{"reporting_entity_name":"SENTARA HEALTH PLANS","reporting_entity_type":"HEALTH INSURANCE ISSUER","plan_name":"CHKD HEALTHY OPTIONS HMO I","plan_id_type":"ein","plan_id":"541278830","plan_market_type":"group","plan_sponsor_name":"CHS HEALTHY OPTIONS","issuer_name":"SENTARA HEALTH PLANS","last_updated_on":"2026-08-01","version":"2.0.0","out_of_network":[{"name":"Administration and interpretation of caregiver-focused health risk assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration and interpretation of caregiver-focused health risk assessment","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.25,"providers":[{"billed_charge":16.00,"npi":[1154346179]},{"billed_charge":16.00,"npi":[1184659898]},{"billed_charge":16.00,"npi":[1316443385]},{"billed_charge":16.00,"npi":[1518901347]},{"billed_charge":16.00,"npi":[1750586012]},{"billed_charge":16.00,"npi":[1851896088]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.25,"providers":[{"billed_charge":16.00,"npi":[1003833757]},{"billed_charge":16.00,"npi":[1003850744]},{"billed_charge":16.00,"npi":[1013150622]},{"billed_charge":16.00,"npi":[1013982289]},{"billed_charge":16.00,"npi":[1023048766]},{"billed_charge":16.00,"npi":[1023502937]},{"billed_charge":16.00,"npi":[1043486566]},{"billed_charge":16.00,"npi":[1053601161]},{"billed_charge":16.00,"npi":[1104876549]},{"billed_charge":16.00,"npi":[1962436543]},{"billed_charge":16.00,"npi":[1992753610]},{"billed_charge":16.00,"npi":[1144462672]},{"billed_charge":16.00,"npi":[1154582054]},{"billed_charge":16.00,"npi":[1184935249]},{"billed_charge":16.00,"npi":[1205455193]},{"billed_charge":16.00,"npi":[1205899796]},{"billed_charge":16.00,"npi":[1225649742]},{"billed_charge":16.00,"npi":[1285677658]},{"billed_charge":16.00,"npi":[1295867083]},{"billed_charge":16.00,"npi":[1306300702]},{"billed_charge":16.00,"npi":[1316105406]},{"billed_charge":16.00,"npi":[1316987712]},{"billed_charge":16.00,"npi":[1326066341]},{"billed_charge":16.00,"npi":[1326400326]},{"billed_charge":16.00,"npi":[1336300391]},{"billed_charge":16.00,"npi":[1366494056]},{"billed_charge":16.00,"npi":[1366885253]},{"billed_charge":16.00,"npi":[1376562926]},{"billed_charge":16.00,"npi":[1386682789]},{"billed_charge":16.00,"npi":[1487185187]},{"billed_charge":16.00,"npi":[1487693727]},{"billed_charge":16.00,"npi":[1497916357]},{"billed_charge":16.00,"npi":[1508819848]},{"billed_charge":16.00,"npi":[1518292127]},{"billed_charge":16.00,"npi":[1578752283]},{"billed_charge":16.00,"npi":[1619910098]},{"billed_charge":16.00,"npi":[1619920543]},{"billed_charge":16.00,"npi":[1629003231]},{"billed_charge":16.00,"npi":[1639119134]},{"billed_charge":16.00,"npi":[1639127194]},{"billed_charge":16.00,"npi":[1649099862]},{"billed_charge":16.00,"npi":[1669430963]},{"billed_charge":16.00,"npi":[1699720953]},{"billed_charge":16.00,"npi":[1700272242]},{"billed_charge":16.00,"npi":[1700405859]},{"billed_charge":16.00,"npi":[1710742838]},{"billed_charge":16.00,"npi":[1720026115]},{"billed_charge":16.00,"npi":[1740441781]},{"billed_charge":16.00,"npi":[1740442268]},{"billed_charge":16.00,"npi":[1790814929]},{"billed_charge":16.00,"npi":[1790913762]},{"billed_charge":16.00,"npi":[1811969140]},{"billed_charge":16.00,"npi":[1831620160]},{"billed_charge":16.00,"npi":[1891006805]},{"billed_charge":16.00,"npi":[1942467204]}]}]}]},{"name":"Administration and interpretation of patient-focused health risk assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration and interpretation of patient-focused health risk assessment","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.25,"providers":[{"billed_charge":8.85,"npi":[1154346179]},{"billed_charge":8.85,"npi":[1316443385]},{"billed_charge":8.85,"npi":[1750586012]},{"billed_charge":8.85,"npi":[1760414338]},{"billed_charge":8.85,"npi":[1851896088]}]},{"allowed_amount":14.50,"providers":[{"billed_charge":17.70,"npi":[1760414338]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.25,"providers":[{"billed_charge":16.00,"npi":[1023041787]},{"billed_charge":16.00,"npi":[1043486566]},{"billed_charge":16.00,"npi":[1114993185]},{"billed_charge":16.00,"npi":[1962436543]},{"billed_charge":16.00,"npi":[1154379022]},{"billed_charge":16.00,"npi":[1205455193]},{"billed_charge":16.00,"npi":[1205899796]},{"billed_charge":16.00,"npi":[1215220355]},{"billed_charge":16.00,"npi":[1225649742]},{"billed_charge":16.00,"npi":[1285677658]},{"billed_charge":16.00,"npi":[1306300702]},{"billed_charge":16.00,"npi":[1326400326]},{"billed_charge":16.00,"npi":[1356397251]},{"billed_charge":16.00,"npi":[1366494056]},{"billed_charge":16.00,"npi":[1366885253]},{"billed_charge":16.00,"npi":[1376562926]},{"billed_charge":16.00,"npi":[1386685782]},{"billed_charge":16.00,"npi":[1396107637]},{"billed_charge":16.00,"npi":[1447205380]},{"billed_charge":16.00,"npi":[1467486027]},{"billed_charge":16.00,"npi":[1487185187]},{"billed_charge":16.00,"npi":[1497916357]},{"billed_charge":16.00,"npi":[1548201973]},{"billed_charge":16.00,"npi":[1558583740]},{"billed_charge":16.00,"npi":[1568625226]},{"billed_charge":16.00,"npi":[1578752283]},{"billed_charge":16.00,"npi":[1619910098]},{"billed_charge":16.00,"npi":[1700405859]},{"billed_charge":16.00,"npi":[1720026115]},{"billed_charge":16.00,"npi":[1740442268]},{"billed_charge":16.00,"npi":[1790913762]},{"billed_charge":16.00,"npi":[1801861596]},{"billed_charge":16.00,"npi":[1912931593]},{"billed_charge":16.00,"npi":[1952562993]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.19,"providers":[{"billed_charge":11.00,"npi":[1104205160]},{"billed_charge":11.00,"npi":[1306897418]},{"billed_charge":11.00,"npi":[1407809023]},{"billed_charge":11.00,"npi":[1427013036]},{"billed_charge":11.00,"npi":[1578817185]},{"billed_charge":11.00,"npi":[1649243031]},{"billed_charge":11.00,"npi":[1730541319]},{"billed_charge":11.00,"npi":[1841428729]},{"billed_charge":11.00,"npi":[1932323904]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":7.25,"providers":[{"billed_charge":16.00,"npi":[1649648940]}]}]}]},{"name":"Administration of first vaccine or toxoid component with counseling (18 years or younger)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Administration of first vaccine or toxoid component with counseling (18 years or younger)","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.31,"providers":[{"billed_charge":56.00,"npi":[1518901347]}]},{"allowed_amount":76.62,"providers":[{"billed_charge":112.00,"npi":[1154346179]},{"billed_charge":112.00,"npi":[1184659898]},{"billed_charge":112.00,"npi":[1518901347]}]},{"allowed_amount":114.93,"providers":[{"billed_charge":168.00,"npi":[1154346179]},{"billed_charge":168.00,"npi":[1184659898]},{"billed_charge":168.00,"npi":[1750586012]}]},{"allowed_amount":191.55,"providers":[{"billed_charge":280.00,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.31,"providers":[{"billed_charge":56.00,"npi":[1013150622]},{"billed_charge":56.00,"npi":[1013982289]},{"billed_charge":56.00,"npi":[1023502937]},{"billed_charge":56.00,"npi":[1083472955]},{"billed_charge":56.00,"npi":[1972143972]},{"billed_charge":56.00,"npi":[1982639183]},{"billed_charge":56.00,"npi":[1992753610]},{"billed_charge":56.00,"npi":[1154379022]},{"billed_charge":56.00,"npi":[1215220355]},{"billed_charge":56.00,"npi":[1225649742]},{"billed_charge":56.00,"npi":[1285677658]},{"billed_charge":56.00,"npi":[1295867083]},{"billed_charge":56.00,"npi":[1306300702]},{"billed_charge":56.00,"npi":[1316105406]},{"billed_charge":56.00,"npi":[1326066341]},{"billed_charge":56.00,"npi":[1326400326]},{"billed_charge":56.00,"npi":[1336535632]},{"billed_charge":56.00,"npi":[1356397251]},{"billed_charge":56.00,"npi":[1376591602]},{"billed_charge":56.00,"npi":[1457314403]},{"billed_charge":56.00,"npi":[1487185187]},{"billed_charge":56.00,"npi":[1487693727]},{"billed_charge":56.00,"npi":[1508286220]},{"billed_charge":56.00,"npi":[1508819848]},{"billed_charge":56.00,"npi":[1518292127]},{"billed_charge":56.00,"npi":[1558583740]},{"billed_charge":56.00,"npi":[1568696110]},{"billed_charge":56.00,"npi":[1619910098]},{"billed_charge":56.00,"npi":[1619920543]},{"billed_charge":56.00,"npi":[1639127194]},{"billed_charge":56.00,"npi":[1669430963]},{"billed_charge":56.00,"npi":[1689964603]},{"billed_charge":56.00,"npi":[1700405859]},{"billed_charge":56.00,"npi":[1740441781]},{"billed_charge":56.00,"npi":[1790913762]},{"billed_charge":56.00,"npi":[1831170562]},{"billed_charge":56.00,"npi":[1912931593]},{"billed_charge":56.00,"npi":[1952562993]}]},{"allowed_amount":76.62,"providers":[{"billed_charge":112.00,"npi":[1013150622]},{"billed_charge":112.00,"npi":[1013982289]},{"billed_charge":112.00,"npi":[1023041787]},{"billed_charge":112.00,"npi":[1043486566]},{"billed_charge":112.00,"npi":[1053601161]},{"billed_charge":112.00,"npi":[1124537923]},{"billed_charge":112.00,"npi":[1205885696]},{"billed_charge":112.00,"npi":[1285677658]},{"billed_charge":112.00,"npi":[1295867083]},{"billed_charge":112.00,"npi":[1316105406]},{"billed_charge":112.00,"npi":[1326066341]},{"billed_charge":112.00,"npi":[1326400326]},{"billed_charge":112.00,"npi":[1366494056]},{"billed_charge":112.00,"npi":[1386682789]},{"billed_charge":112.00,"npi":[1467486027]},{"billed_charge":112.00,"npi":[1487185187]},{"billed_charge":112.00,"npi":[1487693727]},{"billed_charge":112.00,"npi":[1497916357]},{"billed_charge":112.00,"npi":[1558583740]},{"billed_charge":112.00,"npi":[1700405859]},{"billed_charge":112.00,"npi":[1740441781]},{"billed_charge":112.00,"npi":[1801861596]},{"billed_charge":112.00,"npi":[1831620160]},{"billed_charge":112.00,"npi":[1912135013]},{"billed_charge":112.00,"npi":[1942467204]},{"billed_charge":112.00,"npi":[1952690208]}]},{"allowed_amount":114.93,"providers":[{"billed_charge":168.00,"npi":[1003850744]},{"billed_charge":168.00,"npi":[1013982289]},{"billed_charge":168.00,"npi":[1023502937]},{"billed_charge":168.00,"npi":[1053601161]},{"billed_charge":168.00,"npi":[1104876549]},{"billed_charge":168.00,"npi":[1144462672]},{"billed_charge":168.00,"npi":[1992753610]},{"billed_charge":168.00,"npi":[1184935249]},{"billed_charge":168.00,"npi":[1205455193]},{"billed_charge":168.00,"npi":[1205885696]},{"billed_charge":168.00,"npi":[1205899796]},{"billed_charge":168.00,"npi":[1215220355]},{"billed_charge":168.00,"npi":[1225649742]},{"billed_charge":168.00,"npi":[1285677658]},{"billed_charge":168.00,"npi":[1295867083]},{"billed_charge":168.00,"npi":[1326066341]},{"billed_charge":168.00,"npi":[1326400326]},{"billed_charge":168.00,"npi":[1366494056]},{"billed_charge":168.00,"npi":[1366885253]},{"billed_charge":168.00,"npi":[1376591602]},{"billed_charge":168.00,"npi":[1396107637]},{"billed_charge":168.00,"npi":[1457309171]},{"billed_charge":168.00,"npi":[1487185187]},{"billed_charge":168.00,"npi":[1487693727]},{"billed_charge":168.00,"npi":[1508819848]},{"billed_charge":168.00,"npi":[1619910098]},{"billed_charge":168.00,"npi":[1639119134]},{"billed_charge":168.00,"npi":[1639127194]},{"billed_charge":168.00,"npi":[1700405859]},{"billed_charge":168.00,"npi":[1740441781]},{"billed_charge":168.00,"npi":[1740442268]},{"billed_charge":168.00,"npi":[1790814929]},{"billed_charge":168.00,"npi":[1790913762]},{"billed_charge":168.00,"npi":[1801861596]},{"billed_charge":168.00,"npi":[1811969140]},{"billed_charge":168.00,"npi":[1962436543]}]},{"allowed_amount":153.24,"providers":[{"billed_charge":224.00,"npi":[1003833757]},{"billed_charge":224.00,"npi":[1326066341]},{"billed_charge":224.00,"npi":[1376562926]},{"billed_charge":224.00,"npi":[1376591602]},{"billed_charge":224.00,"npi":[1386685782]},{"billed_charge":224.00,"npi":[1487185187]},{"billed_charge":224.00,"npi":[1578752283]},{"billed_charge":224.00,"npi":[1619910098]},{"billed_charge":224.00,"npi":[1942467204]},{"billed_charge":224.00,"npi":[1962436543]}]},{"allowed_amount":191.55,"providers":[{"billed_charge":280.00,"npi":[1487185187]}]},{"allowed_amount":229.86,"providers":[{"billed_charge":336.00,"npi":[1487185187]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":114.93,"providers":[{"billed_charge":168.00,"npi":[1144692377]}]},{"allowed_amount":153.24,"providers":[{"billed_charge":224.00,"npi":[1659765055]}]}]}]},{"name":"Administration