00","npi":"1336465962"},{"billed_charge":"191.00","npi":"1346520434"},{"billed_charge":"191.00","npi":"1437449279"},{"billed_charge":"191.00","npi":"1477087138"},{"billed_charge":"191.00","npi":"1528453503"},{"billed_charge":"191.00","npi":"1588059950"},{"billed_charge":"191.00","npi":"1609004050"},{"billed_charge":"191.00","npi":"1689838542"},{"billed_charge":"191.00","npi":"1720271109"},{"billed_charge":"191.00","npi":"1720605892"},{"billed_charge":"191.00","npi":"1740296730"},{"billed_charge":"191.00","npi":"1851895551"},{"billed_charge":"191.00","npi":"1902347198"},{"billed_charge":"191.00","npi":"1922029495"},{"billed_charge":"191.00","npi":"1962640441"}]},{"allowed_amount":"96.99","providers":[{"billed_charge":"191.00","npi":"1013717909"},{"billed_charge":"191.00","npi":"1033627351"},{"billed_charge":"191.00","npi":"1043900400"},{"billed_charge":"191.00","npi":"1124311600"},{"billed_charge":"191.00","npi":"1134887821"},{"billed_charge":"191.00","npi":"1225221807"},{"billed_charge":"191.00","npi":"1396181202"},{"billed_charge":"191.00","npi":"1396557310"},{"billed_charge":"191.00","npi":"1407398746"},{"billed_charge":"191.00","npi":"1548884851"},{"billed_charge":"191.00","npi":"1689433658"}]}]}]},{"name":"Subsequent hospital inpatient care, typically 35 minutes per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99233","description":"Subsequent hospital inpatient care, typically 35 minutes per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"121.43","providers":[{"billed_charge":"285.00","npi":"1053844258"},{"billed_charge":"285.00","npi":"1194170985"},{"billed_charge":"285.00","npi":"1588112585"},{"billed_charge":"285.00","npi":"1669114641"},{"billed_charge":"285.00","npi":"1689838542"},{"billed_charge":"285.00","npi":"1700464740"},{"billed_charge":"285.00","npi":"1770712283"},{"billed_charge":"285.00","npi":"1841651742"},{"billed_charge":"285.00","npi":"1922029495"}]},{"allowed_amount":"140.09","providers":[{"billed_charge":"285.00","npi":"1043900400"},{"billed_charge":"285.00","npi":"1578118253"}]},{"allowed_amount":"158.33","providers":[{"billed_charge":"285.00","npi":"1205931037"},{"billed_charge":"285.00","npi":"1487188363"}]},{"allowed_amount":"164.80","providers":[{"billed_charge":"285.00","npi":"1033538525"},{"billed_charge":"285.00","npi":"1083101091"},{"billed_charge":"285.00","npi":"1114484490"},{"billed_charge":"285.00","npi":"1225270895"},{"billed_charge":"285.00","npi":"1417416249"},{"billed_charge":"285.00","npi":"1427482611"},{"billed_charge":"285.00","npi":"1447459151"},{"billed_charge":"285.00","npi":"1528379831"},{"billed_charge":"285.00","npi":"1669114641"},{"billed_charge":"285.00","npi":"1730649336"},{"billed_charge":"285.00","npi":"1770712283"},{"billed_charge":"285.00","npi":"1962965012"}]},{"allowed_amount":"67.46","providers":[{"billed_charge":"285.00","npi":"1053730242"},{"billed_charge":"285.00","npi":"1083101091"},{"billed_charge":"285.00","npi":"1235666918"},{"billed_charge":"285.00","npi":"1427482611"}]}]}]},{"name":"Hospital discharge day management, more than 30 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99239","description":"Hospital discharge day management, more than 30 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"117.29","providers":[{"billed_charge":"277.00","npi":"1073002994"},{"billed_charge":"277.00","npi":"1225294853"},{"billed_charge":"277.00","npi":"1255996492"},{"billed_charge":"277.00","npi":"1376040790"},{"billed_charge":"277.00","npi":"1477087138"},{"billed_charge":"277.00","npi":"1669114641"},{"billed_charge":"277.00","npi":"1720271109"},{"billed_charge":"277.00","npi":"1770712283"},{"billed_charge":"277.00","npi":"1922029495"}]},{"allowed_amount":"143.48","providers":[{"billed_charge":"277.00","npi":"1083322150"},{"billed_charge":"277.00","npi":"1548922248"},{"billed_charge":"277.00","npi":"1700911906"},{"billed_charge":"277.00","npi":"1801401344"}]},{"allowed_amount":"161.79","providers":[{"billed_charge":"277.00","npi":"1598347221"}]},{"allowed_amount":"168.80","providers":[{"billed_charge":"277.00","npi":"1033370291"},{"billed_charge":"277.00","npi":"1083101091"},{"billed_charge":"277.00","npi":"1134307499"},{"billed_charge":"277.00","npi":"1225327927"},{"billed_charge":"277.00","npi":"1255996492"},{"billed_charge":"277.00","npi":"1336465962"},{"billed_charge":"277.00","npi":"1457883134"},{"billed_charge":"277.00","npi":"1487188363"},{"billed_charge":"277.00","npi":"1558772533"},{"billed_charge":"277.00","npi":"1700324985"},{"billed_charge":"277.00","npi":"1831630284"},{"billed_charge":"277.00","npi":"1851895551"},{"billed_charge":"277.00","npi":"1881678399"},{"billed_charge":"277.00","npi":"1962936385"},{"billed_charge":"277.00","npi":"1962965012"},{"billed_charge":"277.00","npi":"1972965127"}]},{"allowed_amount":"55.39","providers":[{"billed_charge":"277.00","npi":"1801432265"}]},{"allowed_amount":"65.16","providers":[{"billed_charge":"277.00","npi":"1083925606"},{"billed_charge":"277.00","npi":"1134708712"},{"billed_charge":"277.00","npi":"1417135096"},{"billed_charge":"277.00","npi":"1427482611"},{"billed_charge":"277.00","npi":"1457883134"},{"billed_charge":"277.00","npi":"1578083887"}]},{"allowed_amount":"99.69","providers":[{"billed_charge":"277.00","npi":"1033627351"}]}]}]},{"name":"Emergency department visit, moderately severe problem","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99283","description":"Emergency department visit, moderately severe problem","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"471.22","providers":[{"billed_charge":"1480.03","npi":"1043915523"},{"billed_charge":"1480.03","npi":"1346945839"},{"billed_charge":"1480.03","npi":"1801591391"}]},{"allowed_amount":"624.65","providers":[{"billed_charge":"1480.03","npi":"1801591391"},{"billed_charge":"3226.47","npi":"1801591391"}]},{"allowed_amount":"679.23","providers":[{"billed_charge":"1480.03","npi":"1043915523"},{"billed_charge":"1480.03","npi":"1801591391"},{"billed_charge":"2353.25","npi":"1801591391"}]},{"allowed_amount":"752.59","providers":[{"billed_charge":"1480.03","npi":"1346945839"},{"billed_charge":"2353.25","npi":"1346945839"},{"billed_charge":"3226.47","npi":"1346945839"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"840405257 "}],"service_code":[""],"billing_class":"institutional","payments":[{"allowed_amount":"1117.90","providers":[{"billed_charge":"2353.25","npi":"1043915523"},{"billed_charge":"2353.25","npi":"1801591391"},{"billed_charge":"3226.47","npi":"1801591391"}]},{"allowed_amount":"1182.96","providers":[{"billed_charge":"2353.25","npi":"1346945839"}]},{"allowed_amount":"731.49","providers":[{"billed_charge":"2353.25","npi":"1346945839"}]},{"allowed_amount":"969.08","providers":[{"billed_charge":"2353.25","npi":"1801591391"},{"billed_charge":"3226.47","npi":"1801591391"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"863919738 