of vaccine or toxoid component with counseling (18 years or younger), each additional vaccine or toxoid component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Administration of vaccine or toxoid component with counseling (18 years or younger), each additional vaccine or toxoid component","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.20,"providers":[{"billed_charge":120.00,"npi":[1154346179]},{"billed_charge":120.00,"npi":[1184659898]}]},{"allowed_amount":142.80,"providers":[{"billed_charge":180.00,"npi":[1518901347]},{"billed_charge":180.00,"npi":[1750586012]}]},{"allowed_amount":166.60,"providers":[{"billed_charge":210.00,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23.80,"providers":[{"billed_charge":30.00,"npi":[1225649742]}]},{"allowed_amount":47.60,"providers":[{"billed_charge":60.00,"npi":[1023041787]},{"billed_charge":60.00,"npi":[1053601161]},{"billed_charge":60.00,"npi":[1205455193]},{"billed_charge":60.00,"npi":[1205885696]},{"billed_charge":60.00,"npi":[1215220355]},{"billed_charge":60.00,"npi":[1295867083]},{"billed_charge":60.00,"npi":[1326066341]},{"billed_charge":60.00,"npi":[1366494056]},{"billed_charge":60.00,"npi":[1366885253]},{"billed_charge":60.00,"npi":[1376591602]},{"billed_charge":60.00,"npi":[1396107637]},{"billed_charge":60.00,"npi":[1457309171]},{"billed_charge":60.00,"npi":[1467486027]},{"billed_charge":60.00,"npi":[1487185187]},{"billed_charge":60.00,"npi":[1619910098]},{"billed_charge":60.00,"npi":[1790913762]},{"billed_charge":60.00,"npi":[1801861596]},{"billed_charge":60.00,"npi":[1831620160]},{"billed_charge":60.00,"npi":[1912135013]},{"billed_charge":60.00,"npi":[1942467204]},{"billed_charge":60.00,"npi":[1962436543]}]},{"allowed_amount":71.40,"providers":[{"billed_charge":90.00,"npi":[1508286220]},{"billed_charge":90.00,"npi":[1619920543]}]},{"allowed_amount":95.20,"providers":[{"billed_charge":120.00,"npi":[1003833757]},{"billed_charge":120.00,"npi":[1013982289]},{"billed_charge":120.00,"npi":[1972143972]},{"billed_charge":120.00,"npi":[1376562926]},{"billed_charge":120.00,"npi":[1487185187]},{"billed_charge":120.00,"npi":[1487693727]},{"billed_charge":120.00,"npi":[1700405859]}]},{"allowed_amount":119.00,"providers":[{"billed_charge":150.00,"npi":[1003850744]},{"billed_charge":150.00,"npi":[1023502937]},{"billed_charge":150.00,"npi":[1104876549]},{"billed_charge":150.00,"npi":[1144462672]},{"billed_charge":150.00,"npi":[1992753610]},{"billed_charge":150.00,"npi":[1184935249]},{"billed_charge":150.00,"npi":[1205455193]},{"billed_charge":150.00,"npi":[1205899796]},{"billed_charge":150.00,"npi":[1225649742]},{"billed_charge":150.00,"npi":[1285677658]},{"billed_charge":150.00,"npi":[1295867083]},{"billed_charge":150.00,"npi":[1326066341]},{"billed_charge":150.00,"npi":[1326400326]},{"billed_charge":150.00,"npi":[1366494056]},{"billed_charge":150.00,"npi":[1366885253]},{"billed_charge":150.00,"npi":[1376591602]},{"billed_charge":150.00,"npi":[1487693727]},{"billed_charge":150.00,"npi":[1508819848]},{"billed_charge":150.00,"npi":[1578752283]},{"billed_charge":150.00,"npi":[1619910098]},{"billed_charge":150.00,"npi":[1639119134]},{"billed_charge":150.00,"npi":[1700405859]},{"billed_charge":150.00,"npi":[1740441781]},{"billed_charge":150.00,"npi":[1740442268]},{"billed_charge":150.00,"npi":[1790814929]},{"billed_charge":150.00,"npi":[1811969140]},{"billed_charge":150.00,"npi":[1942467204]},{"billed_charge":150.00,"npi":[1962436543]}]},{"allowed_amount":142.80,"providers":[{"billed_charge":180.00,"npi":[1013150622]},{"billed_charge":180.00,"npi":[1043486566]},{"billed_charge":180.00,"npi":[1053601161]},{"billed_charge":180.00,"npi":[1285677658]},{"billed_charge":180.00,"npi":[1316105406]},{"billed_charge":180.00,"npi":[1326066341]},{"billed_charge":180.00,"npi":[1326400326]},{"billed_charge":180.00,"npi":[1386682789]},{"billed_charge":180.00,"npi":[1487693727]},{"billed_charge":180.00,"npi":[1639127194]},{"billed_charge":180.00,"npi":[1700405859]},{"billed_charge":180.00,"npi":[1790913762]},{"billed_charge":180.00,"npi":[1801861596]}]},{"allowed_amount":166.60,"providers":[{"billed_charge":210.00,"npi":[1205885696]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":47.60,"providers":[{"billed_charge":60.00,"npi":[1659765055]}]},{"allowed_amount":119.00,"providers":[{"billed_charge":150.00,"npi":[1144692377]}]}]}]},{"name":"Assessment of emotional or behavioral problems","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Assessment of emotional or behavioral problems","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.82,"providers":[{"billed_charge":14.00,"npi":[1154346179]},{"billed_charge":14.00,"npi":[1184659898]},{"billed_charge":14.00,"npi":[1518901347]},{"billed_charge":14.00,"npi":[1750586012]},{"billed_charge":14.00,"npi":[1760414338]},{"billed_charge":14.00,"npi":[1851896088]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":11.82,"providers":[{"billed_charge":14.00,"npi":[1487185187]},{"billed_charge":14.00,"npi":[1740442268]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.82,"providers":[{"billed_charge":14.00,"npi":[1013150622]},{"billed_charge":14.00,"npi":[1023041787]},{"billed_charge":14.00,"npi":[1023048766]},{"billed_charge":14.00,"npi":[1053601161]},{"billed_charge":14.00,"npi":[1083472955]},{"billed_charge":14.00,"npi":[1114993185]},{"billed_charge":14.00,"npi":[1124333646]},{"billed_charge":14.00,"npi":[1982639183]},{"billed_charge":14.00,"npi":[1144462672]},{"billed_charge":14.00,"npi":[1154379022]},{"billed_charge":14.00,"npi":[1184006967]},{"billed_charge":14.00,"npi":[1194967901]},{"billed_charge":14.00,"npi":[1205455193]},{"billed_charge":14.00,"npi":[1205885696]},{"billed_charge":14.00,"npi":[1205899796]},{"billed_charge":14.00,"npi":[1225079619]},{"billed_charge":14.00,"npi":[1285677658]},{"billed_charge":14.00,"npi":[1326400326]},{"billed_charge":14.00,"npi":[1336300391]},{"billed_charge":14.00,"npi":[1356397251]},{"billed_charge":14.00,"npi":[1366494056]},{"billed_charge":14.00,"npi":[1366885253]},{"billed_charge":14.00,"npi":[1386685782]},{"billed_charge":14.00,"npi":[1396107637]},{"billed_charge":14.00,"npi":[1467486027]},{"billed_charge":14.00,"npi":[1487185187]},{"billed_charge":14.00,"npi":[1487693727]},{"billed_charge":14.00,"npi":[1518292127]},{"billed_charge":14.00,"npi":[1558583740]},{"billed_charge":14.00,"npi":[1568696110]},{"billed_charge":14.00,"npi":[1619910098]},{"billed_charge":14.00,"npi":[1629239587]},{"billed_charge":14.00,"npi":[1689964603]},{"billed_charge":14.00,"npi":[1700405859]},{"billed_charge":14.00,"npi":[1740442268]},{"billed_charge":14.00,"npi":[1790913762]},{"billed_charge":14.00,"npi":[1801861596]},{"billed_charge":14.00,"npi":[1831620160]},{"billed_charge":14.00,"npi":[1891006805]},{"billed_charge":14.00,"npi":[1912931593]},{"billed_charge":14.00,"npi":[1942467204]},{"billed_charge":14.00,"npi":[1952562993]},{"billed_charge":14.00,"npi":[1952690208]},{"billed_charge":14.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":9.01,"providers":[{"billed_charge":12.00,"npi":[1972251163]},{"billed_charge":12.00,"npi":[1275856916]},{"billed_charge":12.00,"npi":[1619107901]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":9.01,"providers":[{"billed_charge":12.00,"npi":[1164467114]},{"billed_charge":12.00,"npi":[1194068940]},{"billed_charge":12.00,"npi":[1275856916]},{"billed_charge":12.00,"npi":[1497924625]},{"billed_charge":12.00,"npi":[1528530912]},{"billed_charge":12.00,"npi":[1578958526]},{"billed_charge":12.00,"npi":[1679769616]},{"billed_charge":12.00,"npi":[1750549606]},{"billed_charge":12.00,"npi":[1811261332]},{"billed_charge":12.00,"npi":[1851759286]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.82,"providers":[{"billed_charge":14.00,"npi":[1649648940]}]}]}]},{"name":"Blood count, hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Blood count, hemoglobin","allowed_amounts":[{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.44,"providers":[{"billed_charge":16.00,"npi":[1083472955]},{"billed_charge":16.00,"npi":[1124537923]},{"billed_charge":16.00,"npi":[1972143972]},{"billed_charge":16.00,"npi":[1326066341]},{"billed_charge":16.00,"npi":[1376591602]},{"billed_charge":16.00,"npi":[1396107637]},{"billed_charge":16.00,"npi":[1457309171]},{"billed_charge":16.00,"npi":[1487185187]},{"billed_charge":16.00,"npi":[1487693727]},{"billed_charge":16.00,"npi":[1558583740]},{"billed_charge":16.00,"npi":[1619910098]},{"billed_charge":16.00,"npi":[1700405859]},{"billed_charge":16.00,"npi":[1740442268]},{"billed_charge":16.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.44,"providers":[{"billed_charge":16.00,"npi":[1659765055]}]}]}]},{"name":"Blood test, lipids (cholesterol and triglycerides)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Blood test, lipids (cholesterol and triglycerides)","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":12.05,"providers":[{"billed_charge":195.42,"npi":[1912919481]},{"billed_charge":231.65,"npi":[1912919481]},{"billed_charge":233.46,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":30.66,"providers":[{"billed_charge":43.00,"npi":[1023041787]},{"billed_charge":43.00,"npi":[1043204571]},{"billed_charge":43.00,"npi":[1043486566]},{"billed_charge":43.00,"npi":[1992753610]},{"billed_charge":43.00,"npi":[1487693727]},{"billed_charge":43.00,"npi":[1558583740]},{"billed_charge":43.00,"npi":[1619910098]},{"billed_charge":43.00,"npi":[1942467204]},{"billed_charge":43.00,"npi":[1952690208]}]}]}]},{"name":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85025","description":"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":6.99,"providers":[{"billed_charge":154.35,"npi":[1912919481]},{"billed_charge":192.39,"npi":[1912919481]},{"billed_charge":154.35,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"540506463"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":51.52,"providers":[{"billed_charge":92.00,"npi":[1750399192]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":17.79,"providers":[{"billed_charge":30.00,"npi":[1043486566]},{"billed_charge":30.00,"npi":[1225079619]},{"billed_charge":30.00,"npi":[1720026115]}]}]}]},{"name":"Detection test by immunoassay with direct visual observation for influenza virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87804","description":"Detection test by immunoassay with direct visual observation for influenza virus","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":60.52,"providers":[{"billed_charge":105.00,"npi":[1912919481]}]}]}]},{"name":"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87880","description":"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)","allowed_amounts":[{"tin":{"type":"ein","value":"205805198"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":33.06,"providers":[{"billed_charge":45.00,"npi":[1184805574]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":30.22,"providers":[{"billed_charge":171.44,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":30.22,"providers":[{"billed_charge":171.44,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":30.66,"providers":[{"billed_charge":42.00,"npi":[1316105406]},{"billed_charge":42.00,"npi":[1376562926]},{"billed_charge":42.00,"npi":[1518292127]},{"billed_charge":42.00,"npi":[1952690208]}]}]},{"tin":{"type":"ein","value":"630825248"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":16.63,"providers":[{"billed_charge":25.00,"npi":[1114499803]}]}]}]},{"name":"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":128.37,"providers":[{"billed_charge":234.56,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":264.59,"providers":[{"billed_charge":321.00,"npi":[1043486566]},{"billed_charge":321.00,"npi":[1194522219]},{"billed_charge":321.00,"npi":[1205455193]},{"billed_charge":321.00,"npi":[1215220355]},{"billed_charge":321.00,"npi":[1225079619]},{"billed_charge":321.00,"npi":[1285677658]},{"billed_charge":321.00,"npi":[1316987712]},{"billed_charge":321.00,"npi":[1326861139]},{"billed_charge":321.00,"npi":[1336300391]},{"billed_charge":321.00,"npi":[1376562926]},{"billed_charge":321.00,"npi":[1386685782]},{"billed_charge":321.00,"npi":[1427799360]},{"billed_charge":321.00,"npi":[1457314403]},{"billed_charge":321.00,"npi":[1457513673]},{"billed_charge":321.00,"npi":[1487693727]},{"billed_charge":321.00,"npi":[1497175434]},{"billed_charge":321.00,"npi":[1548201973]},{"billed_charge":321.00,"npi":[1578752283]},{"billed_charge":321.00,"npi":[1639127194]},{"billed_charge":321.00,"npi":[1689964603]},{"billed_charge":321.00,"npi":[1700405859]},{"billed_charge":321.00,"npi":[1730634510]},{"billed_charge":321.00,"npi":[1740442268]},{"billed_charge":321.00,"npi":[1952562993]}]}]}]},{"name":"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["81"],"billing_class":"professional","payments":[{"allowed_amount":31.58,"providers":[{"billed_charge":224.36,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":80.38,"providers":[{"billed_charge":99.00,"npi":[1043486566]},{"billed_charge":99.00,"npi":[1124537923]},{"billed_charge":99.00,"npi":[1144462672]},{"billed_charge":99.00,"npi":[1194522219]},{"billed_charge":99.00,"npi":[1205626918]},{"billed_charge":99.00,"npi":[1225079619]},{"billed_charge":99.00,"npi":[1316987712]},{"billed_charge":99.00,"npi":[1326066341]},{"billed_charge":99.00,"npi":[1336300391]},{"billed_charge":99.00,"npi":[1356397251]},{"billed_charge":99.00,"npi":[1366494056]},{"billed_charge":99.00,"npi":[1417060591]},{"billed_charge":99.00,"npi":[1427799360]},{"billed_charge":99.00,"npi":[1457513673]},{"billed_charge":99.00,"npi":[1467486027]},{"billed_charge":99.00,"npi":[1487387775]},{"billed_charge":99.00,"npi":[1487693727]},{"billed_charge":99.00,"npi":[1578752283]},{"billed_charge":99.00,"npi":[1619920543]},{"billed_charge":99.00,"npi":[1639119134]},{"billed_charge":99.00,"npi":[1639120710]},{"billed_charge":99.00,"npi":[1639127194]},{"billed_charge":99.00,"npi":[1700405859]},{"billed_charge":99.00,"npi":[1720026115]},{"billed_charge":99.00,"npi":[1730634510]},{"billed_charge":99.00,"npi":[1831141860]},{"billed_charge":99.00,"npi":[1831620160]},{"billed_charge":99.00,"npi":[1962436543]}]}]}]},{"name":"Developmental screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96110","description":"Developmental screening","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":38.10,"providers":[{"billed_charge":44.00,"npi":[1518901347]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.05,"providers":[{"billed_charge":26.00,"npi":[1013150622]},{"billed_charge":26.00,"npi":[1013982289]},{"billed_charge":26.00,"npi":[1023502937]},{"billed_charge":26.00,"npi":[1053601161]},{"billed_charge":26.00,"npi":[1083472955]},{"billed_charge":26.00,"npi":[1144462672]},{"billed_charge":26.00,"npi":[1154582054]},{"billed_charge":26.00,"npi":[1205455193]},{"billed_charge":26.00,"npi":[1215220355]},{"billed_charge":26.00,"npi":[1225649742]},{"billed_charge":26.00,"npi":[1285677658]},{"billed_charge":26.00,"npi":[1295867083]},{"billed_charge":26.00,"npi":[1306300702]},{"billed_charge":26.00,"npi":[1326066341]},{"billed_charge":26.00,"npi":[1326400326]},{"billed_charge":26.00,"npi":[1336535632]},{"billed_charge":26.00,"npi":[1356397251]},{"billed_charge":26.00,"npi":[1366494056]},{"billed_charge":26.00,"npi":[1366885253]},{"billed_charge":26.00,"npi":[1376562926]},{"billed_charge":26.00,"npi":[1376591602]},{"billed_charge":26.00,"npi":[1386682789]},{"billed_charge":26.00,"npi":[1457314403]},{"billed_charge":26.00,"npi":[1487185187]},{"billed_charge":26.00,"npi":[1487693727]},{"billed_charge":26.00,"npi":[1508819848]},{"billed_charge":26.00,"npi":[1548201973]},{"billed_charge":26.00,"npi":[1558583740]},{"billed_charge":26.00,"npi":[1568625226]},{"billed_charge":26.00,"npi":[1619910098]},{"billed_charge":26.00,"npi":[1619920543]},{"billed_charge":26.00,"npi":[1639127194]},{"billed_charge":26.00,"npi":[1669430963]},{"billed_charge":26.00,"npi":[1689964603]},{"billed_charge":26.00,"npi":[1700272242]},{"billed_charge":26.00,"npi":[1700405859]},{"billed_charge":26.00,"npi":[1740442268]},{"billed_charge":26.00,"npi":[1790913762]},{"billed_charge":26.00,"npi":[1790957447]},{"billed_charge":26.00,"npi":[1831141860]},{"billed_charge":26.00,"npi":[1912135013]},{"billed_charge":26.00,"npi":[1942467204]},{"billed_charge":26.00,"npi":[1952562993]},{"billed_charge":26.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":19.05,"providers":[{"billed_charge":26.00,"npi":[1144692377]},{"billed_charge":26.00,"npi":[1659765055]}]}]}]},{"name":"Diphtheria, tetanus, acellular pertussis, and polio vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Diphtheria, tetanus, acellular pertussis, and polio vaccine","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.05,"providers":[{"billed_charge":290.90,"npi":[1518901347]},{"billed_charge":290.90,"npi":[1750586012]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":71.05,"providers":[{"billed_charge":116.00,"npi":[1013150622]},{"billed_charge":116.00,"npi":[1043486566]},{"billed_charge":116.00,"npi":[1053601161]},{"billed_charge":116.00,"npi":[1285677658]},{"billed_charge":116.00,"npi":[1316105406]},{"billed_charge":116.00,"npi":[1326066341]},{"billed_charge":116.00,"npi":[1326400326]},{"billed_charge":116.00,"npi":[1386682789]},{"billed_charge":116.00,"npi":[1487185187]},{"billed_charge":116.00,"npi":[1487693727]},{"billed_charge":116.00,"npi":[1508286220]},{"billed_charge":116.00,"npi":[1619920543]},{"billed_charge":116.00,"npi":[1700405859]},{"billed_charge":116.00,"npi":[1790913762]}]},{"allowed_amount":73.05,"providers":[{"billed_charge":116.00,"npi":[1639127194]},{"billed_charge":116.00,"npi":[1801861596]}]}]}]},{"name":"Diphtheria, tetanus, acellular pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Diphtheria, tetanus, acellular pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccine","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.93,"providers":[{"billed_charge":582.60,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.93,"providers":[{"billed_charge":287.00,"npi":[1003850744]},{"billed_charge":287.00,"npi":[1023502937]},{"billed_charge":287.00,"npi":[1104876549]},{"billed_charge":287.00,"npi":[1144462672]},{"billed_charge":287.00,"npi":[1992753610]},{"billed_charge":287.00,"npi":[1184935249]},{"billed_charge":287.00,"npi":[1205455193]},{"billed_charge":287.00,"npi":[1205885696]},{"billed_charge":287.00,"npi":[1205899796]},{"billed_charge":287.00,"npi":[1225649742]},{"billed_charge":287.00,"npi":[1285677658]},{"billed_charge":287.00,"npi":[1295867083]},{"billed_charge":287.00,"npi":[1326066341]},{"billed_charge":287.00,"npi":[1326400326]},{"billed_charge":287.00,"npi":[1366494056]},{"billed_charge":287.00,"npi":[1366885253]},{"billed_charge":287.00,"npi":[1376591602]},{"billed_charge":287.00,"npi":[1487693727]},{"billed_charge":287.00,"npi":[1508819848]},{"billed_charge":287.00,"npi":[1578752283]},{"billed_charge":287.00,"npi":[1619910098]},{"billed_charge":287.00,"npi":[1639119134]},{"billed_charge":287.00,"npi":[1700405859]},{"billed_charge":287.00,"npi":[1740441781]},{"billed_charge":287.00,"npi":[1740442268]},{"billed_charge":287.00,"npi":[1790814929]},{"billed_charge":287.00,"npi":[1811969140]},{"billed_charge":287.00,"npi":[1831141860]},{"billed_charge":287.00,"npi":[1942467204]},{"billed_charge":287.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":189.93,"providers":[{"billed_charge":287.00,"npi":[1144692377]}]}]}]},{"name":"Emergency department visit with high level of medical decision making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency department visit with high level of medical decision making","allowed_amounts":[{"tin":{"type":"ein","value":"461707288"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":333.96,"providers":[{"billed_charge":1750.88,"npi":[1376574988]}]}]},{"tin":{"type":"ein","value":"520962668"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":330.72,"providers":[{"billed_charge":1750.88,"npi":[1295123602]}]},{"allowed_amount":333.96,"providers":[{"billed_charge":1750.88,"npi":[1285282368]},{"billed_charge":1750.88,"npi":[1376574988]},{"billed_charge":1750.88,"npi":[1588433585]},{"billed_charge":1750.88,"npi":[1700197548]},{"billed_charge":1750.88,"npi":[1740250687]}]},{"allowed_amount":813.86,"providers":[{"billed_charge":1750.88,"npi":[1235512708]},{"billed_charge":1750.88,"npi":[1275829475]},{"billed_charge":1750.88,"npi":[1578052528]},{"billed_charge":1750.88,"npi":[1598090276]},{"billed_charge":1750.88,"npi":[1700197548]}]}]},{"tin":{"type":"ein","value":"541519724"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":330.72,"providers":[{"billed_charge":351.00,"npi":[1518546464]}]},{"allowed_amount":333.96,"providers":[{"billed_charge":351.00,"npi":[1174594261]},{"billed_charge":351.00,"npi":[1518546464]},{"billed_charge":351.00,"npi":[1912314212]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":333.31,"providers":[{"billed_charge":418.00,"npi":[1063742328]},{"billed_charge":418.00,"npi":[1083661151]},{"billed_charge":418.00,"npi":[1114156155]},{"billed_charge":418.00,"npi":[1144568577]},{"billed_charge":418.00,"npi":[1215355912]},{"billed_charge":418.00,"npi":[1235338385]},{"billed_charge":418.00,"npi":[1255620753]},{"billed_charge":418.00,"npi":[1346568029]},{"billed_charge":418.00,"npi":[1679035885]},{"billed_charge":418.00,"npi":[1750887436]},{"billed_charge":418.00,"npi":[1811526387]},{"billed_charge":418.00,"npi":[1942663737]},{"billed_charge":418.00,"npi":[1952342131]}]}]},{"tin":{"type":"ein","value":"561763695"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":154.62,"providers":[{"billed_charge":1041.00,"npi":[1972811271]}]}]},{"tin":{"type":"ein","value":"621130266"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":242.60,"providers":[{"billed_charge":1752.00,"npi":[1508022716]}]},{"allowed_amount":1328.00,"providers":[{"billed_charge":1660.00,"npi":[1427005008]}]}]},{"tin":{"type":"ein","value":"922417967"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":836.40,"providers":[{"billed_charge":984.00,"npi":[1609401181]}]}]}]},{"name":"Emergency department visit with moderate level of medical decision making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99284","description":"Emergency department visit with moderate level of medical decision