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"288.87","providers":[{"billed_charge":"732.00","npi":"1033503495"},{"billed_charge":"732.00","npi":"1053993329"},{"billed_charge":"732.00","npi":"1154827905"},{"billed_charge":"732.00","npi":"1174268494"},{"billed_charge":"732.00","npi":"1174512669"},{"billed_charge":"732.00","npi":"1215591326"},{"billed_charge":"732.00","npi":"1568103968"},{"billed_charge":"732.00","npi":"1588309652"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"870301301 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"226.09","providers":[{"billed_charge":"876.00","npi":"1619314036"}]},{"allowed_amount":"245.54","providers":[{"billed_charge":"876.00","npi":"1326455478"},{"billed_charge":"876.00","npi":"1366162695"},{"billed_charge":"876.00","npi":"1457948887"},{"billed_charge":"876.00","npi":"1770110520"}]},{"allowed_amount":"288.87","providers":[{"billed_charge":"876.00","npi":"1003042375"},{"billed_charge":"876.00","npi":"1013187525"},{"billed_charge":"876.00","npi":"1053586651"},{"billed_charge":"876.00","npi":"1053873174"},{"billed_charge":"876.00","npi":"1114136132"},{"billed_charge":"876.00","npi":"1144513623"},{"billed_charge":"876.00","npi":"1164172565"},{"billed_charge":"876.00","npi":"1184851230"},{"billed_charge":"876.00","npi":"1205254828"},{"billed_charge":"876.00","npi":"1205586195"},{"billed_charge":"876.00","npi":"1295029304"},{"billed_charge":"876.00","npi":"1346680808"},{"billed_charge":"876.00","npi":"1356729859"},{"billed_charge":"876.00","npi":"1376806802"},{"billed_charge":"876.00","npi":"1376961862"},{"billed_charge":"876.00","npi":"1417375387"},{"billed_charge":"876.00","npi":"1417417536"},{"billed_charge":"876.00","npi":"1427069152"},{"billed_charge":"876.00","npi":"1447472956"},{"billed_charge":"876.00","npi":"1548288806"},{"billed_charge":"876.00","npi":"1578799342"},{"billed_charge":"876.00","npi":"1598776239"},{"billed_charge":"876.00","npi":"1669122883"},{"billed_charge":"876.00","npi":"1679136758"},{"billed_charge":"876.00","npi":"1700804069"},{"billed_charge":"876.00","npi":"1710999685"},{"billed_charge":"876.00","npi":"1730522277"},{"billed_charge":"876.00","npi":"1760802250"},{"billed_charge":"876.00","npi":"1780696641"},{"billed_charge":"876.00","npi":"1780947911"},{"billed_charge":"876.00","npi":"1790708519"},{"billed_charge":"876.00","npi":"1831432723"},{"billed_charge":"876.00","npi":"1851911663"},{"billed_charge":"876.00","npi":"1912141714"},{"billed_charge":"876.00","npi":"1922032978"},{"billed_charge":"876.00","npi":"1942837703"},{"billed_charge":"876.00","npi":"1992384960"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"870492357 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"245.54","providers":[{"billed_charge":"762.00","npi":"1063467819"},{"billed_charge":"762.00","npi":"1184623217"},{"billed_charge":"762.00","npi":"1306462304"},{"billed_charge":"762.00","npi":"1497200539"}]},{"allowed_amount":"288.87","providers":[{"billed_charge":"762.00","npi":"1003863770"},{"billed_charge":"762.00","npi":"1013177328"},{"billed_charge":"762.00","npi":"1104117019"},{"billed_charge":"762.00","npi":"1114967163"},{"billed_charge":"762.00","npi":"1124293139"},{"billed_charge":"762.00","npi":"1144894668"},{"billed_charge":"762.00","npi":"1154364891"},{"billed_charge":"762.00","npi":"1154761849"},{"billed_charge":"762.00","npi":"1164950176"},{"billed_charge":"762.00","npi":"1225201148"},{"billed_charge":"762.00","npi":"1285048363"},{"billed_charge":"762.00","npi":"1376766220"},{"billed_charge":"762.00","npi":"1396782207"},{"billed_charge":"762.00","npi":"1417374737"},{"billed_charge":"762.00","npi":"1437166600"},{"billed_charge":"762.00","npi":"1528640430"},{"billed_charge":"762.00","npi":"1598847568"},{"billed_charge":"762.00","npi":"1629089628"},{"billed_charge":"762.00","npi":"1639584147"},{"billed_charge":"762.00","npi":"1659991321"},{"billed_charge":"762.00","npi":"1700266285"},{"billed_charge":"762.00","npi":"1710220876"},{"billed_charge":"762.00","npi":"1710399944"},{"billed_charge":"762.00","npi":"1770016925"},{"billed_charge":"762.00","npi":"1811932700"},{"billed_charge":"762.00","npi":"1851853477"},{"billed_charge":"762.00","npi":"1932544798"},{"billed_charge":"762.00","npi":"1952713299"},{"billed_charge":"762.00","npi":"1982165833"},{"billed_charge":"762.00","npi":"1992191324"}]},{"allowed_amount":"762.00","providers":[{"billed_charge":"762.00","npi":"1124293139"},{"billed_charge":"762.00","npi":"1154761849"},{"billed_charge":"762.00","npi":"1225201148"},{"billed_charge":"762.00","npi":"1285048363"},{"billed_charge":"762.00","npi":"1639584147"},{"billed_charge":"762.00","npi":"1942240916"},{"billed_charge":"762.00","npi":"1952713299"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"870636000 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"288.87","providers":[{"billed_charge":"762.00","npi":"1124558119"},{"billed_charge":"762.00","npi":"1235636952"},{"billed_charge":"762.00","npi":"1245268390"},{"billed_charge":"762.00","npi":"1285801704"},{"billed_charge":"762.00","npi":"1295994549"},{"billed_charge":"762.00","npi":"1386872828"},{"billed_charge":"762.00","npi":"1477507200"},{"billed_charge":"762.00","npi":"1487278966"},{"billed_charge":"762.00","npi":"1588604532"},{"billed_charge":"762.00","npi":"1588691190"},{"billed_charge":"762.00","npi":"1669425146"},{"billed_charge":"762.00","npi":"1770539744"},{"billed_charge":"762.00","npi":"1780819771"},{"billed_charge":"762.00","npi":"1801457528"},{"billed_charge":"762.00","npi":"1851597090"},{"billed_charge":"762.00","npi":"1902192164"}]},{"allowed_amount":"762.00","providers":[{"billed_charge":"762.00","npi":"1124558119"},{"billed_charge":"762.00","npi":"1285801704"},{"billed_charge":"762.00","npi":"1588604532"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"880262438 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"167.33","providers":[{"billed_charge":"1152.00","npi":"1194131854"},{"billed_charge":"1152.00","npi":"1194301549"},{"billed_charge":"1152.00","npi":"1205412756"},{"billed_charge":"1152.00","npi":"1225771843"},{"billed_charge":"1152.00","npi":"1306135710"},{"billed_charge":"1152.00","npi":"1366429821"},{"billed_charge":"1152.00","npi":"1437685237"},{"billed_charge":"1152.00","npi":"1609821180"},{"billed_charge":"1152.00","npi":"1679550149"},{"billed_charge":"1152.00","npi":"1972505675"},{"billed_charge":"1152.00","npi":"1982362414"},{"billed_charge":"1162.00","npi":"1316488141"},{"billed_charge":"1162.00","npi":"1336898600"},{"billed_charge":"1162.00","npi":"1558685271"}]},{"allowed_amount":"78.07","providers":[{"billed_charge":"1152.00","npi":"1063462364"},{"billed_charge":"1152.00","npi":"1235431388"},{"billed_charge":"1152.00","npi":"1518120971"}]}]}]},{"name":"Emergency department visit, problem of high severity","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99284","description":"Emergency department visit, problem of high severity","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"245.54","providers":[{"billed_charge":"291.00","npi":"1033825732"},{"billed_charge":"291.00","npi":"1366480162"},{"billed_charge":"291.00","npi":"1568996502"},{"billed_charge":"291.00","npi":"1871174888"}]},{"allowed_amount":"288.87","providers":[{"billed_charge":"291.00","npi":"1083634562"},{"billed_charge":"291.00","npi":"1114458262"},{"billed_charge":"291.00","npi":"1225327927"},{"billed_charge":"291.00","npi":"1275112625"},{"billed_charge":"291.00","npi":"1316301419"},{"billed_charge":"291.00","npi":"1346486206"},{"billed_charge":"291.00","npi":"1518461573"},{"billed_charge":"291.00","npi":"1568082550"},{"billed_charge":"291.00","npi":"1588953160"},{"billed_charge":"291.00","npi":"1609219229"},{"billed_charge":"291.00","npi":"1700087004"},{"billed_charge":"291.00","npi":"1740292614"},{"billed_charge":"291.00","npi":"1780002261"},{"billed_charge":"291.00","npi":"1851633218"},{"billed_charge":"291.00","npi":"1912075771"},{"billed_charge":"291.00","npi":"1922685239"},{"billed_charge":"291.00","npi":"1982638334"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"271369141 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"1415.00","providers":[{"billed_charge":"1415.00","npi":"1003133836"}]},{"allowed_amount":"218.97","providers":[{"billed_charge":"1415.00","npi":"1124081534"},{"billed_charge":"1415.00","npi":"1245686369"},{"billed_charge":"1415.00","npi":"1407474182"},{"billed_charge":"1415.00","npi":"1407485584"},{"billed_charge":"1415.00","npi":"1417298266"},{"billed_charge":"1415.00","npi":"1669435327"},{"billed_charge":"1415.00","npi":"1700832342"},{"billed_charge":"1415.00","npi":"1790103653"},{"billed_charge":"1415.00","npi":"1902486699"},{"billed_charge":"1415.00","npi":"1922775493"}]},{"allowed_amount":"302.57","providers":[{"billed_charge":"1415.00","npi":"1891255568"}]},{"allowed_amount":"426.71","providers":[{"billed_charge":"1415.00","npi":"1093595662"},{"billed_charge":"1415.00","npi":"1245686369"},{"billed_charge":"1415.00","npi":"1497735518"},{"billed_charge":"1415.00","npi":"1700832342"},{"billed_charge":"1415.00","npi":"1790103653"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"824523930 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"3522.00","providers":[{"billed_charge":"3522.00","npi":"1255901757"},{"billed_charge":"3522.00","npi":"1467681866"},{"billed_charge":"3522.00","npi":"1912949603"}]},{"allowed_amount":"426.71","providers":[{"billed_charge":"3522.00","npi":"1063629830"},{"billed_charge":"3522.00","npi":"1154381689"},{"billed_charge":"3522.00","npi":"1255693180"},{"billed_charge":"3522.00","npi":"1255901757"},{"billed_charge":"3522.00","npi":"1467681866"},{"billed_charge":"3522.00","npi":"1912949603"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"863919738 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"426.71","providers":[{"billed_charge":"1064.00","npi":"1033503495"},{"billed_charge":"1064.00","npi":"1053993329"},{"billed_charge":"1064.00","npi":"1154827905"},{"billed_charge":"1064.00","npi":"1174512669"},{"billed_charge":"1064.00","npi":"1215591326"},{"billed_charge":"1064.00","npi":"1588309652"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"870301301 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"1272.00","providers":[{"billed_charge":"1272.00","npi":"1942837703"}]},{"allowed_amount":"333.55","providers":[{"billed_charge":"1272.00","npi":"1184398679"},{"billed_charge":"1272.00","npi":"1619314036"}]},{"allowed_amount":"362.70","providers":[{"billed_charge":"1272.00","npi":"1003167594"},{"billed_charge":"1272.00","npi":"1003654831"},{"billed_charge":"1272.00","npi":"1023416047"},{"billed_charge":"1272.00","npi":"1033951595"},{"billed_charge":"1272.00","npi":"1205691649"},{"billed_charge":"1272.00","npi":"1508347006"},{"billed_charge":"1272.00","npi":"1740178946"},{"billed_charge":"1272.00","npi":"1750121281"},{"billed_charge":"1272.00","npi":"1851916993"}]},{"allowed_amount":"426.71","providers":[{"billed_charge":"1272.00","npi":"1043381437"},{"billed_charge":"1272.00","npi":"1053500736"},{"billed_charge":"1272.00","npi":"1053586651"},{"billed_charge":"1272.00","npi":"1053873174"},{"billed_charge":"1272.00","npi":"1073747887"},{"billed_charge":"1272.00","npi":"1114136132"},{"billed_charge":"1272.00","npi":"1114582392"},{"billed_charge":"1272.00","npi":"1124274139"},{"billed_charge":"1272.00","npi":"1144411489"},{"billed_charge":"1272.00","npi":"1144513623"},{"billed_charge":"1272.00","npi":"1205586195"},{"billed_charge":"1272.00","npi":"1306145776"},{"billed_charge":"1272.00","npi":"1326542242"},{"billed_charge":"1272.00","npi":"1336439405"},{"billed_charge":"1272.00","npi":"1336679430"},{"billed_charge":"1272.00","npi":"1346680808"},{"billed_charge":"1272.00","npi":"1356729859"},{"billed_charge":"1272.00","npi":"1366651481"},{"billed_charge":"1272.00","npi":"1376806802"},{"billed_charge":"1272.00","npi":"1407296247"},{"billed_charge":"1272.00","npi":"1417375387"},{"billed_charge":"1272.00","npi":"1427069152"},{"billed_charge":"1272.00","npi":"1548288806"},{"billed_charge":"1272.00","npi":"1548792187"},{"billed_charge":"1272.00","npi":"1578799342"},{"billed_charge":"1272.00","npi":"1598776239"},{"billed_charge":"1272.00","npi":"1619193026"},{"billed_charge":"1272.00","npi":"1619506870"},{"billed_charge":"1272.00","npi":"1639308745"},{"billed_charge":"1272.00","npi":"1639531478"},{"billed_charge":"1272.00","npi":"1649660846"},{"billed_charge":"1272.00","npi":"1659723914"},{"billed_charge":"1272.00","npi":"1679136758"},{"billed_charge":"1272.00","npi":"1700262524"},{"billed_charge":"1272.00","npi":"1700923273"},{"billed_charge":"1272.00","npi":"1710565718"},{"billed_charge":"1272.00","npi":"1710999685"},{"billed_charge":"1272.00","npi":"1760802250"},{"billed_charge":"1272.00","npi":"1770769895"},{"billed_charge":"1272.00","npi":"1790824704"},{"billed_charge":"1272.00","npi":"1790946002"},{"billed_charge":"1272.00","npi":"1790979268"},{"billed_charge":"1272.00","npi":"1801113295"},{"billed_charge":"1272.00","npi":"1821618810"},{"billed_charge":"1272.00","npi":"1831552066"},{"billed_charge":"1272.00","npi":"1841213691"},{"billed_charge":"1272.00","npi":"1851911663"},{"billed_charge":"1272.00","npi":"1902032295"},{"billed_charge":"1272.00","npi":"1902085756"},{"billed_charge":"1272.00","npi":"1922032978"},{"billed_charge":"1272.00","npi":"1932510724"},{"billed_charge":"1272.00","npi":"1942837703"},{"billed_charge":"1272.00","npi":"1972949998"},{"billed_charge":"1272.00","npi":"1982017232"},{"billed_charge":"1272.00","npi":"1992384960"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"870492357 