making","allowed_amounts":[{"tin":{"type":"ein","value":"270892198"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":561.29,"providers":[{"billed_charge":1186.31,"npi":[1023308178]},{"billed_charge":1186.31,"npi":[1215434170]},{"billed_charge":1186.31,"npi":[1447802640]},{"billed_charge":1186.31,"npi":[1760810162]},{"billed_charge":1186.31,"npi":[1790741601]}]}]},{"tin":{"type":"ein","value":"520962668"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":228.50,"providers":[{"billed_charge":1186.31,"npi":[1659693836]},{"billed_charge":1186.31,"npi":[1659869170]},{"billed_charge":1186.31,"npi":[1720576416]}]},{"allowed_amount":230.40,"providers":[{"billed_charge":1186.31,"npi":[1104456565]},{"billed_charge":1186.31,"npi":[1568828432]},{"billed_charge":1186.31,"npi":[1649457730]}]},{"allowed_amount":561.29,"providers":[{"billed_charge":1186.31,"npi":[1114554235]},{"billed_charge":1186.31,"npi":[1659693836]},{"billed_charge":1186.31,"npi":[1740250687]}]}]},{"tin":{"type":"ein","value":"521756326"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":232.64,"providers":[{"billed_charge":985.00,"npi":[1205279049]}]}]},{"tin":{"type":"ein","value":"541141362"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":431.10,"providers":[{"billed_charge":479.00,"npi":[1033136841]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":228.50,"providers":[{"billed_charge":288.00,"npi":[1396304630]}]},{"allowed_amount":229.57,"providers":[{"billed_charge":288.00,"npi":[1063742328]},{"billed_charge":288.00,"npi":[1063808053]},{"billed_charge":288.00,"npi":[1144568577]},{"billed_charge":288.00,"npi":[1194188193]},{"billed_charge":288.00,"npi":[1215355912]},{"billed_charge":288.00,"npi":[1235338385]},{"billed_charge":288.00,"npi":[1245991777]},{"billed_charge":288.00,"npi":[1285253567]},{"billed_charge":288.00,"npi":[1336602960]},{"billed_charge":288.00,"npi":[1346568029]},{"billed_charge":288.00,"npi":[1356051098]},{"billed_charge":288.00,"npi":[1396304630]},{"billed_charge":288.00,"npi":[1407897549]},{"billed_charge":288.00,"npi":[1598053936]},{"billed_charge":288.00,"npi":[1619074531]},{"billed_charge":288.00,"npi":[1689619488]},{"billed_charge":288.00,"npi":[1750887436]},{"billed_charge":288.00,"npi":[1821589359]},{"billed_charge":288.00,"npi":[1902533490]},{"billed_charge":288.00,"npi":[1942734686]},{"billed_charge":288.00,"npi":[1952342131]}]}]},{"tin":{"type":"ein","value":"650622859"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":1253.70,"providers":[{"billed_charge":1393.00,"npi":[1912648767]}]}]},{"tin":{"type":"ein","value":"742730328"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":2439.76,"providers":[{"billed_charge":3641.43,"npi":[1124074273]}]}]}]},{"name":"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":269.84,"providers":[{"billed_charge":379.00,"npi":[1760414338]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":265.93,"providers":[{"billed_charge":759.00,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":269.84,"providers":[{"billed_charge":379.00,"npi":[1487185187]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":269.84,"providers":[{"billed_charge":379.00,"npi":[1023041787]},{"billed_charge":379.00,"npi":[1982639183]},{"billed_charge":379.00,"npi":[1326861139]},{"billed_charge":379.00,"npi":[1386685782]},{"billed_charge":379.00,"npi":[1487185187]},{"billed_charge":379.00,"npi":[1639119134]},{"billed_charge":379.00,"npi":[1740442268]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":342.03,"providers":[{"billed_charge":428.00,"npi":[1255421434]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":272.37,"providers":[{"billed_charge":428.00,"npi":[1164869020]}]},{"allowed_amount":342.03,"providers":[{"billed_charge":428.00,"npi":[1104205160]},{"billed_charge":428.00,"npi":[1154374593]},{"billed_charge":428.00,"npi":[1164073391]},{"billed_charge":428.00,"npi":[1205419116]},{"billed_charge":428.00,"npi":[1255421434]},{"billed_charge":428.00,"npi":[1427013036]},{"billed_charge":428.00,"npi":[1497207013]},{"billed_charge":428.00,"npi":[1528530912]},{"billed_charge":428.00,"npi":[1578958526]},{"billed_charge":428.00,"npi":[1679769616]},{"billed_charge":428.00,"npi":[1851759286]},{"billed_charge":428.00,"npi":[1942438916]}]},{"allowed_amount":428.00,"providers":[{"billed_charge":428.00,"npi":[1013159177]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":269.84,"providers":[{"billed_charge":379.00,"npi":[1144692377]}]}]},{"tin":{"type":"ein","value":"862109896"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":317.15,"providers":[{"billed_charge":444.00,"npi":[1255476974]}]}]}]},{"name":"Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"272120451"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":56.39,"providers":[{"billed_charge":207.00,"npi":[1033191721]}]}]},{"tin":{"type":"ein","value":"272872791"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":252.65,"providers":[{"billed_charge":324.00,"npi":[1730491945]}]}]},{"tin":{"type":"ein","value":"311586565"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":69.26,"providers":[{"billed_charge":190.00,"npi":[1952325037]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":167.90,"providers":[{"billed_charge":289.00,"npi":[1972380764]},{"billed_charge":289.00,"npi":[1952179483]}]},{"allowed_amount":174.31,"providers":[{"billed_charge":289.00,"npi":[1023022795]},{"billed_charge":289.00,"npi":[1033347141]},{"billed_charge":289.00,"npi":[1043673387]},{"billed_charge":289.00,"npi":[1982866943]},{"billed_charge":289.00,"npi":[1285008268]},{"billed_charge":289.00,"npi":[1316984503]},{"billed_charge":289.00,"npi":[1346218195]},{"billed_charge":289.00,"npi":[1366458283]},{"billed_charge":289.00,"npi":[1386175727]},{"billed_charge":289.00,"npi":[1467949586]},{"billed_charge":289.00,"npi":[1508872797]},{"billed_charge":289.00,"npi":[1598770372]},{"billed_charge":289.00,"npi":[1811335011]}]}]},{"tin":{"type":"ein","value":"465598598"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":120.00,"providers":[{"billed_charge":150.00,"npi":[1285177741]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":67.77,"providers":[{"billed_charge":191.00,"npi":[1851896088]}]},{"allowed_amount":133.57,"providers":[{"billed_charge":561.00,"npi":[1912919481]}]},{"allowed_amount":135.53,"providers":[{"billed_charge":191.00,"npi":[1518901347]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":133.57,"providers":[{"billed_charge":561.00,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541206650"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":63.95,"providers":[{"billed_charge":125.00,"npi":[1164411310]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":135.53,"providers":[{"billed_charge":191.00,"npi":[1144462672]},{"billed_charge":191.00,"npi":[1477051449]},{"billed_charge":191.00,"npi":[1497175434]},{"billed_charge":191.00,"npi":[1689964603]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":67.77,"providers":[{"billed_charge":191.00,"npi":[1013150622]},{"billed_charge":191.00,"npi":[1043204571]},{"billed_charge":191.00,"npi":[1114993185]},{"billed_charge":191.00,"npi":[1154379022]},{"billed_charge":191.00,"npi":[1184006967]},{"billed_charge":191.00,"npi":[1205899796]},{"billed_charge":191.00,"npi":[1285677658]},{"billed_charge":191.00,"npi":[1356397251]},{"billed_charge":191.00,"npi":[1366494056]},{"billed_charge":191.00,"npi":[1396107637]},{"billed_charge":191.00,"npi":[1467486027]},{"billed_charge":191.00,"npi":[1487185187]},{"billed_charge":191.00,"npi":[1548201973]},{"billed_charge":191.00,"npi":[1639127194]},{"billed_charge":191.00,"npi":[1801861596]},{"billed_charge":191.00,"npi":[1831170562]},{"billed_charge":191.00,"npi":[1912931593]},{"billed_charge":191.00,"npi":[1952562993]}]},{"allowed_amount":135.53,"providers":[{"billed_charge":191.00,"npi":[1013150622]},{"billed_charge":191.00,"npi":[1023048766]},{"billed_charge":191.00,"npi":[1023502937]},{"billed_charge":191.00,"npi":[1043486566]},{"billed_charge":191.00,"npi":[1053601161]},{"billed_charge":191.00,"npi":[1083472955]},{"billed_charge":191.00,"npi":[1083475214]},{"billed_charge":191.00,"npi":[1104876549]},{"billed_charge":191.00,"npi":[1114993185]},{"billed_charge":191.00,"npi":[1124333646]},{"billed_charge":191.00,"npi":[1124537923]},{"billed_charge":191.00,"npi":[1962436543]},{"billed_charge":191.00,"npi":[1982639183]},{"billed_charge":191.00,"npi":[1992745301]},{"billed_charge":191.00,"npi":[1992753610]},{"billed_charge":191.00,"npi":[1144462672]},{"billed_charge":191.00,"npi":[1154874832]},{"billed_charge":191.00,"npi":[1164518254]},{"billed_charge":191.00,"npi":[1184006967]},{"billed_charge":191.00,"npi":[1184935249]},{"billed_charge":191.00,"npi":[1194522219]},{"billed_charge":191.00,"npi":[1194967901]},{"billed_charge":191.00,"npi":[1205455193]},{"billed_charge":191.00,"npi":[1205626918]},{"billed_charge":191.00,"npi":[1205885696]},{"billed_charge":191.00,"npi":[1205899796]},{"billed_charge":191.00,"npi":[1215220355]},{"billed_charge":191.00,"npi":[1225079619]},{"billed_charge":191.00,"npi":[1255350823]},{"billed_charge":191.00,"npi":[1265429716]},{"billed_charge":191.00,"npi":[1285677658]},{"billed_charge":191.00,"npi":[1295867083]},{"billed_charge":191.00,"npi":[1306300702]},{"billed_charge":191.00,"npi":[1316105406]},{"billed_charge":191.00,"npi":[1316987712]},{"billed_charge":191.00,"npi":[1326066341]},{"billed_charge":191.00,"npi":[1326400326]},{"billed_charge":191.00,"npi":[1326861139]},{"billed_charge":191.00,"npi":[1336300391]},{"billed_charge":191.00,"npi":[1356397251]},{"billed_charge":191.00,"npi":[1366494056]},{"billed_charge":191.00,"npi":[1376591602]},{"billed_charge":191.00,"npi":[1386682789]},{"billed_charge":191.00,"npi":[1386685782]},{"billed_charge":191.00,"npi":[1417048661]},{"billed_charge":191.00,"npi":[1417060591]},{"billed_charge":191.00,"npi":[1427799360]},{"billed_charge":191.00,"npi":[1447205380]},{"billed_charge":191.00,"npi":[1447209085]},{"billed_charge":191.00,"npi":[1457513673]},{"billed_charge":191.00,"npi":[1467486027]},{"billed_charge":191.00,"npi":[1487693727]},{"billed_charge":191.00,"npi":[1497916357]},{"billed_charge":191.00,"npi":[1508286220]},{"billed_charge":191.00,"npi":[1508819848]},{"billed_charge":191.00,"npi":[1528092103]},{"billed_charge":191.00,"npi":[1548201973]},{"billed_charge":191.00,"npi":[1568625226]},{"billed_charge":191.00,"npi":[1568696110]},{"billed_charge":191.00,"npi":[1578752283]},{"billed_charge":191.00,"npi":[1619910098]},{"billed_charge":191.00,"npi":[1619920543]},{"billed_charge":191.00,"npi":[1629239587]},{"billed_charge":191.00,"npi":[1629656111]},{"billed_charge":191.00,"npi":[1639119134]},{"billed_charge":191.00,"npi":[1639120710]},{"billed_charge":191.00,"npi":[1639127194]},{"billed_charge":191.00,"npi":[1649099862]},{"billed_charge":191.00,"npi":[1669430963]},{"billed_charge":191.00,"npi":[1700272242]},{"billed_charge":191.00,"npi":[1700405859]},{"billed_charge":191.00,"npi":[1720026115]},{"billed_charge":191.00,"npi":[1720608599]},{"billed_charge":191.00,"npi":[1730634510]},{"billed_charge":191.00,"npi":[1740441781]},{"billed_charge":191.00,"npi":[1740442268]},{"billed_charge":191.00,"npi":[1790159481]},{"billed_charge":191.00,"npi":[1790429637]},{"billed_charge":191.00,"npi":[1790814929]},{"billed_charge":191.00,"npi":[1790913762]},{"billed_charge":191.00,"npi":[1801861596]},{"billed_charge":191.00,"npi":[1831141860]},{"billed_charge":191.00,"npi":[1831170562]},{"billed_charge":191.00,"npi":[1831620160]},{"billed_charge":191.00,"npi":[1851055651]},{"billed_charge":191.00,"npi":[1891006805]},{"billed_charge":191.00,"npi":[1912931593]},{"billed_charge":191.00,"npi":[1942467204]},{"billed_charge":191.00,"npi":[1952690208]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":171.98,"providers":[{"billed_charge":215.00,"npi":[1467604926]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":171.98,"providers":[{"billed_charge":215.00,"npi":[1073730529]},{"billed_charge":215.00,"npi":[1972251163]},{"billed_charge":215.00,"npi":[1215987854]},{"billed_charge":215.00,"npi":[1285763391]},{"billed_charge":215.00,"npi":[1306058201]},{"billed_charge":215.00,"npi":[1306882543]},{"billed_charge":215.00,"npi":[1366769705]},{"billed_charge":215.00,"npi":[1467604926]},{"billed_charge":215.00,"npi":[1497845895]},{"billed_charge":215.00,"npi":[1497924625]},{"billed_charge":215.00,"npi":[1508812702]},{"billed_charge":215.00,"npi":[1538103346