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"1126.00","providers":[{"billed_charge":"1126.00","npi":"1003863770"},{"billed_charge":"1126.00","npi":"1124293139"},{"billed_charge":"1126.00","npi":"1154761849"},{"billed_charge":"1126.00","npi":"1417374737"},{"billed_charge":"1126.00","npi":"1538216742"},{"billed_charge":"1126.00","npi":"1629089628"},{"billed_charge":"1126.00","npi":"1811932700"},{"billed_charge":"1126.00","npi":"1942240916"}]},{"allowed_amount":"313.08","providers":[{"billed_charge":"1126.00","npi":"1528640430"}]},{"allowed_amount":"362.70","providers":[{"billed_charge":"1126.00","npi":"1063467819"},{"billed_charge":"1126.00","npi":"1184623217"},{"billed_charge":"1126.00","npi":"1306462304"},{"billed_charge":"1126.00","npi":"1497200539"},{"billed_charge":"1126.00","npi":"1770814238"}]},{"allowed_amount":"426.71","providers":[{"billed_charge":"1126.00","npi":"1003863770"},{"billed_charge":"1126.00","npi":"1013177328"},{"billed_charge":"1126.00","npi":"1104117019"},{"billed_charge":"1126.00","npi":"1114967163"},{"billed_charge":"1126.00","npi":"1124293139"},{"billed_charge":"1126.00","npi":"1144894668"},{"billed_charge":"1126.00","npi":"1154364891"},{"billed_charge":"1126.00","npi":"1154761849"},{"billed_charge":"1126.00","npi":"1164950176"},{"billed_charge":"1126.00","npi":"1225201148"},{"billed_charge":"1126.00","npi":"1285048363"},{"billed_charge":"1126.00","npi":"1376766220"},{"billed_charge":"1126.00","npi":"1417319799"},{"billed_charge":"1126.00","npi":"1417374737"},{"billed_charge":"1126.00","npi":"1427478577"},{"billed_charge":"1126.00","npi":"1437166600"},{"billed_charge":"1126.00","npi":"1528402526"},{"billed_charge":"1126.00","npi":"1528640430"},{"billed_charge":"1126.00","npi":"1538216742"},{"billed_charge":"1126.00","npi":"1598847568"},{"billed_charge":"1126.00","npi":"1629089628"},{"billed_charge":"1126.00","npi":"1639584147"},{"billed_charge":"1126.00","npi":"1659991321"},{"billed_charge":"1126.00","npi":"1679520456"},{"billed_charge":"1126.00","npi":"1699712836"},{"billed_charge":"1126.00","npi":"1700266285"},{"billed_charge":"1126.00","npi":"1710220876"},{"billed_charge":"1126.00","npi":"1710399944"},{"billed_charge":"1126.00","npi":"1770016925"},{"billed_charge":"1126.00","npi":"1811932700"},{"billed_charge":"1126.00","npi":"1851853477"},{"billed_charge":"1126.00","npi":"1932544798"},{"billed_charge":"1126.00","npi":"1942240916"},{"billed_charge":"1126.00","npi":"1952713299"},{"billed_charge":"1126.00","npi":"1982165833"},{"billed_charge":"1126.00","npi":"1992191324"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"870629690 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"1272.00","providers":[{"billed_charge":"1272.00","npi":"1376922047"},{"billed_charge":"1272.00","npi":"1720065782"}]},{"allowed_amount":"284.44","providers":[{"billed_charge":"1272.00","npi":"1093753709"},{"billed_charge":"1272.00","npi":"1164584074"},{"billed_charge":"1272.00","npi":"1437455318"},{"billed_charge":"1272.00","npi":"1578540498"},{"billed_charge":"1272.00","npi":"1689022519"},{"billed_charge":"1272.00","npi":"1730634916"},{"billed_charge":"1272.00","npi":"1821370461"}]},{"allowed_amount":"333.55","providers":[{"billed_charge":"1272.00","npi":"1720065782"}]},{"allowed_amount":"334.63","providers":[{"billed_charge":"1272.00","npi":"1174146096"},{"billed_charge":"1272.00","npi":"1215165469"},{"billed_charge":"1272.00","npi":"1235495862"},{"billed_charge":"1272.00","npi":"1245764117"},{"billed_charge":"1272.00","npi":"1306860531"},{"billed_charge":"1272.00","npi":"1346429552"},{"billed_charge":"1272.00","npi":"1417218769"},{"billed_charge":"1272.00","npi":"1871579193"},{"billed_charge":"1272.00","npi":"1932330263"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"870636000 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"1126.00","providers":[{"billed_charge":"1126.00","npi":"1285801704"},{"billed_charge":"1126.00","npi":"1386872828"},{"billed_charge":"1126.00","npi":"1477507200"},{"billed_charge":"1126.00","npi":"1487278966"},{"billed_charge":"1126.00","npi":"1588604532"},{"billed_charge":"1126.00","npi":"1588691190"},{"billed_charge":"1126.00","npi":"1669425146"},{"billed_charge":"1126.00","npi":"1770539744"},{"billed_charge":"1126.00","npi":"1801457528"},{"billed_charge":"1126.00","npi":"1851597090"}]},{"allowed_amount":"426.71","providers":[{"billed_charge":"1126.00","npi":"1124558119"},{"billed_charge":"1126.00","npi":"1235636952"},{"billed_charge":"1126.00","npi":"1245268390"},{"billed_charge":"1126.00","npi":"1295994549"},{"billed_charge":"1126.00","npi":"1386872828"},{"billed_charge":"1126.00","npi":"1477507200"},{"billed_charge":"1126.00","npi":"1487278966"},{"billed_charge":"1126.00","npi":"1588604532"},{"billed_charge":"1126.00","npi":"1588691190"},{"billed_charge":"1126.00","npi":"1669425146"},{"billed_charge":"1126.00","npi":"1740217264"},{"billed_charge":"1126.00","npi":"1770539744"},{"billed_charge":"1126.00","npi":"1780819771"},{"billed_charge":"1126.00","npi":"1801457528"},{"billed_charge":"1126.00","npi":"1851597090"},{"billed_charge":"1126.00","npi":"1902192164"}]},{"allowed_amount":"589.44","providers":[{"billed_charge":"1126.00","npi":"1801457528"}]},{"allowed_amount":"675.60","providers":[{"billed_charge":"1126.00","npi":"1477507200"}]}]}]},{"name":"Emergency department visit, problem with significant threat to life or function","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99285","description":"Emergency department visit, problem with significant threat to life or function","allowed_amounts":[{"tin":[{"type":"ein","value":"880262438 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"122.89","providers":[{"billed_charge":"1687.00","npi":"1679550149"},{"billed_charge":"1687.00","npi":"1811308604"},{"billed_charge":"1687.00","npi":"1851592497"},{"billed_charge":"1712.00","npi":"1316488141"}]},{"allowed_amount":"245.56","providers":[{"billed_charge":"1522.00","npi":"1801209705"},{"billed_charge":"1687.00","npi":"1003566670"},{"billed_charge":"1687.00","npi":"1194301549"},{"billed_charge":"1687.00","npi":"1205412756"},{"billed_charge":"1687.00","npi":"1225771843"},{"billed_charge":"1687.00","npi":"1366429821"},{"billed_charge":"1687.00","npi":"1407506645"},{"billed_charge":"1687.00","npi":"1508055765"},{"billed_charge":"1687.00","npi":"1518120971"},{"billed_charge":"1687.00","npi":"1669474235"},{"billed_charge":"1687.00","npi":"1679550149"},{"billed_charge":"1687.00","npi":"1699418145"},{"billed_charge":"1687.00","npi":"1699777391"},{"billed_charge":"1687.00","npi":"1730169111"},{"billed_charge":"1687.00","npi":"1740714757"},{"billed_charge":"1687.00","npi":"1811308604"},{"billed_charge":"1687.00","npi":"1831576131"},{"billed_charge":"1687.00","npi":"1982362414"}]}]}]},{"name":"Critical care delivery critically ill or injured patient, first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99291","description":"Critical care delivery critically ill or injured patient, first 30-74 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"870492357 "}],"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":"463.71","providers":[{"billed_charge":"1434.00","npi":"1770814238"}]},{"allowed_amount":"545.53","providers":[{"billed_charge":"1434.00","npi":"1003863770"},{"billed_charge":"1434.00","npi":"1114967163"},{"billed_charge":"1434.00","npi":"1144894668"},{"billed_charge":"1434.00","npi":"1225201148"},{"billed_charge":"1434.00","npi":"1427478577"},{"billed_charge":"1434.00","npi":"1528402526"},{"billed_charge":"1434.00","npi":"1679520456"},{"billed_charge":"1434.00","npi":"1700266285"},{"billed_charge":"1434.00","npi":"1770016925"},{"billed_charge":"1434.00","npi":"1811932700"},{"billed_charge":"1434.00","npi":"1851853477"},{"billed_charge":"1434.00","npi":"1932544798"},{"billed_charge":"1434.00","npi":"1952713299"},{"billed_charge":"1434.00","npi":"1982165833"},{"billed_charge":"1434.00","npi":"1992191324"}]}]}]},{"name":"Critical care delivery critically ill or injured patient, first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99291","description":"Critical care delivery critically ill or injured patient, first 30-74 minutes","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"175.93","providers":[{"billed_charge":"514.00","npi":"1578107215"}]},{"allowed_amount":"206.97","providers":[{"billed_charge":"514.00","npi":"1952612467"}]},{"allowed_amount":"294.71","providers":[{"billed_charge":"514.00","npi":"1205931037"},{"billed_charge":"514.00","npi":"1386624377"}]},{"allowed_amount":"372.55","providers":[{"billed_charge":"514.00","npi":"1558772533"},{"billed_charge":"514.00","npi":"1871728469"}]},{"allowed_amount":"463.71","providers":[{"billed_charge":"514.00","npi":"1225221807"},{"billed_charge":"514.00","npi":"1578107215"},{"billed_charge":"514.00","npi":"1902317837"}]},{"allowed_amount":"514.00","providers":[{"billed_charge":"514.00","npi":"1013994813"},{"billed_charge":"514.00","npi":"1104244714"},{"billed_charge":"514.00","npi":"1114453925"},{"billed_charge":"514.00","npi":"1154611986"},{"billed_charge":"514.00","npi":"1205931037"},{"billed_charge":"514.00","npi":"1679866560"},{"billed_charge":"514.00","npi":"1902149909"}]}]}]},{"name":"Established patient periodic preventive medicine examination age 18-39 years","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99395","description":"Established patient periodic preventive medicine examination age 18-39 years","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"102.33","providers":[{"billed_charge":"285.00","npi":"1003567785"},{"billed_charge":"285.00","npi":"1275224016"},{"billed_charge":"285.00","npi":"1356993661"},{"billed_charge":"285.00","npi":"1417945023"},{"billed_charge":"285.00","npi":"1689141442"},{"billed_charge":"285.00","npi":"1902239478"}]},{"allowed_amount":"120.39","providers":[{"billed_charge":"285.00","npi":"1104830884"},{"billed_charge":"285.00","npi":"1144717802"},{"billed_charge":"285.00","npi":"1235719774"},{"billed_charge":"285.00","npi":"1265069462"},{"billed_charge":"285.00","npi":"1326135807"},{"billed_charge":"285.00","npi":"1376838326"},{"billed_charge":"285.00","npi":"1538497524"},{"billed_charge":"285.00","npi":"1871696898"}]},{"allowed_amount":"148.88","providers":[{"billed_charge":"285.00","npi":"1851627640"}]},{"allowed_amount":"175.14","providers":[{"billed_charge":"285.00","npi":"1497259675"}]},{"allowed_amount":"56.85","providers":[{"billed_charge":"285.00","npi":"1154014769"},{"billed_charge":"285.00","npi":"1902239478"}]},{"allowed_amount":"66.89","providers":[{"billed_charge":"285.00","npi":"1053703793"},{"billed_charge":"285.00","npi":"1538497524"},{"billed_charge":"285.00","npi":"1730765504"},{"billed_charge":"285.00","npi":"1881343036"},{"billed_charge":"285.00","npi":"1912949082"}]},{"allowed_amount":"93.64","providers":[{"billed_charge":"285.00","npi":"1326135807"}]}]}]},{"name":"Established patient periodic preventive medicine examination age 40-64 years","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99396","description":"Established patient periodic preventive medicine examination age 40-64 years","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"108.78","providers":[{"billed_charge":"302.00","npi":"1003567785"},{"billed_charge":"302.00","npi":"1427609403"},{"billed_charge":"302.00","npi":"1497307979"},{"billed_charge":"302.00","npi":"1730571126"},{"billed_charge":"302.00","npi":"1861852527"},{"billed_charge":"302.00","npi":"1891341574"}]},{"allowed_amount":"127.98","providers":[{"billed_charge":"302.00","npi":"1063701654"},{"billed_charge":"302.00","npi":"1124400692"},{"billed_charge":"302.00","npi":"1144724857"},{"billed_charge":"302.00","npi":"1255744652"},{"billed_charge":"302.00","npi":"1407275787"},{"billed_charge":"302.00","npi":"1487815650"},{"billed_charge":"302.00","npi":"1639117823"},{"billed_charge":"302.00","npi":"1770642480"},{"billed_charge":"302.00","npi":"1831106681"},{"billed_charge":"302.00","npi":"1891763199"},{"billed_charge":"302.00","npi":"1962964742"},{"billed_charge":"302.00","npi":"1972559557"}]},{"allowed_amount":"60.44","providers":[{"billed_charge":"302.00","npi":"1134744014"},{"billed_charge":"302.00","npi":"1255362323"},{"billed_charge":"302.00","npi":"1275224016"},{"billed_charge":"302.00","npi":"1730571126"},{"billed_charge":"302.00","npi":"1790188829"}]},{"allowed_amount":"71.10","providers":[{"billed_charge":"302.00","npi":"1154360691"},{"billed_charge":"302.00","npi":"1265616304"},{"billed_charge":"302.00","npi":"1295171247"},{"billed_charge":"302.00","npi":"1326061920"},{"billed_charge":"302.00","npi":"1497259675"},{"billed_charge":"302.00","npi":"1619928140"},{"billed_charge":"302.00","npi":"1831106681"},{"billed_charge":"302.00","npi":"1992047286"}]}]}]},{"name":"Subsequent inpatient hospital critical care of newborn, 28 days of age or younger, per day","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99469","description":"Subsequent inpatient hospital critical care of newborn, 28 days of age or younger, per day","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"375.56","providers":[{"billed_charge":"923.00","npi":"1265571269"},{"billed_charge":"923.00","npi":"1346531597"},{"billed_charge":"923.00","npi":"1427094028"}]},{"allowed_amount":"574.61","providers":[{"billed_charge":"923.00","npi":"1841949401"}]},{"allowed_amount":"676.01","providers":[{"billed_charge":"923.00","npi":"1003366766"},{"billed_charge":"923.00","npi":"1265926570"},{"billed_charge":"923.00","npi":"1508271990"},{"billed_charge":"923.00","npi":"1558740316"},{"billed_charge":"923.00","npi":"1609220565"},{"billed_charge":"923.00","npi":"1871729699"}]},{"allowed_amount":"923.00","providers":[{"billed_charge":"923.00","npi":"1003366766"},{"billed_charge":"923.00","npi":"1508271990"},{"billed_charge":"923.00","npi":"1588677660"},{"billed_charge":"923.00","npi":"1609220565"},{"billed_charge":"923.00","npi":"1720234776"},{"billed_charge":"923.00","npi":"1871023226"}]}]}]},{"name":"Subsequent