]},{"billed_charge":215.00,"npi":[1558303453]},{"billed_charge":215.00,"npi":[1649340845]},{"billed_charge":215.00,"npi":[1669665881]},{"billed_charge":215.00,"npi":[1679769616]},{"billed_charge":215.00,"npi":[1689615544]},{"billed_charge":215.00,"npi":[1710271465]},{"billed_charge":215.00,"npi":[1730541319]},{"billed_charge":215.00,"npi":[1750549606]},{"billed_charge":215.00,"npi":[1790170587]},{"billed_charge":215.00,"npi":[1841225455]},{"billed_charge":215.00,"npi":[1841428729]},{"billed_charge":215.00,"npi":[1871116343]},{"billed_charge":215.00,"npi":[1902171093]},{"billed_charge":215.00,"npi":[1922219435]}]}]},{"tin":{"type":"ein","value":"550492006"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":182.40,"providers":[{"billed_charge":192.00,"npi":[1275504508]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":135.53,"providers":[{"billed_charge":191.00,"npi":[1649423880]},{"billed_charge":191.00,"npi":[1649648940]}]}]},{"tin":{"type":"ein","value":"582380955"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":106.74,"providers":[{"billed_charge":330.00,"npi":[1144279670]}]}]}]},{"name":"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"311586565"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":98.47,"providers":[{"billed_charge":290.00,"npi":[1952325037]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":257.75,"providers":[{"billed_charge":408.00,"npi":[1033347141]},{"billed_charge":408.00,"npi":[1982866943]},{"billed_charge":408.00,"npi":[1285008268]},{"billed_charge":408.00,"npi":[1346218195]},{"billed_charge":408.00,"npi":[1366458283]},{"billed_charge":408.00,"npi":[1396117180]},{"billed_charge":408.00,"npi":[1528187069]},{"billed_charge":408.00,"npi":[1528245297]},{"billed_charge":408.00,"npi":[1598770372]},{"billed_charge":408.00,"npi":[1811335011]},{"billed_charge":408.00,"npi":[1841451184]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":200.41,"providers":[{"billed_charge":270.00,"npi":[1184659898]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":200.41,"providers":[{"billed_charge":270.00,"npi":[1154346179]},{"billed_charge":270.00,"npi":[1316443385]},{"billed_charge":270.00,"npi":[1477597763]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":197.50,"providers":[{"billed_charge":644.00,"npi":[1912919481]},{"billed_charge":1288.00,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541607867"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":95.16,"providers":[{"billed_charge":375.00,"npi":[1982832960]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":200.41,"providers":[{"billed_charge":270.00,"npi":[1144462672]},{"billed_charge":270.00,"npi":[1366885253]},{"billed_charge":270.00,"npi":[1376562926]},{"billed_charge":270.00,"npi":[1619910098]},{"billed_charge":270.00,"npi":[1740442268]},{"billed_charge":270.00,"npi":[1922534999]},{"billed_charge":270.00,"npi":[1942467204]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.21,"providers":[{"billed_charge":270.00,"npi":[1982639183]},{"billed_charge":270.00,"npi":[1205455193]},{"billed_charge":270.00,"npi":[1306300702]},{"billed_charge":270.00,"npi":[1326400326]},{"billed_charge":270.00,"npi":[1356397251]},{"billed_charge":270.00,"npi":[1487185187]},{"billed_charge":270.00,"npi":[1568696110]},{"billed_charge":270.00,"npi":[1689964603]},{"billed_charge":270.00,"npi":[1790913762]},{"billed_charge":270.00,"npi":[1801861596]},{"billed_charge":270.00,"npi":[1912931593]}]},{"allowed_amount":200.41,"providers":[{"billed_charge":270.00,"npi":[1013150622]},{"billed_charge":270.00,"npi":[1013982289]},{"billed_charge":270.00,"npi":[1023041787]},{"billed_charge":270.00,"npi":[1023048766]},{"billed_charge":270.00,"npi":[1043204571]},{"billed_charge":270.00,"npi":[1043486566]},{"billed_charge":270.00,"npi":[1053601161]},{"billed_charge":270.00,"npi":[1083472955]},{"billed_charge":270.00,"npi":[1124333646]},{"billed_charge":270.00,"npi":[1972143972]},{"billed_charge":270.00,"npi":[1992745301]},{"billed_charge":270.00,"npi":[1144462672]},{"billed_charge":270.00,"npi":[1154582054]},{"billed_charge":270.00,"npi":[1184006967]},{"billed_charge":270.00,"npi":[1184935249]},{"billed_charge":270.00,"npi":[1205455193]},{"billed_charge":270.00,"npi":[1205885696]},{"billed_charge":270.00,"npi":[1215220355]},{"billed_charge":270.00,"npi":[1225079619]},{"billed_charge":270.00,"npi":[1285677658]},{"billed_charge":270.00,"npi":[1316987712]},{"billed_charge":270.00,"npi":[1326066341]},{"billed_charge":270.00,"npi":[1336300391]},{"billed_charge":270.00,"npi":[1366885253]},{"billed_charge":270.00,"npi":[1376562926]},{"billed_charge":270.00,"npi":[1376591602]},{"billed_charge":270.00,"npi":[1386685782]},{"billed_charge":270.00,"npi":[1417060591]},{"billed_charge":270.00,"npi":[1447205380]},{"billed_charge":270.00,"npi":[1457314403]},{"billed_charge":270.00,"npi":[1457513673]},{"billed_charge":270.00,"npi":[1487387775]},{"billed_charge":270.00,"npi":[1497175434]},{"billed_charge":270.00,"npi":[1508286220]},{"billed_charge":270.00,"npi":[1508819848]},{"billed_charge":270.00,"npi":[1518292127]},{"billed_charge":270.00,"npi":[1538120290]},{"billed_charge":270.00,"npi":[1568696110]},{"billed_charge":270.00,"npi":[1578752283]},{"billed_charge":270.00,"npi":[1619910098]},{"billed_charge":270.00,"npi":[1629003231]},{"billed_charge":270.00,"npi":[1629656111]},{"billed_charge":270.00,"npi":[1639127194]},{"billed_charge":270.00,"npi":[1689964603]},{"billed_charge":270.00,"npi":[1720608599]},{"billed_charge":270.00,"npi":[1730634510]},{"billed_charge":270.00,"npi":[1740441781]},{"billed_charge":270.00,"npi":[1740442268]},{"billed_charge":270.00,"npi":[1790159481]},{"billed_charge":270.00,"npi":[1790913762]},{"billed_charge":270.00,"npi":[1801861596]},{"billed_charge":270.00,"npi":[1831620160]},{"billed_charge":270.00,"npi":[1891006805]},{"billed_charge":270.00,"npi":[1912931593]},{"billed_charge":270.00,"npi":[1922534999]},{"billed_charge":270.00,"npi":[1942467204]},{"billed_charge":270.00,"npi":[1952562993]},{"billed_charge":270.00,"npi":[1952690208]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":242.61,"providers":[{"billed_charge":303.00,"npi":[1972251163]},{"billed_charge":303.00,"npi":[1275856916]},{"billed_charge":303.00,"npi":[1437461977]},{"billed_charge":303.00,"npi":[1467414995]},{"billed_charge":303.00,"npi":[1558303453]},{"billed_charge":303.00,"npi":[1619107901]},{"billed_charge":303.00,"npi":[1750549606]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":242.61,"providers":[{"billed_charge":303.00,"npi":[1023303583]},{"billed_charge":303.00,"npi":[1023395233]},{"billed_charge":303.00,"npi":[1023502705]},{"billed_charge":303.00,"npi":[1033352547]},{"billed_charge":303.00,"npi":[1073730529]},{"billed_charge":303.00,"npi":[1104205160]},{"billed_charge":303.00,"npi":[1972251163]},{"billed_charge":303.00,"npi":[1164073391]},{"billed_charge":303.00,"npi":[1164467114]},{"billed_charge":303.00,"npi":[1164588331]},{"billed_charge":303.00,"npi":[1194068940]},{"billed_charge":303.00,"npi":[1215987854]},{"billed_charge":303.00,"npi":[1245636836]},{"billed_charge":303.00,"npi":[1255421434]},{"billed_charge":303.00,"npi":[1275856916]},{"billed_charge":303.00,"npi":[1306882543]},{"billed_charge":303.00,"npi":[1306897418]},{"billed_charge":303.00,"npi":[1336198126]},{"billed_charge":303.00,"npi":[1366769705]},{"billed_charge":303.00,"npi":[1386852028]},{"billed_charge":303.00,"npi":[1407809023]},{"billed_charge":303.00,"npi":[1427007491]},{"billed_charge":303.00,"npi":[1437461977]},{"billed_charge":303.00,"npi":[1467414995]},{"billed_charge":303.00,"npi":[1467604926]},{"billed_charge":303.00,"npi":[1467959221]},{"billed_charge":303.00,"npi":[1497924625]},{"billed_charge":303.00,"npi":[1508028515]},{"billed_charge":303.00,"npi":[1538103346]},{"billed_charge":303.00,"npi":[1538131255]},{"billed_charge":303.00,"npi":[1538570130]},{"billed_charge":303.00,"npi":[1548652928]},{"billed_charge":303.00,"npi":[1578761268]},{"billed_charge":303.00,"npi":[1578817185]},{"billed_charge":303.00,"npi":[1578958526]},{"billed_charge":303.00,"npi":[1619107901]},{"billed_charge":303.00,"npi":[1649243031]},{"billed_charge":303.00,"npi":[1699755066]},{"billed_charge":303.00,"npi":[1710271465]},{"billed_charge":303.00,"npi":[1730541319]},{"billed_charge":303.00,"npi":[1750549606]},{"billed_charge":303.00,"npi":[1760742530]},{"billed_charge":303.00,"npi":[1770711269]},{"billed_charge":303.00,"npi":[1790959625]},{"billed_charge":303.00,"npi":[1811261332]},{"billed_charge":303.00,"npi":[1841225455]},{"billed_charge":303.00,"npi":[1841428729]},{"billed_charge":303.00,"npi":[1841860137]},{"billed_charge":303.00,"npi":[1851759286]},{"billed_charge":303.00,"npi":[1861757304]},{"billed_charge":303.00,"npi":[1861883779]},{"billed_charge":303.00,"npi":[1871116343]},{"billed_charge":303.00,"npi":[1902171093]},{"billed_charge":303.00,"npi":[1922219435]},{"billed_charge":303.00,"npi":[1922494871]},{"billed_charge":303.00,"npi":[1932323904]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":200.41,"providers":[{"billed_charge":270.00,"npi":[1144692377]},{"billed_charge":270.00,"npi":[1649648940]}]}]},{"tin":{"type":"ein","value":"630649108"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":201.72,"providers":[{"billed_charge":246.00,"npi":[1508028002]}]}]},{"tin":{"type":"ein","value":"934104475"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":232.40,"providers":[{"billed_charge":332.00,"npi":[1629841788]}]}]}]},{"name":"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"311610834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":105.34,"providers":[{"billed_charge":180.00,"npi":[1134547128]},{"billed_charge":180.00,"npi":[1467949586]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":40.95,"providers":[{"billed_charge":120.00,"npi":[1154346179]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":80.72,"providers":[{"billed_charge":487.00,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":81.90,"providers":[{"billed_charge":120.00,"npi":[1225079619]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":40.95,"providers":[{"billed_charge":120.00,"npi":[1285677658]},{"billed_charge":120.00,"npi":[1376591602]},{"billed_charge":120.00,"npi":[1386682789]},{"billed_charge":120.00,"npi":[1558583740]},{"billed_charge":120.00,"npi":[1891006805]}]},{"allowed_amount":81.90,"providers":[{"billed_charge":120.00,"npi":[1184935249]},{"billed_charge":120.00,"npi":[1366480220]},{"billed_charge":120.00,"npi":[1447209085]},{"billed_charge":120.00,"npi":[1558583740]},{"billed_charge":120.00,"npi":[1619920543]},{"billed_charge":120.00,"npi":[1942467204]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":107.25,"providers":[{"billed_charge":134.00,"npi":[1316914674]},{"billed_charge":134.00,"npi":[1407809023]}]}]},{"tin":{"type":"ein","value":"561071426"},"service_code":["02"],"billing_class":"professional","payments":[{"allowed_amount":136.00,"providers":[{"billed_charge":136.00,"npi":[1518588391]}]}]}]},{"name":"Established patient periodic preventive medicine examination (1-4 years)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Established patient periodic preventive medicine examination (1-4 