inpatient hospital critical care of infant or young child, 29 days through 24 months of a","billing_code_type":"CPT","billing_code_type_version":"4","billing_code":"99472","description":"Subsequent inpatient hospital critical care of infant or young child, 29 days through 24 months of a","allowed_amounts":[{"tin":[{"type":"ein","value":"942854057 "}],"service_code":["21"],"billing_class":"professional","payments":[{"allowed_amount":"385.40","providers":[{"billed_charge":"959.00","npi":"1265926570"},{"billed_charge":"959.00","npi":"1396847034"},{"billed_charge":"959.00","npi":"1427094028"},{"billed_charge":"959.00","npi":"1497078075"},{"billed_charge":"959.00","npi":"1508271990"},{"billed_charge":"959.00","npi":"1538172606"},{"billed_charge":"959.00","npi":"1609220565"},{"billed_charge":"959.00","npi":"1871023226"}]},{"allowed_amount":"693.72","providers":[{"billed_charge":"959.00","npi":"1508271990"},{"billed_charge":"959.00","npi":"1609220565"},{"billed_charge":"959.00","npi":"1871023226"},{"billed_charge":"959.00","npi":"1871729699"}]},{"allowed_amount":"959.00","providers":[{"billed_charge":"959.00","npi":"1265926570"},{"billed_charge":"959.00","npi":"1508271990"},{"billed_charge":"959.00","npi":"1609220565"},{"billed_charge":"959.00","npi":"1720234776"},{"billed_charge":"959.00","npi":"1871023226"},{"billed_charge":"959.00","npi":"1871729699"}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":[{"type":"ein","value":"753134967 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1056.00","providers":[{"billed_charge":"1056.00","npi":"1053574673"}]},{"allowed_amount":"1140.48","providers":[{"billed_charge":"1140.48","npi":"1053574673"}]},{"allowed_amount":"126.72","providers":[{"billed_charge":"126.72","npi":"1053574673"}]},{"allowed_amount":"1351.68","providers":[{"billed_charge":"1351.68","npi":"1053574673"}]},{"allowed_amount":"168.96","providers":[{"billed_charge":"168.96","npi":"1053574673"}]},{"allowed_amount":"211.20","providers":[{"billed_charge":"211.20","npi":"1053574673"}]},{"allowed_amount":"253.44","providers":[{"billed_charge":"253.44","npi":"1053574673"}]},{"allowed_amount":"295.68","providers":[{"billed_charge":"295.68","npi":"1053574673"}]},{"allowed_amount":"337.92","providers":[{"billed_charge":"337.92","npi":"1053574673"}]},{"allowed_amount":"380.16","providers":[{"billed_charge":"380.16","npi":"1053574673"}]},{"allowed_amount":"549.12","providers":[{"billed_charge":"549.12","npi":"1053574673"}]},{"allowed_amount":"591.36","providers":[{"billed_charge":"591.36","npi":"1053574673"}]},{"allowed_amount":"633.60","providers":[{"billed_charge":"633.60","npi":"1053574673"}]},{"allowed_amount":"675.84","providers":[{"billed_charge":"675.84","npi":"1053574673"}]},{"allowed_amount":"84.48","providers":[{"billed_charge":"84.48","npi":"1053574673"}]},{"allowed_amount":"844.80","providers":[{"billed_charge":"844.80","npi":"1053574673"}]},{"allowed_amount":"929.28","providers":[{"billed_charge":"929.28","npi":"1053574673"}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":[{"type":"ein","value":"870277106 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"109.82","providers":[{"billed_charge":"109.82","npi":"1679560502"}]},{"allowed_amount":"1098.24","providers":[{"billed_charge":"1098.24","npi":"1679560502"}]},{"allowed_amount":"1140.48","providers":[{"billed_charge":"1140.48","npi":"1679560502"}]},{"allowed_amount":"126.72","providers":[{"billed_charge":"126.72","npi":"1679560502"}]},{"allowed_amount":"1309.44","providers":[{"billed_charge":"1309.44","npi":"1679560502"}]},{"allowed_amount":"14065.92","providers":[{"billed_charge":"14065.92","npi":"1679560502"}]},{"allowed_amount":"1436.16","providers":[{"billed_charge":"1436.16","npi":"1679560502"}]},{"allowed_amount":"1562.88","providers":[{"billed_charge":"1562.88","npi":"1679560502"}]},{"allowed_amount":"168.96","providers":[{"billed_charge":"168.96","npi":"1679560502"}]},{"allowed_amount":"1731.84","providers":[{"billed_charge":"1731.84","npi":"1679560502"}]},{"allowed_amount":"1816.32","providers":[{"billed_charge":"1816.32","npi":"1679560502"}]},{"allowed_amount":"185.85","providers":[{"billed_charge":"185.85","npi":"1679560502"}]},{"allowed_amount":"1858.56","providers":[{"billed_charge":"1858.56","npi":"1679560502"}]},{"allowed_amount":"1943.04","providers":[{"billed_charge":"1943.04","npi":"1679560502"}]},{"allowed_amount":"1985.28","providers":[{"billed_charge":"1985.28","npi":"1679560502"}]},{"allowed_amount":"211.20","providers":[{"billed_charge":"211.20","npi":"1679560502"}]},{"allowed_amount":"2196.48","providers":[{"billed_charge":"2196.48","npi":"1679560502"}]},{"allowed_amount":"2323.20","providers":[{"billed_charge":"2323.20","npi":"1679560502"}]},{"allowed_amount":"253.44","providers":[{"billed_charge":"253.44","npi":"1679560502"}]},{"allowed_amount":"2618.88","providers":[{"billed_charge":"2618.88","npi":"1679560502"}]},{"allowed_amount":"295.68","providers":[{"billed_charge":"295.68","npi":"1679560502"}]},{"allowed_amount":"337.92","providers":[{"billed_charge":"337.92","npi":"1679560502"}]},{"allowed_amount":"380.16","providers":[{"billed_charge":"380.16","npi":"1679560502"}]},{"allowed_amount":"405.50","providers":[{"billed_charge":"405.50","npi":"1679560502"}]},{"allowed_amount":"42.24","providers":[{"billed_charge":"42.24","npi":"1679560502"},{"billed_charge":"71.51","npi":"1679560502"}]},{"allowed_amount":"422.40","providers":[{"billed_charge":"422.40","npi":"1679560502"}]},{"allowed_amount":"460.41","providers":[{"billed_charge":"460.41","npi":"1679560502"}]},{"allowed_amount":"464.64","providers":[{"billed_charge":"464.64","npi":"1679560502"}]},{"allowed_amount":"506.88","providers":[{"billed_charge":"506.88","npi":"1679560502"}]},{"allowed_amount":"549.12","providers":[{"billed_charge":"549.12","npi":"1679560502"}]},{"allowed_amount":"591.36","providers":[{"billed_charge":"591.36","npi":"1679560502"}]},{"allowed_amount":"633.60","providers":[{"billed_charge":"633.60","npi":"1679560502"}]},{"allowed_amount":"6378.24","providers":[{"billed_charge":"6378.24","npi":"1679560502"}]},{"allowed_amount":"6462.72","providers":[{"billed_charge":"6462.72","npi":"1679560502"}]},{"allowed_amount":"675.84","providers":[{"billed_charge":"675.84","npi":"1679560502"}]},{"allowed_amount":"7138.56","providers":[{"billed_charge":"7138.56","npi":"1679560502"}]},{"allowed_amount":"760.32","providers":[{"billed_charge":"760.32","npi":"1679560502"}]},{"allowed_amount":"802.56","providers":[{"billed_charge":"802.56","npi":"1679560502"}]},{"allowed_amount":"819.45","providers":[{"billed_charge":"819.45","npi":"1679560502"}]},{"allowed_amount":"84.48","providers":[{"billed_charge":"84.48","npi":"1679560502"}]},{"allowed_amount":"887.04","providers":[{"billed_charge":"887.04","npi":"1679560502"}]},{"allowed_amount":"929.28","providers":[{"billed_charge":"929.28","npi":"1679560502"}]},{"allowed_amount":"971.52","providers":[{"billed_charge":"971.52","npi":"1679560502"}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":[{"type":"ein","value":"876000243 