years)","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.83,"providers":[{"billed_charge":258.00,"npi":[1154346179]},{"billed_charge":258.00,"npi":[1518901347]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.83,"providers":[{"billed_charge":258.00,"npi":[1013150622]},{"billed_charge":258.00,"npi":[1013982289]},{"billed_charge":258.00,"npi":[1023502937]},{"billed_charge":258.00,"npi":[1043486566]},{"billed_charge":258.00,"npi":[1053601161]},{"billed_charge":258.00,"npi":[1083472955]},{"billed_charge":258.00,"npi":[1124537923]},{"billed_charge":258.00,"npi":[1962436543]},{"billed_charge":258.00,"npi":[1972143972]},{"billed_charge":258.00,"npi":[1144462672]},{"billed_charge":258.00,"npi":[1154582054]},{"billed_charge":258.00,"npi":[1205455193]},{"billed_charge":258.00,"npi":[1205885696]},{"billed_charge":258.00,"npi":[1215220355]},{"billed_charge":258.00,"npi":[1285677658]},{"billed_charge":258.00,"npi":[1295867083]},{"billed_charge":258.00,"npi":[1306300702]},{"billed_charge":258.00,"npi":[1316105406]},{"billed_charge":258.00,"npi":[1316987712]},{"billed_charge":258.00,"npi":[1326066341]},{"billed_charge":258.00,"npi":[1326400326]},{"billed_charge":258.00,"npi":[1336300391]},{"billed_charge":258.00,"npi":[1366494056]},{"billed_charge":258.00,"npi":[1366885253]},{"billed_charge":258.00,"npi":[1376562926]},{"billed_charge":258.00,"npi":[1376591602]},{"billed_charge":258.00,"npi":[1386682789]},{"billed_charge":258.00,"npi":[1396107637]},{"billed_charge":258.00,"npi":[1457309171]},{"billed_charge":258.00,"npi":[1457314403]},{"billed_charge":258.00,"npi":[1487185187]},{"billed_charge":258.00,"npi":[1487693727]},{"billed_charge":258.00,"npi":[1497916357]},{"billed_charge":258.00,"npi":[1508286220]},{"billed_charge":258.00,"npi":[1548201973]},{"billed_charge":258.00,"npi":[1558583740]},{"billed_charge":258.00,"npi":[1619910098]},{"billed_charge":258.00,"npi":[1639127194]},{"billed_charge":258.00,"npi":[1669430963]},{"billed_charge":258.00,"npi":[1689964603]},{"billed_charge":258.00,"npi":[1700272242]},{"billed_charge":258.00,"npi":[1700405859]},{"billed_charge":258.00,"npi":[1720026115]},{"billed_charge":258.00,"npi":[1740442268]},{"billed_charge":258.00,"npi":[1790913762]},{"billed_charge":258.00,"npi":[1790957447]},{"billed_charge":258.00,"npi":[1801861596]},{"billed_charge":258.00,"npi":[1831141860]},{"billed_charge":258.00,"npi":[1912135013]},{"billed_charge":258.00,"npi":[1942467204]},{"billed_charge":258.00,"npi":[1952562993]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.83,"providers":[{"billed_charge":258.00,"npi":[1659765055]}]}]}]},{"name":"Established patient periodic preventive medicine examination (12-17 years)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Established patient periodic preventive medicine examination (12-17 years)","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":216.40,"providers":[{"billed_charge":283.00,"npi":[1154346179]},{"billed_charge":283.00,"npi":[1851896088]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":216.40,"providers":[{"billed_charge":283.00,"npi":[1023041787]},{"billed_charge":283.00,"npi":[1023048766]},{"billed_charge":283.00,"npi":[1043486566]},{"billed_charge":283.00,"npi":[1962436543]},{"billed_charge":283.00,"npi":[1982639183]},{"billed_charge":283.00,"npi":[1154379022]},{"billed_charge":283.00,"npi":[1205885696]},{"billed_charge":283.00,"npi":[1205899796]},{"billed_charge":283.00,"npi":[1285677658]},{"billed_charge":283.00,"npi":[1326400326]},{"billed_charge":283.00,"npi":[1356397251]},{"billed_charge":283.00,"npi":[1366494056]},{"billed_charge":283.00,"npi":[1386685782]},{"billed_charge":283.00,"npi":[1396107637]},{"billed_charge":283.00,"npi":[1467486027]},{"billed_charge":283.00,"npi":[1487185187]},{"billed_charge":283.00,"npi":[1487693727]},{"billed_charge":283.00,"npi":[1518292127]},{"billed_charge":283.00,"npi":[1558583740]},{"billed_charge":283.00,"npi":[1568696110]},{"billed_charge":283.00,"npi":[1689964603]},{"billed_charge":283.00,"npi":[1912931593]},{"billed_charge":283.00,"npi":[1952690208]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":216.40,"providers":[{"billed_charge":283.00,"npi":[1649648940]}]}]}]},{"name":"Established patient periodic preventive medicine examination (5-11 years)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Established patient periodic preventive medicine examination (5-11 years)","allowed_amounts":[{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":197.16,"providers":[{"billed_charge":257.00,"npi":[1003833757]},{"billed_charge":257.00,"npi":[1013150622]},{"billed_charge":257.00,"npi":[1043204571]},{"billed_charge":257.00,"npi":[1053601161]},{"billed_charge":257.00,"npi":[1114993185]},{"billed_charge":257.00,"npi":[1962436543]},{"billed_charge":257.00,"npi":[1992753610]},{"billed_charge":257.00,"npi":[1144462672]},{"billed_charge":257.00,"npi":[1164518254]},{"billed_charge":257.00,"npi":[1184006967]},{"billed_charge":257.00,"npi":[1205885696]},{"billed_charge":257.00,"npi":[1215220355]},{"billed_charge":257.00,"npi":[1265597967]},{"billed_charge":257.00,"npi":[1285677658]},{"billed_charge":257.00,"npi":[1295867083]},{"billed_charge":257.00,"npi":[1306300702]},{"billed_charge":257.00,"npi":[1316105406]},{"billed_charge":257.00,"npi":[1326066341]},{"billed_charge":257.00,"npi":[1326400326]},{"billed_charge":257.00,"npi":[1356397251]},{"billed_charge":257.00,"npi":[1366494056]},{"billed_charge":257.00,"npi":[1366885253]},{"billed_charge":257.00,"npi":[1386685782]},{"billed_charge":257.00,"npi":[1447209085]},{"billed_charge":257.00,"npi":[1457513673]},{"billed_charge":257.00,"npi":[1467486027]},{"billed_charge":257.00,"npi":[1487693727]},{"billed_charge":257.00,"npi":[1497175434]},{"billed_charge":257.00,"npi":[1558583740]},{"billed_charge":257.00,"npi":[1578752283]},{"billed_charge":257.00,"npi":[1619910098]},{"billed_charge":257.00,"npi":[1619920543]},{"billed_charge":257.00,"npi":[1629003231]},{"billed_charge":257.00,"npi":[1629239587]},{"billed_charge":257.00,"npi":[1639127194]},{"billed_charge":257.00,"npi":[1669430963]},{"billed_charge":257.00,"npi":[1689964603]},{"billed_charge":257.00,"npi":[1699720953]},{"billed_charge":257.00,"npi":[1700405859]},{"billed_charge":257.00,"npi":[1720026115]},{"billed_charge":257.00,"npi":[1740442268]},{"billed_charge":257.00,"npi":[1790814929]},{"billed_charge":257.00,"npi":[1790913762]},{"billed_charge":257.00,"npi":[1801861596]},{"billed_charge":257.00,"npi":[1831170562]},{"billed_charge":257.00,"npi":[1831620160]},{"billed_charge":257.00,"npi":[1942467204]},{"billed_charge":257.00,"npi":[1952562993]}]}]}]},{"name":"Established patient periodic preventive medicine examination (younger than 1 year)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Established patient periodic preventive medicine examination (younger than 1 year)","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.23,"providers":[{"billed_charge":243.00,"npi":[1184659898]},{"billed_charge":243.00,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.23,"providers":[{"billed_charge":243.00,"npi":[1003833757]},{"billed_charge":243.00,"npi":[1003850744]},{"billed_charge":243.00,"npi":[1013150622]},{"billed_charge":243.00,"npi":[1013982289]},{"billed_charge":243.00,"npi":[1023502937]},{"billed_charge":243.00,"npi":[1043486566]},{"billed_charge":243.00,"npi":[1083475214]},{"billed_charge":243.00,"npi":[1104876549]},{"billed_charge":243.00,"npi":[1962436543]},{"billed_charge":243.00,"npi":[1992753610]},{"billed_charge":243.00,"npi":[1144462672]},{"billed_charge":243.00,"npi":[1184935249]},{"billed_charge":243.00,"npi":[1205455193]},{"billed_charge":243.00,"npi":[1205899796]},{"billed_charge":243.00,"npi":[1215220355]},{"billed_charge":243.00,"npi":[1225649742]},{"billed_charge":243.00,"npi":[1285677658]},{"billed_charge":243.00,"npi":[1295867083]},{"billed_charge":243.00,"npi":[1306300702]},{"billed_charge":243.00,"npi":[1326066341]},{"billed_charge":243.00,"npi":[1326400326]},{"billed_charge":243.00,"npi":[1326861139]},{"billed_charge":243.00,"npi":[1336535632]},{"billed_charge":243.00,"npi":[1356397251]},{"billed_charge":243.00,"npi":[1366494056]},{"billed_charge":243.00,"npi":[1366885253]},{"billed_charge":243.00,"npi":[1376562926]},{"billed_charge":243.00,"npi":[1376591602]},{"billed_charge":243.00,"npi":[1386682789]},{"billed_charge":243.00,"npi":[1396107637]},{"billed_charge":243.00,"npi":[1487185187]},{"billed_charge":243.00,"npi":[1487693727]},{"billed_charge":243.00,"npi":[1508819848]},{"billed_charge":243.00,"npi":[1568625226]},{"billed_charge":243.00,"npi":[1578752283]},{"billed_charge":243.00,"npi":[1619910098]},{"billed_charge":243.00,"npi":[1629003231]},{"billed_charge":243.00,"npi":[1639119134]},{"billed_charge":243.00,"npi":[1639127194]},{"billed_charge":243.00,"npi":[1649099862]},{"billed_charge":243.00,"npi":[1699720953]},{"billed_charge":243.00,"npi":[1700405859]},{"billed_charge":243.00,"npi":[1710742838]},{"billed_charge":243.00,"npi":[1740441781]},{"billed_charge":243.00,"npi":[1740442268]},{"billed_charge":243.00,"npi":[1790814929]},{"billed_charge":243.00,"npi":[1790913762]},{"billed_charge":243.00,"npi":[1811969140]},{"billed_charge":243.00,"npi":[1831620160]},{"billed_charge":243.00,"npi":[1891006805]},{"billed_charge":243.00,"npi":[1942467204]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":185.23,"providers":[{"billed_charge":243.00,"npi":[1144692377]},{"billed_charge":243.00,"npi":[1659765055]}]}]}]},{"name":"Ground mileage, per statute mile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage, per statute mile","allowed_amounts":[{"tin":{"type":"ein","value":"470829179"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":93.96,"providers":[{"billed_charge":183.00,"npi":[1871991125]}]},{"allowed_amount":187.93,"providers":[{"billed_charge":366.00,"npi":[1871991125]}]}]},{"tin":{"type":"ein","value":"540721442"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":55.00,"providers":[{"billed_charge":55.00,"npi":[1659385938]}]},{"allowed_amount":66.00,"providers":[{"billed_charge":66.00,"npi":[1659385938]}]},{"allowed_amount":121.00,"providers":[{"billed_charge":121.00,"npi":[1659385938]}]},{"allowed_amount":157.30,"providers":[{"billed_charge":157.30,"npi":[1659385938]}]}]},{"tin":{"type":"ein","value":"540722061"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":26.00,"providers":[{"billed_charge":26.00,"npi":[1013704246]}]},{"allowed_amount":39.00,"providers":[{"billed_charge":39.00,"npi":[1013704246]}]},{"allowed_amount":65.00,"providers":[{"billed_charge":65.00,"npi":[1013704246]}]},{"allowed_amount":169.00,"providers":[{"billed_charge":169.00,"npi":[1013704246]}]}]},{"tin":{"type":"ein","value":"546001336"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":22.00,"providers":[{"billed_charge":22.00,"npi":[1174578736]}]}]},{"tin":{"type":"ein","value":"546001365"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":112.59,"providers":[{"billed_charge":112.59,"npi":[1225243678]}]}]},{"tin":{"type":"ein","value":"546001455"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":11.00,"providers":[{"billed_charge":11.00,"npi":[1114977816]}]},{"allowed_amount":22.00,"providers":[{"billed_charge":22.00,"npi":[1114977816]}]},{"allowed_amount":44.00,"providers":[{"billed_charge":44.00,"npi":[1114977816]}]},{"allowed_amount":88.00,"providers":[{"billed_charge":88.00,"npi":[1114977816]}]},{"allowed_amount":99.00,"providers":[{"billed_charge":99.00,"npi":[1114977816]}]},{"allowed_amount":108.90,"providers":[{"billed_charge":108.90,"npi":[1114977816]}]}]},{"tin":{"type":"ein","value":"546001512"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":32.95,"providers":[{"billed_charge":32.95,"npi":[1528022571]}]}]},{"tin":{"type":"ein","value":"546001636"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":58.00,"providers":[{"billed_charge":58.00,"npi":[1639260094]}]},{"allowed_amount":70.00,"providers":[{"billed_charge":70.00,"npi":[1639260094]}]}]},{"tin":{"type":"ein","value":"546001680"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":65.80,"providers":[{"billed_charge":65.80,"npi":[1689620221]}]}]},{"tin":{"type":"ein","value":"546001696"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":110.60,"providers":[{"billed_charge":110.60,"npi":[1811120959]}]}]},{"tin":{"type":"ein","value":"566000292"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":335.04,"providers":[{"billed_charge":349.70,"npi":[1265479497]}]}]},{"tin":{"type":"ein","value":"566000328"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":62.40,"providers":[{"billed_charge":78.00,"npi":[1760445191]}]}]},{"tin":{"type":"ein","value":"566000347"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":248.18,"providers":[{"billed_charge":361.18,"npi":[1922098029]}]}]},{"tin":{"type":"ein","value":"810747842"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":114.70,"providers":[{"billed_charge":114.70,"npi":[1366807646]}]}]},{"tin":{"type":"ein","value":"853178817"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":648.00,"providers":[{"billed_charge":648.00,"npi":[1245994557]}]}]}]},{"name":"Hepatitis