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"126.72","providers":[{"billed_charge":"126.72","npi":"1336746940"}]},{"allowed_amount":"1267.20","providers":[{"billed_charge":"1267.20","npi":"1336746940"}]},{"allowed_amount":"1309.44","providers":[{"billed_charge":"1309.44","npi":"1336746940"}]},{"allowed_amount":"1351.68","providers":[{"billed_charge":"1351.68","npi":"1336746940"}]},{"allowed_amount":"168.96","providers":[{"billed_charge":"168.96","npi":"1336746940"}]},{"allowed_amount":"2238.72","providers":[{"billed_charge":"2238.72","npi":"1336746940"}]},{"allowed_amount":"2280.96","providers":[{"billed_charge":"2280.96","npi":"1336746940"}]},{"allowed_amount":"2323.20","providers":[{"billed_charge":"2323.20","npi":"1336746940"}]},{"allowed_amount":"337.92","providers":[{"billed_charge":"337.92","npi":"1336746940"}]},{"allowed_amount":"3590.40","providers":[{"billed_charge":"3590.40","npi":"1336746940"}]},{"allowed_amount":"3632.64","providers":[{"billed_charge":"3632.64","npi":"1336746940"}]},{"allowed_amount":"3843.84","providers":[{"billed_charge":"3843.84","npi":"1336746940"}]},{"allowed_amount":"76.03","providers":[{"billed_charge":"76.03","npi":"1336746940"}]},{"allowed_amount":"84.48","providers":[{"billed_charge":"84.48","npi":"1336746940"}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":[{"type":"ein","value":"876000257 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"118.27","providers":[{"billed_charge":"118.27","npi":"1801968243"}]},{"allowed_amount":"126.72","providers":[{"billed_charge":"139.39","npi":"1801968243"},{"billed_charge":"143.62","npi":"1801968243"}]},{"allowed_amount":"1436.16","providers":[{"billed_charge":"1444.61","npi":"1801968243"},{"billed_charge":"1448.83","npi":"1801968243"}]},{"allowed_amount":"1457.28","providers":[{"billed_charge":"1457.28","npi":"1801968243"}]},{"allowed_amount":"147.84","providers":[{"billed_charge":"147.84","npi":"1801968243"}]},{"allowed_amount":"152.06","providers":[{"billed_charge":"152.06","npi":"1801968243"}]},{"allowed_amount":"1605.12","providers":[{"billed_charge":"1605.12","npi":"1801968243"}]},{"allowed_amount":"1647.36","providers":[{"billed_charge":"1647.36","npi":"1801968243"}]},{"allowed_amount":"1719.17","providers":[{"billed_charge":"1719.17","npi":"1801968243"}]},{"allowed_amount":"21.12","providers":[{"billed_charge":"21.12","npi":"1801968243"}]},{"allowed_amount":"211.20","providers":[{"billed_charge":"219.65","npi":"1801968243"}]},{"allowed_amount":"253.44","providers":[{"billed_charge":"261.89","npi":"1801968243"},{"billed_charge":"270.34","npi":"1801968243"}]},{"allowed_amount":"2737.15","providers":[{"billed_charge":"2737.15","npi":"1801968243"}]},{"allowed_amount":"2787.84","providers":[{"billed_charge":"2787.84","npi":"1801968243"}]},{"allowed_amount":"295.68","providers":[{"billed_charge":"295.68","npi":"1801968243"}]},{"allowed_amount":"2956.80","providers":[{"billed_charge":"2961.02","npi":"1801968243"}]},{"allowed_amount":"42.24","providers":[{"billed_charge":"42.24","npi":"1801968243"},{"billed_charge":"54.91","npi":"1801968243"}]},{"allowed_amount":"464.64","providers":[{"billed_charge":"477.31","npi":"1801968243"}]},{"allowed_amount":"80.26","providers":[{"billed_charge":"80.26","npi":"1801968243"}]},{"allowed_amount":"844.80","providers":[{"billed_charge":"844.80","npi":"1801968243"}]},{"allowed_amount":"887.04","providers":[{"billed_charge":"903.94","npi":"1801968243"}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":[{"type":"ein","value":"876113473 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1140.48","providers":[{"billed_charge":"1140.48","npi":"1437260817"}]},{"allowed_amount":"1182.72","providers":[{"billed_charge":"1182.72","npi":"1437260817"}]},{"allowed_amount":"1224.96","providers":[{"billed_charge":"1224.96","npi":"1437260817"}]},{"allowed_amount":"126.72","providers":[{"billed_charge":"126.72","npi":"1437260817"}]},{"allowed_amount":"168.96","providers":[{"billed_charge":"168.96","npi":"1437260817"}]},{"allowed_amount":"337.92","providers":[{"billed_charge":"337.92","npi":"1437260817"}]},{"allowed_amount":"549.12","providers":[{"billed_charge":"549.12","npi":"1437260817"}]},{"allowed_amount":"633.60","providers":[{"billed_charge":"633.60","npi":"1437260817"}]},{"allowed_amount":"675.84","providers":[{"billed_charge":"675.84","npi":"1437260817"}]}]}]},{"name":"Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0426","description":"Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)","allowed_amounts":[{"tin":[{"type":"ein","value":"870277106 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1630.31","providers":[{"billed_charge":"1630.31","npi":"1679560502"}]},{"allowed_amount":"2383.73","providers":[{"billed_charge":"2383.73","npi":"1679560502"}]}]}]},{"name":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","allowed_amounts":[{"tin":[{"type":"ein","value":"753134967 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"2383.73","providers":[{"billed_charge":"2383.73","npi":"1053574673"}]},{"allowed_amount":"824.69","providers":[{"billed_charge":"824.69","npi":"1053574673"}]}]}]},{"name":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","allowed_amounts":[{"tin":[{"type":"ein","value":"870277106 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1630.31","providers":[{"billed_charge":"1630.31","npi":"1679560502"}]},{"allowed_amount":"2383.73","providers":[{"billed_charge":"2383.73","npi":"1679560502"}]}]}]},{"name":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","allowed_amounts":[{"tin":[{"type":"ein","value":"876000243 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"2383.73","providers":[{"billed_charge":"2383.73","npi":"1336746940"},{"billed_charge":"2388.67","npi":"1336746940"}]}]}]},{"name":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0427","description":"Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)","allowed_amounts":[{"tin":[{"type":"ein","value":"876113473 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1630.31","providers":[{"billed_charge":"1630.31","npi":"1437260817"}]},{"allowed_amount":"2383.73","providers":[{"billed_charge":"2383.73","npi":"1437260817"}]}]}]},{"name":"Ambulance service, basic life support, emergency transport (bls-emergency)","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A0429","description":"Ambulance service, basic life support, emergency transport (bls-emergency)","allowed_amounts":[{"tin":[{"type":"ein","value":"753134967 "}],"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":"1234.92","providers":[{"billed_charge":"1234.92","npi":"1053574673"}]}]}]},{"name":"Tubing with integrated heating element for use with positive airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A4604","description":"Tubing with integrated heating element for use with positive airway pressure device","allowed_amounts":[{"tin":[{"type":"ein","value":"870529529 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"26.60","providers":[{"billed_charge":"67.00","npi":"1023726171"}]},{"allowed_amount":"47.87","providers":[{"billed_charge":"66.81","npi":"1023726171"},{"billed_charge":"67.00","npi":"1023726171"},{"billed_charge":"69.00","npi":"1023726171"}]},{"allowed_amount":"48.22","providers":[{"billed_charge":"67.00","npi":"1689392847"}]}]}]},{"name":"Full face mask used with positive airway pressure device, each","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7030","description":"Full face mask used with positive airway pressure device, each","allowed_amounts":[{"tin":[{"type":"ein","value":"870529529 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"103.50","providers":[{"billed_charge":"190.00","npi":"1023726171"}]},{"allowed_amount":"57.50","providers":[{"billed_charge":"190.00","npi":"1023726171"}]}]}]},{"name":"Face mask interface, replacement for full face mask, each","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7031","description":"Face mask interface, replacement for full face mask, each","allowed_amounts":[{"tin":[{"type":"ein","value":"870529529 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"119.52","providers":[{"billed_charge":"225.00","npi":"1023726171"}]},{"allowed_amount":"39.84","providers":[{"billed_charge":"75.00","npi":"1023726171"}]},{"allowed_amount":"66.40","providers":[{"billed_charge":"225.00","npi":"1023726171"}]}]}]},{"name":"Headgear used with positive airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7035","description":"Headgear used with positive airway pressure device","allowed_amounts":[{"tin":[{"type":"ein","value":"870529529 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"12.14","providers":[{"billed_charge":"40.00","npi":"1023726171"}]},{"allowed_amount":"21.85","providers":[{"billed_charge":"40.00","npi":"1023726171"}]},{"allowed_amount":"21.97","providers":[{"billed_charge":"40.00","npi":"1689392847"}]}]}]},{"name":"Filter, disposable, used with positive airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"A7038","description":"Filter, disposable, used with positive airway pressure device","allowed_amounts":[{"tin":[{"type":"ein","value":"870529529 "}],"service_code":["12"],"billing_class":"professional","payments":[{"allowed_amount":"14.69","providers":[{"billed_charge":"33.00","npi":"1023726171"}]},{"allowed_amount":"15.36","providers":[{"billed_charge":"33.00","npi":"1689392847"}]},{"allowed_amount":"8.16","providers":[{"billed_charge":"33.00","npi":"1023726171"}]}]}]},{"name":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0277","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","allowed_amounts":[{"tin":[{"type":"ein","value":"873975257 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"356.15","providers":[{"billed_charge":"1220.00","npi":"1669838405"},{"billed_charge":"2000.00","npi":"1669838405"}]},{"allowed_amount":"419.00","providers":[{"billed_charge":"1220.00","npi":"1366705097"},{"billed_charge":"2000.00","npi":"1366705097"}]},{"allowed_amount":"754.20","providers":[{"billed_charge":"1220.00","npi":"1366705097"},{"billed_charge":"1220.00","npi":"1669838405"},{"billed_charge":"2000.00","npi":"1669838405"}]},{"allowed_amount":"754.40","providers":[{"billed_charge":"2000.00","npi":"1366705097"}]}]}]},{"name":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0480","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","allowed_amounts":[{"tin":[{"type":"ein","value":"843172409 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"137.32","providers":[{"billed_charge":"1540.50","npi":"1003437500"}]},{"allowed_amount":"51.96","providers":[{"billed_charge":"1540.50","npi":"1003437500"}]}]}]},{"name":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0481","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","allowed_amounts":[{"tin":[{"type":"ein","value":"474815114 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"119.79","providers":[{"billed_charge":"250.54","npi":"1215302245"}]},{"allowed_amount":"234.89","providers":[{"billed_charge":"250.54","npi":"1215302245"}]},{"allowed_amount":"66.55","providers":[{"billed_charge":"250.54","npi":"1215302245"}]}]}]},{"name":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"G0481","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug","allowed_amounts":[{"tin":[{"type":"ein","value":"880241758 "}],"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":"27.18","providers":[{"billed_charge":"587.00","npi":"1699782722"}]},{"allowed_amount":"27.19","providers":[{"billed_charge":"587.00","npi":"1699782722"}]},{"allowed_amount":"98.39","providers":[{"billed_charge":"587.00","npi":"1699782722"}]}]}]},{"name":"Injection, testosterone cypionate, 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2022","billing_code":"J1071","description":"Injection, testosterone cypionate, 1 mg","allowed_amounts":[{"tin":[{"type":"ein","value":"275505337 "}],"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":"1.76","providers":[{"billed_charge":"9.60","npi":"1871259184"}]},{"allowed_amount":"2.09","providers":[{"billed_charge":"11.40","npi":"1790582591"}]},{"allowed_amount":"2.31","providers":[{"billed_charge":"8.40","npi":"1598556805"}]},{"allowed_amount":"2.48","providers":[{"billed_charge":"9.00","npi":"1598556805"}]},{"allowed_amount":"2.64","providers":[{"billed_charge":"9.60","npi":"1871259184"}]},{"allowed_amount":"2.97","providers":[{"billed_charge":"10.80","npi":"1790582591"}]},{"allowed_amount":"3.14","providers":[{"billed_charge":"11.40","npi":"1790582591"}]},{"allowed_amount":"3.17","providers":[{"billed_charge":"9.60","npi":"1790582591"}]},{"allowed_amount":"3.30","providers":[{"billed_charge":"12.00","npi":"1790582591"}]},{"allowed_amount":"3.47","providers":[{"billed_charge":"12.60","npi":"1790582591"}]},{"allowed_amount":"4.46","providers":[{"billed_charge":"9.00","npi":"1790582591"}]},{"allowed_amount":"4.75","providers":[{"billed_charge":"9.60","npi":"1790582591"}]},{"allowed_amount":"5.05","providers":[{"billed_charge":"10.20","npi":"1790582591"}]}]}]}]}