A vaccine pediatric or adolescent dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepatitis A vaccine pediatric or adolescent dosage","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":44.46,"providers":[{"billed_charge":196.80,"npi":[1316443385]},{"billed_charge":196.80,"npi":[1518901347]},{"billed_charge":196.80,"npi":[1750586012]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":44.46,"providers":[{"billed_charge":82.00,"npi":[1013982289]},{"billed_charge":82.00,"npi":[1023502937]},{"billed_charge":82.00,"npi":[1053601161]},{"billed_charge":82.00,"npi":[1083472955]},{"billed_charge":82.00,"npi":[1124537923]},{"billed_charge":82.00,"npi":[1225649742]},{"billed_charge":82.00,"npi":[1295867083]},{"billed_charge":82.00,"npi":[1306300702]},{"billed_charge":82.00,"npi":[1326066341]},{"billed_charge":82.00,"npi":[1326400326]},{"billed_charge":82.00,"npi":[1366494056]},{"billed_charge":82.00,"npi":[1376562926]},{"billed_charge":82.00,"npi":[1376591602]},{"billed_charge":82.00,"npi":[1386685782]},{"billed_charge":82.00,"npi":[1396107637]},{"billed_charge":82.00,"npi":[1457309171]},{"billed_charge":82.00,"npi":[1457314403]},{"billed_charge":82.00,"npi":[1558583740]},{"billed_charge":82.00,"npi":[1619910098]},{"billed_charge":82.00,"npi":[1639127194]},{"billed_charge":82.00,"npi":[1912135013]},{"billed_charge":82.00,"npi":[1952562993]},{"billed_charge":82.00,"npi":[1962436543]}]},{"allowed_amount":45.45,"providers":[{"billed_charge":82.00,"npi":[1639127194]},{"billed_charge":82.00,"npi":[1700405859]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":44.46,"providers":[{"billed_charge":82.00,"npi":[1659765055]}]}]}]},{"name":"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":375.02,"providers":[{"billed_charge":1109.20,"npi":[1184659898]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":375.02,"providers":[{"billed_charge":633.00,"npi":[1013150622]},{"billed_charge":633.00,"npi":[1053601161]},{"billed_charge":633.00,"npi":[1982639183]},{"billed_charge":633.00,"npi":[1992753610]},{"billed_charge":633.00,"npi":[1154379022]},{"billed_charge":633.00,"npi":[1205455193]},{"billed_charge":633.00,"npi":[1205885696]},{"billed_charge":633.00,"npi":[1215220355]},{"billed_charge":633.00,"npi":[1285677658]},{"billed_charge":633.00,"npi":[1316105406]},{"billed_charge":633.00,"npi":[1326066341]},{"billed_charge":633.00,"npi":[1326400326]},{"billed_charge":633.00,"npi":[1366885253]},{"billed_charge":633.00,"npi":[1386685782]},{"billed_charge":633.00,"npi":[1487185187]},{"billed_charge":633.00,"npi":[1487693727]},{"billed_charge":633.00,"npi":[1568696110]},{"billed_charge":633.00,"npi":[1619910098]},{"billed_charge":633.00,"npi":[1629239587]},{"billed_charge":633.00,"npi":[1790913762]},{"billed_charge":633.00,"npi":[1801861596]},{"billed_charge":633.00,"npi":[1831170562]},{"billed_charge":633.00,"npi":[1912135013]},{"billed_charge":633.00,"npi":[1912931593]}]}]}]},{"name":"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage","allowed_amounts":[{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23.22,"providers":[{"billed_charge":42.00,"npi":[1215220355]},{"billed_charge":42.00,"npi":[1225649742]},{"billed_charge":42.00,"npi":[1326066341]},{"billed_charge":42.00,"npi":[1336535632]},{"billed_charge":42.00,"npi":[1356397251]},{"billed_charge":42.00,"npi":[1366494056]},{"billed_charge":42.00,"npi":[1376591602]},{"billed_charge":42.00,"npi":[1386682789]},{"billed_charge":42.00,"npi":[1487185187]},{"billed_charge":42.00,"npi":[1508819848]},{"billed_charge":42.00,"npi":[1578752283]},{"billed_charge":42.00,"npi":[1619910098]},{"billed_charge":42.00,"npi":[1669430963]},{"billed_charge":42.00,"npi":[1700405859]},{"billed_charge":42.00,"npi":[1790913762]},{"billed_charge":42.00,"npi":[1942467204]},{"billed_charge":42.00,"npi":[1952690208]}]}]}]},{"name":"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":201.76,"providers":[{"billed_charge":620.30,"npi":[1154346179]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":201.76,"providers":[{"billed_charge":317.00,"npi":[1053601161]},{"billed_charge":317.00,"npi":[1205455193]},{"billed_charge":317.00,"npi":[1205885696]},{"billed_charge":317.00,"npi":[1215220355]},{"billed_charge":317.00,"npi":[1285677658]},{"billed_charge":317.00,"npi":[1366494056]},{"billed_charge":317.00,"npi":[1366885253]},{"billed_charge":317.00,"npi":[1386685782]},{"billed_charge":317.00,"npi":[1467486027]},{"billed_charge":317.00,"npi":[1487185187]},{"billed_charge":317.00,"npi":[1487693727]},{"billed_charge":317.00,"npi":[1558583740]},{"billed_charge":317.00,"npi":[1689964603]},{"billed_charge":317.00,"npi":[1790913762]},{"billed_charge":317.00,"npi":[1801861596]},{"billed_charge":317.00,"npi":[1831620160]},{"billed_charge":317.00,"npi":[1942467204]}]}]}]},{"name":"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"270484506"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":124.68,"providers":[{"billed_charge":287.50,"npi":[1386182608]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":258.15,"providers":[{"billed_charge":365.00,"npi":[1033347141]},{"billed_charge":365.00,"npi":[1043673387]},{"billed_charge":365.00,"npi":[1316984503]},{"billed_charge":365.00,"npi":[1346218195]},{"billed_charge":365.00,"npi":[1386175727]},{"billed_charge":365.00,"npi":[1457120214]},{"billed_charge":365.00,"npi":[1467949586]},{"billed_charge":365.00,"npi":[1548290125]},{"billed_charge":365.00,"npi":[1588187553]},{"billed_charge":365.00,"npi":[1598770372]},{"billed_charge":365.00,"npi":[1811335011]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":176.86,"providers":[{"billed_charge":365.00,"npi":[1962871376]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":183.62,"providers":[{"billed_charge":365.00,"npi":[1336147719]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.36,"providers":[{"billed_charge":244.00,"npi":[1184659898]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":197.81,"providers":[{"billed_charge":617.00,"npi":[1912919481]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":100.36,"providers":[{"billed_charge":244.00,"npi":[1104876549]},{"billed_charge":244.00,"npi":[1992753610]},{"billed_charge":244.00,"npi":[1396107637]},{"billed_charge":244.00,"npi":[1497916357]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":212.42,"providers":[{"billed_charge":266.00,"npi":[1073730529]},{"billed_charge":266.00,"npi":[1164588331]},{"billed_charge":266.00,"npi":[1306885876]},{"billed_charge":266.00,"npi":[1447210802]},{"billed_charge":266.00,"npi":[1487748448]},{"billed_charge":266.00,"npi":[1528018074]},{"billed_charge":266.00,"npi":[1538103346]},{"billed_charge":266.00,"npi":[1538131255]},{"billed_charge":266.00,"npi":[1558303453]},{"billed_charge":266.00,"npi":[1619107901]},{"billed_charge":266.00,"npi":[1649340845]},{"billed_charge":266.00,"npi":[1861883779]}]}]},{"tin":{"type":"ein","value":"582380955"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":130.81,"providers":[{"billed_charge":335.00,"npi":[1144279670]}]}]},{"tin":{"type":"ein","value":"593209688"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":293.40,"providers":[{"billed_charge":326.00,"npi":[1073565610]}]}]}]},{"name":"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more","allowed_amounts":[{"tin":{"type":"ein","value":"205805198"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":215.90,"providers":[{"billed_charge":254.00,"npi":[1184805574]}]}]},{"tin":{"type":"ein","value":"311610834"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":393.55,"providers":[{"billed_charge":558.00,"npi":[1033347141]},{"billed_charge":558.00,"npi":[1528245297]},{"billed_charge":558.00,"npi":[1598770372]},{"billed_charge":558.00,"npi":[1881561959]},{"billed_charge":558.00,"npi":[1922624790]}]}]},{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":301.56,"providers":[{"billed_charge":396.00,"npi":[1912919481]}]},{"allowed_amount":306.00,"providers":[{"billed_charge":372.00,"npi":[1760414338]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":306.00,"providers":[{"billed_charge":372.00,"npi":[1013150622]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["10"],"billing_class":"professional","payments":[{"allowed_amount":316.52,"providers":[{"billed_charge":396.00,"npi":[1306882543]}]}]},{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":316.52,"providers":[{"billed_charge":396.00,"npi":[1033324470]},{"billed_charge":396.00,"npi":[1033352547]},{"billed_charge":396.00,"npi":[1073730529]},{"billed_charge":396.00,"npi":[1104205160]},{"billed_charge":396.00,"npi":[1972251163]},{"billed_charge":396.00,"npi":[1164467114]},{"billed_charge":396.00,"npi":[1164588331]},{"billed_charge":396.00,"npi":[1245636836]},{"billed_charge":396.00,"npi":[1275856916]},{"billed_charge":396.00,"npi":[1285763391]},{"billed_charge":396.00,"npi":[1306882543]},{"billed_charge":396.00,"npi":[1366539488]},{"billed_charge":396.00,"npi":[1366769705]},{"billed_charge":396.00,"npi":[1407809023]},{"billed_charge":396.00,"npi":[1467604926]},{"billed_charge":396.00,"npi":[1487748448]},{"billed_charge":396.00,"npi":[1497924625]},{"billed_charge":396.00,"npi":[1508812702]},{"billed_charge":396.00,"npi":[1538103346]},{"billed_charge":396.00,"npi":[1619107901]},{"billed_charge":396.00,"npi":[1619139136]},{"billed_charge":396.00,"npi":[1649243031]},{"billed_charge":396.00,"npi":[1669665881]},{"billed_charge":396.00,"npi":[1750549606]},{"billed_charge":396.00,"npi":[1790170587]},{"billed_charge":396.00,"npi":[1790959625]},{"billed_charge":396.00,"npi":[1841225455]},{"billed_charge":396.00,"npi":[1841428729]},{"billed_charge":396.00,"npi":[1861757304]},{"billed_charge":396.00,"npi":[1871116343]},{"billed_charge":396.00,"npi":[1922155233]},{"billed_charge":396.00,"npi":[1922494871]},{"billed_charge":396.00,"npi":[1932323904]}]}]},{"tin":{"type":"ein","value":"582380955"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":196.02,"providers":[{"billed_charge":430.00,"npi":[1144279670]}]}]},{"tin":{"type":"ein","value":"621872100"},"service_code":["20"],"billing_class":"professional","payments":[{"allowed_amount":198.41,"providers":[{"billed_charge":416.00,"npi":[1992746879]}]}]},{"tin":{"type":"ein","value":"630825248"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":183.45,"providers":[{"billed_charge":262.00,"npi":[1114499803]}]}]}]},{"name":"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":341.00,"providers":[{"billed_charge":965.90,"npi":[1154346179]},{"billed_charge":965.90,"npi":[1184659898]},{"billed_charge":965.90,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":341.00,"providers":[{"billed_charge":639.00,"npi":[1003833757]},{"billed_charge":639.00,"npi":[1003850744]},{"billed_charge":639.00,"npi":[1013982289]},{"billed_charge":639.00,"npi":[1023502937]},{"billed_charge":639.00,"npi":[1104876549]},{"billed_charge":639.00,"npi":[1124537923]},{"billed_charge":639.00,"npi":[1144462672]},{"billed_charge":639.00,"npi":[1992753610]},{"billed_charge":639.00,"npi":[1184935249]},{"billed_charge":639.00,"npi":[1205455193]},{"billed_charge":639.00,"npi":[1205885696]},{"billed_charge":639.00,"npi":[1205899796]},{"billed_charge":639.00,"npi":[1225649742]},{"billed_charge":639.00,"npi":[1285677658]},{"billed_charge":639.00,"npi":[1295867083]},{"billed_charge":639.00,"npi":[1326066341]},{"billed_charge":639.00,"npi":[1326400326]},{"billed_charge":639.00,"npi":[1366494056]},{"billed_charge":639.00,"npi":[1366885253]},{"billed_charge":639.00,"npi":[1376562926]},{"billed_charge":639.00,"npi":[1376591602]},{"billed_charge":639.00,"npi":[1396107637]},{"billed_charge":639.00,"npi":[1487185187]},{"billed_charge":639.00,"npi":[1487693727]},{"billed_charge":639.00,"npi":[1497916357]},{"billed_charge":639.00,"npi":[1508819848]},{"billed_charge":639.00,"npi":[1578752283]},{"billed_charge":639.00,"npi":[1619910098]},{"billed_charge":639.00,"npi":[1639119134]},{"billed_charge":639.00,"npi":[1700405859]},{"billed_charge":639.00,"npi":[1740441781]},{"billed_charge":639.00,"npi":[1740442268]},{"billed_charge":639.00,"npi":[1790814929]},{"billed_charge":639.00,"npi":[1811969140]},{"billed_charge":639.00,"npi":[1831141860]},{"billed_charge":639.00,"npi":[1942467204]},{"billed_charge":639.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":341.00,"providers":[{"billed_charge":639.00,"npi":[1144692377]},{"billed_charge":639.00,"npi":[1659765055]}]}]}]},{"name":"Professional service for multiple injections of allergen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Professional service for multiple injections of allergen","allowed_amounts":[{"tin":{"type":"ein","value":"541871633"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":21.96,"providers":[{"billed_charge":35.00,"npi":[1407809023]},{"billed_charge":35.00,"npi":[1649243031]},{"billed_charge":35.00,"npi":[1841428729]},{"billed_charge":35.00,"npi":[1932323904]}]}]}]},{"name":"Rotavirus vaccine, pentavalent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rotavirus vaccine, pentavalent","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":116.98,"providers":[{"billed_charge":355.40,"npi":[1184659898]},{"billed_charge":355.40,"npi":[1316443385]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":116.98,"providers":[{"billed_charge":203.00,"npi":[1003833757]},{"billed_charge":203.00,"npi":[1003850744]},{"billed_charge":203.00,"npi":[1013982289]},{"billed_charge":203.00,"npi":[1023502937]},{"billed_charge":203.00,"npi":[1104876549]},{"billed_charge":203.00,"npi":[1144462672]},{"billed_charge":203.00,"npi":[1992753610]},{"billed_charge":203.00,"npi":[1184935249]},{"billed_charge":203.00,"npi":[1205455193]},{"billed_charge":203.00,"npi":[1205899796]},{"billed_charge":203.00,"npi":[1225649742]},{"billed_charge":203.00,"npi":[1285677658]},{"billed_charge":203.00,"npi":[1295867083]},{"billed_charge":203.00,"npi":[1326066341]},{"billed_charge":203.00,"npi":[1326400326]},{"billed_charge":203.00,"npi":[1366885253]},{"billed_charge":203.00,"npi":[1376562926]},{"billed_charge":203.00,"npi":[1376591602]},{"billed_charge":203.00,"npi":[1487185187]},{"billed_charge":203.00,"npi":[1487693727]},{"billed_charge":203.00,"npi":[1508819848]},{"billed_charge":203.00,"npi":[1578752283]},{"billed_charge":203.00,"npi":[1619910098]},{"billed_charge":203.00,"npi":[1639119134]},{"billed_charge":203.00,"npi":[1700405859]},{"billed_charge":203.00,"npi":[1740441781]},{"billed_charge":203.00,"npi":[1740442268]},{"billed_charge":203.00,"npi":[1790814929]},{"billed_charge":203.00,"npi":[1811969140]},{"billed_charge":203.00,"npi":[1831141860]},{"billed_charge":203.00,"npi":[1942467204]},{"billed_charge":203.00,"npi":[1962436543]}]}]},{"tin":{"type":"ein","value":"561960102"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":116.98,"providers":[{"billed_charge":203.00,"npi":[1144692377]}]}]}]},{"name":"Screening for visual sharpness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Screening for visual sharpness","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.88,"providers":[{"billed_charge":38.59,"npi":[1750586012]},{"billed_charge":38.59,"npi":[1952337909]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":5.88,"providers":[{"billed_charge":20.00,"npi":[1013150622]},{"billed_charge":20.00,"npi":[1114993185]},{"billed_charge":20.00,"npi":[1962436543]},{"billed_charge":20.00,"npi":[1982639183]},{"billed_charge":20.00,"npi":[1992753610]},{"billed_charge":20.00,"npi":[1164518254]},{"billed_charge":20.00,"npi":[1184006967]},{"billed_charge":20.00,"npi":[1205885696]},{"billed_charge":20.00,"npi":[1215220355]},{"billed_charge":20.00,"npi":[1265597967]},{"billed_charge":20.00,"npi":[1306300702]},{"billed_charge":20.00,"npi":[1326066341]},{"billed_charge":20.00,"npi":[1326400326]},{"billed_charge":20.00,"npi":[1366494056]},{"billed_charge":20.00,"npi":[1386685782]},{"billed_charge":20.00,"npi":[1396107637]},{"billed_charge":20.00,"npi":[1447209085]},{"billed_charge":20.00,"npi":[1457513673]},{"billed_charge":20.00,"npi":[1467486027]},{"billed_charge":20.00,"npi":[1487185187]},{"billed_charge":20.00,"npi":[1518292127]},{"billed_charge":20.00,"npi":[1619910098]},{"billed_charge":20.00,"npi":[1619920543]},{"billed_charge":20.00,"npi":[1629003231]},{"billed_charge":20.00,"npi":[1639127194]},{"billed_charge":20.00,"npi":[1669430963]},{"billed_charge":20.00,"npi":[1689964603]},{"billed_charge":20.00,"npi":[1700405859]},{"billed_charge":20.00,"npi":[1740442268]},{"billed_charge":20.00,"npi":[1790814929]},{"billed_charge":20.00,"npi":[1801861596]},{"billed_charge":20.00,"npi":[1831170562]},{"billed_charge":20.00,"npi":[1912931593]},{"billed_charge":20.00,"npi":[1952562993]}]}]}]},{"name":"Screening of eye with special instrument with remote analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Screening of eye with special instrument with remote analysis","allowed_amounts":[{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":11.15,"providers":[{"billed_charge":65.00,"npi":[1013150622]},{"billed_charge":65.00,"npi":[1013982289]},{"billed_charge":65.00,"npi":[1043486566]},{"billed_charge":65.00,"npi":[1053601161]},{"billed_charge":65.00,"npi":[1962436543]},{"billed_charge":65.00,"npi":[1285677658]},{"billed_charge":65.00,"npi":[1295867083]},{"billed_charge":65.00,"npi":[1306300702]},{"billed_charge":65.00,"npi":[1316105406]},{"billed_charge":65.00,"npi":[1326066341]},{"billed_charge":65.00,"npi":[1326400326]},{"billed_charge":65.00,"npi":[1336300391]},{"billed_charge":65.00,"npi":[1376562926]},{"billed_charge":65.00,"npi":[1376591602]},{"billed_charge":65.00,"npi":[1386682789]},{"billed_charge":65.00,"npi":[1396107637]},{"billed_charge":65.00,"npi":[1457309171]},{"billed_charge":65.00,"npi":[1487185187]},{"billed_charge":65.00,"npi":[1487693727]},{"billed_charge":65.00,"npi":[1497175434]},{"billed_charge":65.00,"npi":[1508286220]},{"billed_charge":65.00,"npi":[1548201973]},{"billed_charge":65.00,"npi":[1558583740]},{"billed_charge":65.00,"npi":[1578752283]},{"billed_charge":65.00,"npi":[1619910098]},{"billed_charge":65.00,"npi":[1619920543]},{"billed_charge":65.00,"npi":[1669430963]},{"billed_charge":65.00,"npi":[1689964603]},{"billed_charge":65.00,"npi":[1700405859]},{"billed_charge":65.00,"npi":[1720026115]},{"billed_charge":65.00,"npi":[1740442268]},{"billed_charge":65.00,"npi":[1790913762]},{"billed_charge":65.00,"npi":[1801861596]},{"billed_charge":65.00,"npi":[1942467204]}]}]}]},{"name":"Test for screening hearing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Test for screening hearing","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23.00,"providers":[{"billed_charge":28.00,"npi":[1154346179]},{"billed_charge":28.00,"npi":[1750586012]},{"billed_charge":28.00,"npi":[1952337909]}]}]},{"tin":{"type":"ein","value":"541778786"},"service_code":["11"],"billing_class":"professional","payments":[{"allowed_amount":23.00,"providers":[{"billed_charge":28.00,"npi":[1003833757]},{"billed_charge":28.00,"npi":[1013150622]},{"billed_charge":28.00,"npi":[1043486566]},{"billed_charge":28.00,"npi":[1053601161]},{"billed_charge":28.00,"npi":[1114993185]},{"billed_charge":28.00,"npi":[1144462672]},{"billed_charge":28.00,"npi":[1982639183]},{"billed_charge":28.00,"npi":[1992753610]},{"billed_charge":28.00,"npi":[1164518254]},{"billed_charge":28.00,"npi":[1184006967]},{"billed_charge":28.00,"npi":[1205885696]},{"billed_charge":28.00,"npi":[1215220355]},{"billed_charge":28.00,"npi":[1265597967]},{"billed_charge":28.00,"npi":[1285677658]},{"billed_charge":28.00,"npi":[1295867083]},{"billed_charge":28.00,"npi":[1306300702]},{"billed_charge":28.00,"npi":[1316105406]},{"billed_charge":28.00,"npi":[1326066341]},{"billed_charge":28.00,"npi":[1326400326]},{"billed_charge":28.00,"npi":[1386682789]},{"billed_charge":28.00,"npi":[1386685782]},{"billed_charge":28.00,"npi":[1396107637]},{"billed_charge":28.00,"npi":[1447209085]},{"billed_charge":28.00,"npi":[1457513673]},{"billed_charge":28.00,"npi":[1467486027]},{"billed_charge":28.00,"npi":[1487185187]},{"billed_charge":28.00,"npi":[1487693727]},{"billed_charge":28.00,"npi":[1497175434]},{"billed_charge":28.00,"npi":[1497916357]},{"billed_charge":28.00,"npi":[1518292127]},{"billed_charge":28.00,"npi":[1578752283]},{"billed_charge":28.00,"npi":[1619910098]},{"billed_charge":28.00,"npi":[1619920543]},{"billed_charge":28.00,"npi":[1629003231]},{"billed_charge":28.00,"npi":[1639127194]},{"billed_charge":28.00,"npi":[1669430963]},{"billed_charge":28.00,"npi":[1689964603]},{"billed_charge":28.00,"npi":[1699720953]},{"billed_charge":28.00,"npi":[1700405859]},{"billed_charge":28.00,"npi":[1720026115]},{"billed_charge":28.00,"npi":[1740442268]},{"billed_charge":28.00,"npi":[1790814929]},{"billed_charge":28.00,"npi":[1790913762]},{"billed_charge":28.00,"npi":[1831170562]},{"billed_charge":28.00,"npi":[1912931593]},{"billed_charge":28.00,"npi":[1942467204]},{"billed_charge":28.00,"npi":[1952562993]},{"billed_charge":28.00,"npi":[1952690208]},{"billed_charge":28.00,"npi":[1962436543]}]}]}]},{"name":"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":84.13,"providers":[{"billed_charge":193.49,"npi":[1912919481]}]},{"allowed_amount":168.26,"providers":[{"billed_charge":386.98,"npi":[1912919481]}]}]}]},{"name":"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":75.58,"providers":[{"billed_charge":183.29,"npi":[1912919481]}]},{"allowed_amount":151.16,"providers":[{"billed_charge":366.58,"npi":[1912919481]}]},{"allowed_amount":226.74,"providers":[{"billed_charge":549.87,"npi":[1912919481]}]},{"allowed_amount":302.32,"providers":[{"billed_charge":733.16,"npi":[1912919481]}]},{"allowed_amount":377.90,"providers":[{"billed_charge":916.45,"npi":[1912919481]}]}]}]},{"name":"Therapy procedure using functional activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapy procedure using functional activities","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":111.45,"providers":[{"billed_charge":211.95,"npi":[1912919481]}]},{"allowed_amount":222.90,"providers":[{"billed_charge":423.90,"npi":[1912919481]}]},{"allowed_amount":334.35,"providers":[{"billed_charge":635.85,"npi":[1912919481]}]}]}]},{"name":"Treatment of speech, language, voice, communication, and\/or hearing processing disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92507","description":"Treatment of speech, language, voice, communication, and\/or hearing processing disorder","allowed_amounts":[{"tin":{"type":"ein","value":"540506321"},"service_code":["22"],"billing_class":"professional","payments":[{"allowed_amount":182.57,"providers":[{"billed_charge":325.51,"npi":[1912919481]}]}]}]}]}